Hemangiosarcoma of the Heart

TL;DR. Kanser agresif saluran darah jantung: pendarahan mengejut, tamponade, kecemasan. Prognosis berjaga-jaga.

Biasanya atrium kanan; darah dalam perikardium.

Apa itu?

Tumor malignan sel endotelium. Pada anjing sering atrium/aurikel kanan. Ruptur mengisi perikardium dan boleh 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."

Punca dan faktor risiko

Punca tidak diketahui; predisposisi genetik. Anjing pertengahan hingga tua. Jika ada jisim 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 diperhatikan

Biasa

• Runtuh; sinkop; kelemahan; gusi pucat; aritmia; bunyi jantung redup; kegagalan kanan; kelainan darah

Kadang-kadang

• Asites; akantosit; bunyi desiran

Kelemahan mengejut dan gusi pucat memberi amaran pendarahan 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 cecair 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, X-ray, US abdomen; histopatologi

Ekokardiografi memaparkan jisim dan cecair.

Rawatan

Penstabilan kecemasan

Perikardiosentesis melegakan tamponade.

Pembedahan

Reseksi aurikel dan/atau perikardiektomi separa (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..."

Sokongan

glucocorticoids paliatif mungkin.

Prognosis

Tanpa rawatan: sering hari-minggu. Pembedahan + VAC: median ~189-195 hari. Kucing: data terhad.

Pencegahan

Tiada pencegahan diketahui. Echo saringan baka berisiko usia pertengahan.

Bila hubungi doktor haiwan

Kecemasan:

• Runtuh mengejut; kelemahan ekstrem; gusi pucat/biru; sesak nafas teruk; sinkop; kembung abdomen akut

Untuk baka tertentu

Baka 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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