December 13, 2002
Source/history:
Hemoabdomen, ruptured splenic mass
Microscopic description:
The spleen and a wedge of liver were submitted for examination. The splenic mass is composed of regions of hypercellularity mixed with zones of acute hemorrage and necrosis. The hypercellular areas are characterized by occult to collapsed vascular channels lined/formed by a neoplastic endothelium. These are plump cells with hypertrophied nuclei and amphophilic cytoplasm. Mitotic figures are noted but low in numbers.
The liver shows sinusoidal and portal aggeragates of macrophages filled with hemosiderin pigment.
Diagnosis:
Splenic Hemangiosarcoma
Comments:
Hemangiosarcoma in the canine spleen has an extremely poor prognosis. In a large series of dogs with splenic hemangiosarcoma (JUIM 1997; 11:166-171). The mean survival following splenectomy was only two months; however, a subpopulation of dogs with only a single lesion visble (such as this case) demonstrated better survival characteristics. Dogs with more than one splenic lesion experienced 100% mortality within eight months postoperatively, while those with single lesions experienced 84% mortality in the first twelve months postoperatively.
Having a single nodule of hemangiosarcoma certainly does not guarantee long-term survivial; however the odds for long term survival of this dog are significantly improved based on the timeliness of the splenectomy in this case.
Although the benefit of chemotherapy remains questionable for this disease, there are papers that propose increasted postoperative survival intervals following complete excision of the neoplasm (splenectomy) along with chemotherapy. (JVIM 1996: 10: 379-384).
Anticipated complications in this case include metastisis to the liver, continued abdominal bleeding, seeding of tumor cells to adjacent visceral or mesenteric surfaces, cogaulation anomalies and abnormal erythrocyte morphology.
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Copyright © 2002-2003, Diane Blackman Created: December 20, 2002 Updated November 12, 2007
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