Presentation
Presents with limb swelling and lameness.
Patient Data
There is significant osteolysis throughout the distal radius with cortical bone destruction along the cranial and caudal aspects of the distal radial diaphysis. The cortices are malaligned indicating pathologic fracture. There is irregular periosteal proliferation and tumor new bone on the cranial aspect of the distal radial diaphysis that extends into the soft tissues. There is a long zone of transition. There is a complete transverse fracture of the distal diaphysis of the ulna with caudal displacement of both proximal and distal fragments. There is soft tissue swelling that is concentrated on the cranial aspect of the distal radius.
Impression:
Primary bone tumor (osteosarcoma) with pathologic fracture of the radius and ulna.
There is a large cranial soft tissue mediastinal mass causing dorsal deviation of the trachea and widening of the mediastinum. The cardiovascular structures are within normal limits. The pulmonary parenchyma is within normal limits. There is mild osteophytosis of the scapulohumeral joints.
Impression:
Cranial mediastinal mass, primary or metastatic.
There are multiple pulmonary nodules. The cranial mediastinum is slightly wider with increased opacity compared to prior. The cardiovascular structures continue to be within normal limits. There is static multifocal spondylosis deformans. There is static mild hepatomegaly. there are radiolucencies in the proximal right humerus with radiolucency surrounding the vascular foramen at the level of the mid diaphysis of the humerus. There is surrounding ill defined and spiculated periosteal proliferation which also extends along the caudal cortex of the humerus to the level of the distal diaphysis.
Impression:
Pulmonary and osseous metastatic lesions.
Case Discussion
On presentation, the mass was presumed to be osteosarcoma however fine needle aspirate was inconclusive. The cranial mediastinal mass was also aspirated with ultrasound guidance, and cytology found malignant epithelioid neoplasia with necrosis and hemorrhage. At the time metastasis from the primary tumor was suspected but other primary neoplasia such as thymoma or chemodectoma was considered.
After amputation of the limb, osteosarcoma was found on histopathology. The dog was treated with chemotherapy however developed metastatic disease to the humerus and lungs. The mediastinal mass increased in size. No necropsy was performed.
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