Michael Clark By: Macie Ruble Photographer: Michael Clark Project: Photographer Research Project.
Macie
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Transcript of Macie
MACIE
11 yo Golden RetrieverAccession: 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 Smoothly irregular boney proliferation along
medial wall of pelvis no hip pain L hip easily subluxates and reduces readily with
manipulation
Macie’s Radiographs
7/18
4/1
8/119/29
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
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
Chondrosarcoma Neoplastic chondrocytes 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%
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
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?
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
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 fungalosteomyelitis; or a bone cyst. “
References Waltman SS, et al. Clinical Outcome of Nonnasal
Chondrosarcoma 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.