Hemangiosarcoma of the Heart

TL;DR. Kanker agresif pembuluh jantung: perdarahan mendadak, tamponade, darurat. Prognosis hati-hati.

Sering atrium kanan; darah di perikardium.

Apa itu?

Tumor ganas sel endotel. Pada anjing sering atrium/aurikel kanan. Ruptur mengisi perikardium dan dapat menyebabkan tamponade.

"The age distribution of cats with cardiac tumors is different from that of dogs; about 28% are 7 years old or younger. It is unknown whether reproductive status affects relative risk for cardiac tumors in cats."

Penyebab dan faktor risiko

Penyebab tidak diketahui; predisposisi genetik. Anjing paruh baya hingga tua. Jika ada massa jantung, nilai limpa dan hati.

"Approximately 50% of the tumors originate in the spleen, 25% in the right atrium, 13% in subcutaneous tissue, 5% in the liver, 5% in the liver-spleen-right atrium, and 1% to 2% simultaneously in other organs (i. e. , kidney, urinary bladder, bone, tongue, prostate)."

Tanda yang perlu diwaspadai

Umum

• Kolaps; sinkop; kelemahan; gusi pucat; aritmia; bunyi jantung redup; gagal kanan; kelainan darah

Sesekali

• Asites; akantosit; bising

Kelemahan mendadak dan gusi pucat memperingatkan perdarahan tumor jantung.

Diagnosis

• Pemeriksaan: bunyi redup, nadi lemah, gusi pucat
• Ekokardiografi: alat utama

"Echography reveals an intrapericardial cystic mass compressing the cardiac cavities. However, this echographic aspect can be similar to that of a cardiac hemangiosarcoma..."

• Sitologi cairan perikardium: sering tidak definitif

"An additional problem with effusions is that they frequently contain reactive mesothelial cells that may resemble neoplastic cells, leading to a false-positive diagnosis of HSA. In general, a presumptive clinical or cytologic diagnosis of HSA should be confirmed histopathologically, if feasible."

• CBC, troponin I, rontgen, USG abdomen; histopatologi

Ekokardiografi memvisualisasikan massa dan cairan.

Pengobatan

Stabilisasi darurat

Perikardiosentesis meredakan tamponade.

Bedah

Reseksi aurikel dan/atau perikardiektomi parsial (paliatif).

Kemoterapi (VAC)

Vincristine, Doxorubicin, Cyclophosphamide

"Sixty-seven dogs with HSA in different anatomic locations were evaluated retrospectively. All dogs received the VAC protocol, as adjuvant to surgery ( n = 50), neoadjuvant ( n = 3), or as the sole treatment modality ( n = 14). There was no signi ficant difference between the MST [median survival time] of dogs with stage III ( n = 25; 195 days) and stage I/II ( n = 42; 189 days) HSA..."

Suportif

glucocorticoids paliatif mungkin.

Prognosis

Tanpa pengobatan: sering hari-minggu. Bedah + VAC: median ~189-195 hari. Kucing: data terbatas.

Pencegahan

Tidak ada pencegahan diketahui. Echo skrining ras berisiko usia paruh baya.

Kapan menghubungi dokter hewan

Darurat:

• Kolaps mendadak; kelemahan ekstrem; gusi pucat/kebiruan; sesak napas berat; sinkop; distensi abdomen akut

Untuk ras tertentu

Ras berisiko:

• German Shepherd Dog
• Golden Retriever
• Labrador Retriever
• American Cocker Spaniel
• English Setter
• Miniature Poodle
• Afghan Hound

Sumber

• Veterinary Internal Medicine, 5th Edition, pages 203, 1220-1222.
• Clinical Echocardiography of the Dog and Cat, page 261.

My highlights & notes

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