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[Hemangiosarcoma of the heart].

The clinical appearance, typical localization, diagnostic procedure and the treatment of hemangiosarcoma--the most frequent malignant tumor of the heart are reported by the case of a 27 years old woman. The patient suffered from dyspnea, congestion of the superior caval vein and paroxysmal tachycardia. X-ray showed cardiac enlargement due to pericardial effusion. Echocardiography revealed a large tumor in the right atrium. Computertomography and angiocardiography showed tumor masses at the orifice of the superior caval vein and a bypass of the blood flow via the azygos vein. Thoracotomy yielded an inoperable hemangiosarcoma. By the combined treatment of irradiation and chemotherapy the cardiac tumor completely disappeared, the patient was temporary symptomless. Later metastases occurred and the patient died 13 months after diagnosis.

Adult↗

Hemangiosarcoma of the adrenal glands: CT findings in two cases.

Hemangiosarcomas of the adrenal gland, both benign and malignant, are exceedingly rare; only a dozen of them have been reported in literature to our knowledge. We describe herein the findings at CT of 2 primary hemangiosarcomas of the adrenal glands. We also discuss their etiology, incidence, and differential diagnosis, particularly in relation to more frequent primary adrenal lesions, such as adrenal adenomas and carcinomas. CT will generally show a heterogeneous mass with frequent necrosis, contrast-enhancement, and occasional calcifications. A prospective diagnosis cannot be made by imaging alone, and pathology represents the discriminating method for a correct diagnosis.

Adrenal Gland Neoplasms↗

Splenic hemangiosarcoma with massive calcification.

We present a case of large splenic hemangiosarcoma in a 40-year-old man associated with consumptive coagulopathy. Computed tomography showed radial calcification within the splenic tumor. On magnetic resonance imaging, T2 shortening represented a meshwork of calcification and surrounding fibrosis. The possibility of hemangiosarcoma should be considered when a large splenic tumor with massive calcification is noted.

Adult↗

Hepatic hemangiosarcoma: imaging findings and differential diagnosis.

Primary hepatic angiosarcoma is a rare mesenchymal tumor of the liver that usually presents with nonspecific symptoms in elderly men. We present four cases of hepatic hemangiosarcoma and discuss the imaging characteristics of this entity. Our series shows that this tumor is not uncommon in younger patients with no associated risk factors such as previous exposure to thorotrast or vinyl chloride. Our experiences on a limited number of patients suggests that the combined use of angiography and dual-phase helical CT provides a better identification of the tumor and its complications. Analysis of imaging studies in patients with hepatic hemangiosarcoma reveals hypervascular lesions. Common complications were portal vein thrombosis, Budd-Chiari syndrome, as well as arterio-venous or arterio-portal shunts. Due to the vascularity of the tumor, percutaneous liver biopsy is hazardous.

Adult↗

Mode of action of butoxyethanol-induced mouse liver hemangiosarcomas and hepatocellular carcinomas.

