11 year old FS Aussie presented for collapsing on a walk yesterday. I struggle with saying yes or no to a right auricular mass in cases like this that don’t have an obvious, cavitated mass. I am seeing what looks like fibrin coming off the auricle, but at the junction between the atria and auricle, there is shadowing in the region and I could talk myself into a mass there. Impression from the images provided?
11 year old FS Aussie presented for collapsing on a walk yesterday. I struggle with saying yes or no to a right auricular mass in cases like this that don’t have an obvious, cavitated mass. I am seeing what looks like fibrin coming off the auricle, but at the junction between the atria and auricle, there is shadowing in the region and I could talk myself into a mass there. Impression from the images provided?
Comments
Fibrin tends to be echogenic
Fibrin tends to be echogenic and clots tend to not organize like the hypoechoic irregular contoured lesion here in the first image screen shot from your second video. Plus the RVFW in the screen shot from your 4th video is very nodular and often a site for HSA spread. To me this is HSA til proven otherwise. I always check the abdomen especially the spleen for other HSA looking lesions to further support calling a mass or not on this scenario.
You can always drain and tx adriamycin empirically and watch if it goes away. Adria reduces HSA but blood clots remain theoretically. I did exactly this oin 2009 and got about 5 months in a GRET wiht a large cardac mass. Ill dig up th ecase of the month link on it.
Here’s an article abstract on that concept:
Doxorubicin chemotherapy for presumptive cardiac hemangiosarcoma in dogs†
C. M. Mullin1,2, M. A. Arkans2,3, C. D. Sammarco2, D. M. Vail8, B. M. Britton2,4, K. R. Vickery2,5, R. E. Risbon2,7, J. Lachowicz2,4, K. E. Burgess2,6, C. A. Manley1,2 and C. A. Clifford2,5
1The Oncology Service, Washington, DC, USA
2Red Bank Veterinary Hospital, Tinton Falls, NJ, USA
3North Carolina State University, Raleigh, NC, USA
4BluePearl Veterinary Partners, New York, NY, USA
5Hope Veterinary Specialists, Malvern, PA, USA
6Tufts Cummings School of Veterinary Medicine, North Grafton, MA, USA 7Veterinary Specialty & Emergency Center, Levittown, PA USA
8University of Wisconsin School of Veterinary Medicine, Madison, WI, USA
Abstract
Sixty-four dogs were treated with single-agent doxorubicin (DOX) for presumptive cardiac hemangiosarcoma (cHSA). The objective response rate (CR + PR) was 41%, and the biologic response rate (CR + PR + SD), or clinical benefit, was 68%. The median progression-free survival (PFS) for treated dogs was 66 days. The median survival time (MST) for this group was 116 days and was significantly improved compared to a MST of 12 days for untreated control dogs (P = 0.0001). Biologic response was significantly associated with improved PFS (P < 0.0001) and OS (P < 0.0001). Univariate analysis identified larger tumour size as a variable negatively associated with PFS. The high rate of clinical benefit and improved MST suggest that DOX has activity in canine cHSA.
Here is the case of the month
Here is the case of the month from 2009 where we got, my mistake, not 5 but 6 months on adria empirically on this dog.
http://sonopath.com/resources/cases-month/cardiac-hemangiosarcoma-tamponade