Hemangiosarcoma

TL;DR. Kanser agresif saluran darah terutamanya pada anjing: pendarahan dalaman, kelemahan mengejut, kecemasan. Metastasis awal.

Selalunya bermula dengan lesu atau kelemahan sebelum krisis akut.

Apa itu?

Tumor malignan sel endotelium. Membentuk saluran rapuh yang mudah pecah. Limpa paling kerap; juga atrium kanan, subkutaneus, hati. Lebih kerap pada anjing; kucing juga. Metastasis sering sangat awal.

"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)."

Punca dan faktor risiko

Punca bentuk dalaman tidak diketahui; multifaktor, genetik utama. Tiada bukti diet, gaya hidup atau vaksin rutin. Bentuk kulit: UV pada anjing berbulu pendek dan kulit cerah. Umur pertengahan hingga tua.

"Solar damage may be involved in the development of tumors on the ventral glabrous skin in short-coated, lightly pigmented dogs (especially Whippets, Italian Greyhounds, Beagles, Great Danes, and English bulldogs), and on the head and ears"

Tanda yang perlu diperhatikan

Kardinal

• Anemia

Biasa

• Kelemahan atau lesu; pendarahan spontan; hemoabdomen; kolaps akut; trombositopenia

Kadang-kadang

• Tamponade jantung; aritmia ventrikel; distensi abdomen; alopecia atau ulserasi (kulit)

Gusi pucat atau putih menandakan anemia teruk dan pendarahan dalaman.

Corak klasik: kelemahan naik-turun (runtuh, pulih sekejap, pecah semula).

Diagnosis

• CBC/smear: anemia, skistosit, akantosit; sering trombositopenia/DIC
• Ultrasound abdomen: jisim limpa/hati, cecair bebas
• X-ray dada 3 pandangan: metastasis paru
• Ekokardiografi: atrium kanan, efusi perikardium
• Histopatologi (biopsi): piawaian rujukan; FNA sering tidak diagnostik

"Most dogs with HSAs (83%) evaluated at the author's clinic are anemic; more than one half had RBC fragmentation and acanthocytosis. The pretreatment hemostasis profiles are normal in less than 20% of the dogs; most dogs (75%) have thrombocytopenia. Approximately one half of the hemostasis profiles meet three or more criteria for diagnosis of DIC."

Ultrasound memaparkan jisim pada limpa atau hati.

Rawatan

Stabilkan, kawal pendarahan, perlahan penyebaran: pembedahan plus kemoterapi.

Pembedahan

Splenektomi atau eksisi kulit; sahaja jarang menyembuhkan bentuk dalaman.

Kemoterapi

Disyorkan selepas pembedahan.

Sokongan

Cecair IV, transfusi, analgesia, kawalan aritmia.

Drugs: Doxorubicin, Cyclophosphamide, Vincristine.

Prognosis

Tanpa rawatan sering 20-60 hari. Pembedahan + kemo kira-kira 140-202 hari. Bentuk kulit dieksisi awal: lebih baik. Kucing: data terhad.

Pencegahan

Bentuk dalaman tidak boleh dicegah. Kulit: hadkan matahari (10:00-16:00), sunsreen pet-safe, baju UV. Ultrasound saringan pada senior baka berisiko.

Bila hubungi doktor haiwan

Kecemasan: runtuh mengejut; gusi sangat pucat; sesak nafas teruk; kembung abdomen akut; lesu melampau; lebam atau pendarahan hidung/mulut tanpa sebab.

Untuk baka tertentu

Baka berisiko tinggi disenaraikan di bawah.

Abdominal: German Shepherd Dogs, Golden Retrievers, and Labrador Retrievers.

"Abdominal hemangiosarcoma is principally found in older dogs, especially German Shepherd Dogs and Golden Retrievers."

Other: English Cocker Spaniels, English Setters, Afghan Hounds, Siberian Huskies, Irish Setters, and Great Danes. Greyhounds: intramuscular hind limb.

"Greyhounds with intramuscular HSA typically present with a swollen and bruised rear limb; the tumor is frequently in the biceps femoris or quadriceps."

Cutaneous: Whippets, Italian Greyhounds, Beagles, Great Danes, and English Bulldogs.

Sumber

• Small Animal Internal Medicine, 5th Edition, pages 529, 1220.
• Small Animal Dermatology: A Color Atlas and Therapeutic Guide, page 466.

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