Chronic exposure to 2-butoxyethanol resulted in an increase in liver hemangiosarcomas and hepatic carcinomas in male mouse liver. No increase in liver neoplasia was observed in similarly exposed male and female rats or female mice. We have proposed that the production of liver neoplasia in the male mouse is the result of oxidative damage secondary to the hemolytic deposition of iron in the liver. Our working hypothesis is that the mode of action of butoxyethanol-induced mouse liver hemangiosarcomas and hepatic neoplasia involves the metabolism of 2-butoxyethanol to butoxyacetic acid which results in the induction of RBC hemolysis. This hemolytic response is translated into the accumulation of iron in both liver hepatocytes and Kupffer cells. The Kupffer cell response to this insult is two-fold: (1) the production of oxidative species-through both Kupffer cell activation and through the Fenton reaction involving iron and (2) the production of cytokines (for example TNF alpha). The induction of reactive oxygen species can, if not scavenged, produce oxidative DNA damage (the formation of OH8dG), as well as increase cell growth through modulation of gene expression. While the reactive oxygen species generation would occur in the both rats and mice, the ability of the rat to detoxify the reactive oxygen species would preclude the remaining steps from occurring. In contrast, in the mouse, the reactive oxygen species would override antioxidant defense mechanisms and allow the proposed mode of action to move forward. Our results to date in male B6C3F1 mice and male F344 rats treated with 2-butoxyethanol (via daily gavage; five times per week) at doses of 0, 225, 450, and 900 mg/kg/day (mice) and 0, 225, 450 mg/kg/day (rats), respectively, showed: an increase in hemolysis in 2-butoxyethanol treated rats and mice in a dose-dependent manner, in addition, an increase in the percent of iron stained Kupffer cells in the liver was observed following treatment with 450 and 900 mg/kg of 2-butoxyethanol in mice and 225 and 450 mg/kg of 2-butoxyethanol in rat. With the iron deposition, a biphasic increase in oxidative damage (OH8dG and malondialdehyde) was seen in mouse liver after treatment with 2-butoxyethanol. In contrast, no increase in oxidative damage was observed in the rat liver at any of the doses examined. Concomitant with the increase in oxidative damage, Vitamin E levels were similarly reduced by 2-butoxyethanol in both mice and rat liver. However, the basal level of Vitamin E in rat liver was 2.5-fold greater than in mouse liver. A biphasic induction of DNA synthesis was seen following 2-butoxyethanol in the mouse. In mouse liver, increased DNA synthesis was observed in hepatocytes at 90 days and in endothelial cells at 7 and 14 days at all doses. No change in DNA synthesis was seen in 2-butoxyethanol treated rat liver. No apparent differences in apoptosis and mitosis in the liver were observed in mouse and rat liver between 2-butoxyethanol treatment groups and untreated controls. These results suggest that the induction of DNA synthesis, possibly from oxidative stress and/or Kupffer cell activation, occurs selectively in the mouse liver, in endothelial cells and in hepatocytes following exposure to 2-butoxyethanol, and support the hypothesis proposed above.

Administration, Oral↗

Hemangiosarcoma of the third eyelid in a cat.

A case of hemangiosarcoma of the third eyelid in a 15-year-old Domestic Short-haired cat is reported. A small red mass protruding from the anterior surface of the third eyelid in the left eye was present. Only mild bilateral conjunctivitis and nuclear sclerosis were revealed on initial ophthalmic examination. After anti-inflammatory treatment, surgery and cryotherapy were performed. On histopathologic examination the mass was located just beneath the conjunctival epithelium, suggesting that the conjunctiva was the tissue of origin. The tumor showed high cellularity and was composed of pleomorphic spindle and polygonal cells arranged in interlacing bundles and solid sheets. The presence of slit-like spaces between tumor cells containing erythrocytes demonstrated the vascular differentiation. Mitotic activity was moderate, but atypical mitoses were detected. The surgical area healed uneventfully and after 7 months there was no recurrence. To the authors' knowledge, this is the first report of conjunctival hemangiosarcoma of the third eyelid in a cat.

Animals↗

Hemangiosarcoma of the rectum after chronic anorectal ulceration.

A 37-year-old man with a 30-year history of recurrent anorectal ulceration developed a hemangiosarcoma of the rectum. This diagnosis was made based on histology and immunocytochemistry. We believe this is the fifth reported case of hemangiosarcoma of the rectum and is another example of a rare granulation tissue sarcoma.

Adult↗

Splenic hemangiosarcoma with sinus endothelial differentiation.

A case of primary splenic hemangiosarcoma where the tumors entirely replaced the spleen is reported. Histologically, the splenic tumors consisted of two major components: (i) solid and nodular areas, in which spindle cells (SC) were arranged in interlacing fascicles; and (ii) vasoformative areas, in which vascular lining cells (VC) closely resembled normal splenic sinus endothelial cells (SSEC) in shape. Both SC and VC were immunoreactive with the markers of vascular endothelial cells (EC) including SSEC, JC70, von Willebrand factor, OKM5, vimentin MAb and Ulex europaeus-1 lectin. The tumor cells were positive for OKM5 MAb as well as normal SSEC and sheathed arterial EC, but other vascular EC in normal spleen were negative. Enzyme-histochemically, the tumor cells and normal SSEC revealed naphthol AS-D acetate esterase activity but no reaction for ALPase, whereas normal vascular EC other than SSEC in the spleen were positive for the latter but negative for the former. These studies revealed that the tumor cells expressed the same phenotype as normal SSEC. To the present author's knowledge this is the first report demonstrating sinus endothelial differentiation of splenic hemangiosarcoma, enzyme- and immuno-histochemically.

Aged↗

Hemangiosarcoma of the third eyelid in a dog.

