Lecture 22 4/7/25 Flashcards
What are the general characteristics of splenic masses?
-common finding in older dogs
-can present asymptomatically
-may have signs of hemorrhagic shock
-can have an acute or chronic presentation
What are the characteristics of benign splenic masses?
-include hematomas and extramedullary hematopoiesis
-can still rupture even if non-cancerous
-larger masses are less likely to be hemangiosarcoma and less likely to be benign
What is the chance that a non-bleeding splenic mass is cancerous?
30 to 50%
What is the rule of 2/3 regarding splenic masses?
-old: for non-traumatic bleeding splenic masses, 2/3 are cancerous and 2/3 are hemangiosarcoma
-new: 60% of all non-traumatic bleeding splenic masses are hemangiosarcoma
-odds are much lower to be neoplastic if hemoabdomen is traumatic
What are the characteristics of splenic mass treatment?
-stabilize and screen for metastasis prior to anesthesia
-surgery is treatment of choice for bleeding splenic masses regardless of type, unless metastasis is present
-majority of dogs survive surgery and the post-op period
-should monitor animals for arrhythmias and thromboembolic dz
-careful trimming of spleen required for proper dx; submitting whole spleen is preferred
What are the characteristics of sampling splenic masses prior to surgery?
-not commonly samples before surgery if bleeding since they need to be removed anyway
-non-bleeding masses that are incidentally discovered may be sampled; histopath. will not always match FNA
-tru-cut biopsies are NOT more accurate than FNA and carry a risk of bleeding
What are the characteristics of hemangiosarcoma (HSA)?
-tumor of endothelial cells
-can occur anywhere in body; most commonly seen in spleen, liver, and right auricle
-older, large breed dogs predisposed
-GSDs and golden retrievers especially predisposed
-slight male predilection
-no known cause of visceral form
What are the characteristics of splenic HSA behavior?
-extremely aggressive biologic behavior
-90 to 95% have metastasized at diagnosis, even if not seen on rads/ultrasound
-main sites of metastasis are liver, omentum, lungs, and right atrium/auricle
-most common tumor that metastasizes to CNS
What are the findings on diagnostics in HSA patients?
-non-regenerative anemia on CBC if bleeding
-schistocytes on blood smear
-thrombocytopenia and/or signs of DIC on coag. testing
-possibly no albumin; otherwise chemistry unremarkable
-metastasis may be seen on chest rads, abdominal ultrasound, and/or echocardiogram
What are the characteristics of HSA treatment?
-surgery to stop bleeding and obtain diagnosis is preferred treatment
-doxorubicin clearly shown to prolong survival after surgery
-carboplatin also has activity
-unclear if metronomic chemo has an affect
What are the characteristics of yunnan naiyao?
-alternative treatment for HSA that may cause apoptosis in tumor cells
-thought to strengthen clots
-one study shows improved survival when combined with doxorubicin
What are the characteristics of turkey tail mushrooms?
-supplement that may extend survival when combined with surgery
-newer data suggests no benefit or possible decreased survival
What is the prognosis for HSA?
-surgery alone has MST of 2 weeks to 3 months
-surgery + doxorubicin has MST of 4 to 6 months if no mets
-non-ruptured, non-metastatic HSA has MST of 9 months with surgery and chemo
What are the characteristics of immunotherapy for HSA treatment?
-autologous vx for metastatic splenic hemangiosarcoma has been studied in combo with splenectomy
-dogs lived comparable to times to others that underwent splenectomy + chemo
-lots of limitations to study; requires further investigation
What is the outcome when animals have recurrent bleeding after splenectomy and doxorubicin for HSA?
recurrent bleeding occurred after about 4 months; required euthanasia as treatment
What are the characteristics of right auricular/atrial HSA?
-most common heart tumor
-often present with collapse, lethargy, and GI signs
-can cause sudden death
-may cause pericardial effusion, arrhythmias, and/or metastasis
What are the treatment options for right auricular/atrial HSA?
one or multiple of the following:
-pericardiocentesis if tamponade is present
-mass resection
-doxorubicin
-radiation
What are the characteristics of cutaneous HSA?
-present as red, possibly ulcerated masses in hairless/lightly haired areas
-commonly seen on ventral abdomen and prepuce
-often UV light induced; more aggressive if NOT induced by UV
-lower metastasis rate than other HSA types; rarely metastasizes if tumor is only in dermis
-prognosis with surgery is good but recurrence is common
What are the characteristics of subcutaneous/intramuscular HSA?
-very aggressive behavior
-aggressive surgery and chemo recommended
-radiation can be done if surgery is not possible
-metastatic rate of 50 to 80%; goes to same sites as visceral form
-moderate MST; does better with aggressive treatment
What are the characteristics of feline visceral HSA?
-much rarer than in dogs
-acts and presents similarly to dz in dogs
-splenic mass and hemoabdomen in cats is likely HSA
-most common location is liver
-chemo not proven to help
-MST is poor
What are the characteristics of feline cutaneous HSA?
-much rarer than in dogs
-acts similarly to dz in dogs
-often UV induced
-surgery is treatment of choice
-more aggressive if subcutaneous
-can do chemo, not proven to help
-can occur on ventral abdomen; more aggressive in this location
