Читать книгу Veterinary Surgical Oncology - Группа авторов - Страница 159

Lymphangiosarcoma is a highly malignant neoplasm of the lymphatic endothelium. Lymphangiosarcomas are rare in dogs and cats. Lymphangiosarcoma in the majority of human and canine patients is an aggressively malignant tumor, with few patients surviving despite various attempted surgical and adjunctive treatments. The tumor has been reported mostly in medium‐ to large‐breed dogs, slightly more frequently in males than females, with an age range of 8 weeks to 13 years, with the majority of being in the age group of 5 years and older. The tumor commonly arises in the subcutaneous tissues, rapidly invades underlying tissues, and can spread via the hematogenous and lymphatic routes to frequently involve the pleura and chest. Lymphoid oozing of the skin is sometimes observed (Galeotti et al. 2004; Jackson et al. 2011; Mineshige et al. 2015; Thongtharb et al. 2015; Williams 2005).

Early tissue biopsies for histology and immunochemistry are recommended for progressive edematous lesions of unknown origin as cytology consisted of mild inflammation in dogs diagnosed with lymphangiosarcoma (Curran et al. 2016).

The cell‐specific immunohistochemical lymphatic vessel endothelial receptor‐1 (LYVE‐1) has been successfully used as a marker to diagnose lymphangiosarcoma in cats (Galeotti et al. 2004). LYVE‐1 in conjunction with Prospero‐related homeobox gene‐1 (PROX‐1) is recommended by Halsey et al. (2016) to differentiate between lymphangiosarcoma and HSA in dogs.

The prognosis is poor, with reported survival times being only a few months (Lenard et al. 2007; Williams 2005) up to over one year. In case series of 12 dogs, survival ranged from 60 to 876 days for 3 dogs with palliation; 90 days with prednisone in 1; 182 days with chemotherapy in 1; 240–941 days for 5 dogs receiving surgery; and 574 days for 1 receiving surgery, radiation, and chemotherapy. One dog is alive with recurrence at 243 days following surgery and carboplatin chemotherapy (Curran et al. 2016).

A five‐year‐old Giant schnauzer, suffering from chylothorax and a lymphangiosarcoma involving the whole left sublumbar area was treated surgically by mass resection, pleural omentalization, and pericardiectomy followed by mitoxantrone administration. The dog was still alive 10 months after surgery (Sicotte et al. 2012).

Doxorubicin treatment resulted in a six‐month recurrence‐free interval in a five‐year‐old female Boxer after incomplete local resection in the area of the caudal mammary gland. At relapse Toceranib resulted in almost complete regression of a lymphangiosarcoma, leaving just a skin plaque. Metronomic chemotherapy using chlorambucil and meloxicam had failed to adequately control the disease in this dog (Marcinowska et al. 2013).