Abstract A case of hemangiosarcoma of the third eyelid in a 7-year-old Caucasian Sheepdog is reported. A voluminous red mass protruding from the free edge of the third eyelid in the right eye was present. The mass and the free edge of the third eyelid were surgically excised. On histopathologic examination the tumor was seen to infiltrate the propria of the third eyelid and was composed of neoplastic mesenchymal cells forming irregular channels containing blood. These plump cells showed moderate anisocytosis and anisokaryosis with a low mitotic index. The surgical wound healed successfully and after 9 months there had been no recurrence. To the authors' knowledge, this is the first hemangiosarcoma of the third eyelid reported in the dog.

Animals↗

Feline conjunctival hemangioma and hemangiosarcoma: a retrospective evaluation of eight cases (1993-2004).

The purpose of this retrospective study was to evaluate feline primary conjunctival vascular tumors of endothelial origin. Eight cases (six hemangiomas, two hemangiosarcomas) from a collection of 3460 feline submissions between 1993 and 2004 were evaluated using routine hematoxylin and eosin (H&E). Signalment, location, size, duration, epithelial pigmentation, margins, adjuvant therapy, outdoor activity, and geographic location, comparing ultraviolet (UV) radiation levels by state, were recorded. Follow-up information was available for five cases. In this study, the average age was 10.6 years, with neutered males over-represented. The Domestic Short-haired cat was most commonly affected. The most common anatomic site was the nictitating membrane, with the left eye preferentially affected. The average size and duration, prior to presentation, was 7.5 mm and 4.4 months, respectively. Seven of eight cases were devoid of epithelial pigmentation in nonaffected areas and the majority of cases were from states with high annual UV-light exposure. Only cases of hemangiosarcoma underwent surgical re-excisions following incomplete excision; however, no further recurrences were reported. No cases evaluated had evidence of metastatic disease at the time of excision. Surgical excision alone may be curative. However, recurrence is possible. These tumors demonstrate similar predilection sites and involvement of nonpigmented epithelium, as is true in canine cases, which may relate to risk factors as well.

Animals↗

Hemostatic abnormalities in dogs with hemangiosarcoma.

The hemostasis profiles of 24 dogs with histologically confirmed hemangiosarcoma were prospectively evaluated. Microangiopathic hemolysis was defined as the presence of schistocytes; disseminated intravascular coagulation was defined as 1) thrombocytopenia, 2) fibrin(ogen) degradation products greater than 10 micrograms/mL, 3) prolongation of one or more coagulation times (activated partial thromboplastin time or one-stage prothrombin time) by greater than 25% of the control, 4) fragmented red blood cells (greater than or equal to 1+ based on a semiquantitative grading scale), and 5) fibrinogen less than or equal to 80 mg/dL. Three of the five criteria listed above had to be met for disseminated intravascular coagulation to be diagnosed. Fifty percent of the dogs were considered to have disseminated intravascular coagulation at presentation. Thrombocytopenia was present in 75% of the dogs and was the most common abnormality. The mean platelet count was 137,800/microL. Twenty-five percent of the dogs died as a result of the hemostatic abnormalities. Only 12% of the dogs had microangiopathic hemolysis without other evidence of disseminated intravascular coagulation. Hemostatic abnormalities are present in many dogs with hemangiosarcoma at the initial clinical presentation and represent an important clinical finding.

Animals↗

Splenic hemangiosarcoma. A case report.

Splenic hemangiosarcoma is a rare and aggressive tumor. Up to now, less than 150 cases have been reported. We describe a patient with a rapide course. The diagnosis of hemangiosarcoma was based on immunohistochemical tests (factor-VIII-associated antigen, CD31, CD34). Despite the improvement of diagnostic techniques, pathological examination and immunohistochemistry remain the only methods available for the diagnosis.

Antigens, CD34↗

Hemangiosarcoma of the left foot and tibia: case report.

A case of a hemangiosarcoma involving the bones of the foot in a diabetic patient who had swelling of the left foot is reported. Radiographs demonstrated multiple lytic areas throughout the bones of the foot. Clinically and radiographically, infection was suspected, but the biopsy revealed the presence of tumor. Metastases to the tibia were found and an above the knee amputation was performed. Chemotherapy was given, but 6 months later the patient died. Hemangiosarcoma is known to involve the different bones of the foot in a "multicentric" fashion and should be considered in the differential diagnosis of lytic lesions of multiple bones of the lower extremities.

Bone Neoplasms↗

Canine splenic hemangiosarcoma with abdominal dissemination.

