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Macie

Macie. 11 yo Golden Retriever Accession: 102165. Macie. Previous hx : bilateral CCL rupture repair, surgically excised MCT, no further tx July 2008-presented to RDVM for increased stiffness and difficulty rising August Orthopedic Sx appt- Difficulty rising

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Macie

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  1. Macie 11 yo Golden Retriever Accession: 102165

  2. Macie • Previous hx: bilateral CCL rupture repair, surgically excised MCT, no further tx • July 2008-presented to RDVM for increased stiffness and difficulty rising • August Orthopedic Sx appt- • Difficulty rising • Smoothly irregular boney proliferation along medial wall of pelvis • no hip pain • L hip easily subluxates and reduces readily with manipulation

  3. Macie’s Radiographs 4/1 9/29 7/18 8/11

  4. 8/12-CT findings • Extensive, mildly irregular periosteal reaction and hyperostosis • Non-displaced acetabular fracture • Widening of the joint space by fluid attenuating material • Expansion of joint capsule with contrast enhancing rim • The lack of a soft tissue component made neoplasia unlikely • Acetabular fx with pelvic hyperostosis; chronic infection cannot be ruled out

  5. Macie • Managed medically for 5 wks, became slightly worse according to owner • CT and radiographs repeated on 9/29 • Acetabular fracture line mildly less apparent • Hyperostosis similar if not mildly smoother • No osseous destruction noted • FHO and acetabular and joint capsule biopsies • HXPX: • Joint capsule: diffuse, moderate fibrosis • Acetabulum: CHONDROSARCOMA with invasion into the bone marrow

  6. Chondrosarcoma • Neoplasticchondrocytes that produce chondroid matrix • Second most common primary bone tumor, <10% of primary bone tumors in dogs • Primarily large breed dogs • Locations: • 30% of chondrosarcomas are nasal • In 31 non-nasal chondrosarcomas (Waltman, et al, 2007): • Ribs (12) • Long bones (13) • Maxilla/Mandible (5) • Scapula (1) • Metastatic rate historically related to site: • Rib& long bone-57% • Facial bone-40%

  7. Non-nasal Chondrosarcoma • Clinical Outcomes (Waltman, et al, 2007) • Treated with wide surgical excision • Metastatic sites: lung, liver, kidney, lymph nodes, adrenal gland, bone • Metastatic rate NOT statistically altered by treatment: 15 (treated)-28(untreated)% • Survival better with rib and limb chondrosarcoma, possibly b/c determined resectability • Survival times • Mean (treated)=3097 d; Median (treated)=not reached • Mean (untreated)=523 d; Mediatn (untreated)=495 d • Histologic grade was prognostic

  8. Coccygeal Vertebral Chondrosarcoma • 6 yo St. Bernard • Tail-base mass over 3 months duration • Cortical destruction, mottled mineralized densities, ill-defined margins, and continuous but relatively slow growth • HxPx: Chondrosarcoma • Chondrosarcomas are predominantly osteolytic?

  9. What Is Your Diagnosis? • 10 yo Labrador • Unwilling to climb stairs 4 wks • Neck pain, resistant to dorsoflexion • Radiographs: Focal lucency in the dorsal lamina of C2 • MRI: Extradural mass at the level of C2 • Surgery: Thinning of lamina of C2, with extradural mass ventral and to right of dog • HxPx: Chondrosarcoma • Recurrence of C/S: within 2 months with subsequent euthanasia

  10. What Is Your Diagnosis? • 7 yo Boxer • 4 wk history lameness • Non-specific stifle lameness • Multi-loculated lytic bone lesion of distal femoral metaphysis • Medial soft tissue mineralization • “Differential diagnoses include a primarybone tumor, such as osteosarcoma, chondrosarcoma, fibrosarcoma, hemangiosarcoma, liposarcoma, giant cell tumor, • or plasma cell tumor; multiple myeloma; bacterial or fungal • osteomyelitis; or a bone cyst. “

  11. References • Waltman SS, et al. Clinical Outcome of NonnasalChondrosarcoma in Dogs: 31 Cases (1986-2003). Veterinary Surgery, Vol 36, 2007. pp 266-271. • Hamersalg KL, et al. Coccygeal Vertebral Chondrosarcoma in a Saint Bernard: A Case Report. Vet Rad & US, Vol. 21, No.5, 1980: pp 194-196. • Mazur WJ, et al. What Is Your Diagnosis? JAVMA, Vol 226, No. 8, 2008; pp 1301-1302. • Haper TA, et. Al. What Is Your Diagnosis? JAVMA, Vol 232, No. 5, 2008; pp 681-682.

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