Disseminated hemangiosarcoma was encountered in a 12-year-old female Maltese dog. Tumor tissues were dispersed on the serosal surface of the liver, kidney, digestive tract, omentum and diaphragm. Metastatic lesions were not observed in the parenchyma of the lung and heart. The spleen was enlarged with rupture at the anterior region of the hilus. The disseminated protruding tumor masses could be easily peeled off from the organ surfaces. The tumor cells were round or spindle in shape, with hyperchromatic nuclei containing prominent nucleoli. Various-sized vascular spaces containing erythrocytes and serum could be identified in this tumor. This case was diagnosed as hemangiosarcoma originating from the spleen with abdominal dissemination.

Abdominal Neoplasms↗

Mutations of phosphatase and tensin homolog deleted from chromosome 10 in canine hemangiosarcoma.

We examined the presence of phosphatase and tensin homolog deleted from chromosome 10 (PTEN) abnormalities that could contribute to the origin or progression of naturally occurring canine endothelial tumors (hemangiosarcoma). Our results document somatic point mutations or deletions encompassing the PTEN C-terminal domain in canine hemangiosarcoma that might provide cells a survival advantage within their microenvironment. This represents the first characterization of a naturally occurring, highly metastatic tumor with biologically significant mutations of PTEN in the C-terminal domain.

Amino Acid Sequence↗

Primary cerebral hemangiosarcoma in a 6-week-old dog.

A primary cerebral hemangiosarcoma was identified in a 6-week-old, female, cross-breed dog. Grossly, the tumor mass was poorly demarcated from the adjacent neuropil, hemorrhagic, and caused effacement of the right dorsolateral cerebral hemisphere. Microscopically, the tumor was composed of an infiltrative mass of small vascular channels lined by neoplastic endothelial cells that stained variably with factor VIII-related antigen and negatively with glial fibrillary acidic protein. This is the first description of a primary intracranial hemangiosarcoma in an immature dog.

Animals↗

A case of hemangiosarcoma in thyroid with severe anemia due to bone marrow metastasis.

A 56-year-old woman presented with rapidly enlarging thyroid mass and deep anemia. There was no history of gastrointestinal bleeding, and endoscopic examinations of the gastrointestinal system were normal. Fine needle aspiration cytology from the thyroid nodule was suspicious. After blood transfusion, total thyroidectomy was performed. Postoperative histopathological examination of the specimen revealed hemangiosarcoma of the thyroid. After establishment of the diagnosis chemotherapy was started. But hemoglobin values decreased again and hepatosplenomegaly developed at the second month of surgery. Bone marrow aspiration cytology which was performed demonstrated the same tumoral cells infiltrating bone marrow. The patient died at 12th week after surgery. Thyroid hemangiosarcoma can metastasize to the bone marrow and anemia may be an indicator of the advanced disease. In the differential diagnosis of the anemia, bone marrow metastasis and bone marrow biopsy should be considered in suspected cases.

Anemia↗

Interleukin-12 inhibits tumor growth in a novel angiogenesis canine hemangiosarcoma xenograft model.

We established a canine hemangiosarcoma cell line derived from malignant endothelial cells comprising a spontaneous tumor in a dog to provide a renewable source of endothelial cells for studies of angiogenesis in malignancy. Pieces of the hemangiosarcoma biopsy were engrafted subcutaneously in a bg/nu/XID mouse allowing the tumor cells to expand in vivo. A cell line, SB-HSA, was derived from the xenograft. SB-HSA cells expressed vascular endothelial growth factor (VEGF) receptors 1 and 2, CD31, CD146, and alpha(v)beta(3) integrin, and produced several growth factors and cytokines, including VEGF, basic fibroblast growth factor, and interleukin (IL)-8 that are stimulatory to endothelial cell growth. These results indicated that the cells recapitulated features of mitotically activated endothelia. In vivo, SB-HSA cells stimulated robust angiogenic responses in mice and formed tumor masses composed of aberrant vascular channels in immunocompromised mice providing novel opportunities for investigating the effectiveness of antiangiogenic agents. Using this model, we determined that IL-12, a cytokine with both immunostimulatory and antiangiogenic effects, suppressed angiogenesis induced by, and tumor growth of, SB-HSA cells. The endothelial cell model we have described offers unique opportunities to pursue further investigations with IL-12, as well as other antiangiogenic approaches in cancer therapy.

Animals↗