- 12 yr old mn labX
- hx of chronic cough, decreased energy, and inappetence
- Chest radiographs show nodules consistent with metastatic disease
- Abdominal ultrasound was wnl except for pericardial effusion seen cranial to the diaphragm
- Echocardiogram shows an approximately 3 x 5cm right atrial mass that appears to be extending into the right ventricle on right parasternal transverse views
- Mild to moderate pericardial effusion is present but no evidence of cardiac tamponade
- 12 yr old mn labX
- hx of chronic cough, decreased energy, and inappetence
- Chest radiographs show nodules consistent with metastatic disease
- Abdominal ultrasound was wnl except for pericardial effusion seen cranial to the diaphragm
- Echocardiogram shows an approximately 3 x 5cm right atrial mass that appears to be extending into the right ventricle on right parasternal transverse views
- Mild to moderate pericardial effusion is present but no evidence of cardiac tamponade
- Cardiac measurements (mm) are as follows: IVSd=12, LVIDd=41, LVPWd=12.6, IVSs=13.8, LVIDs=23.4, LVPWs=19.2. FS=44%
Assuming that this is hemangiosarcoma, what palliative treatment would you consider to help his heart?
Thanks in advance for any help!
Comments
Nice image melissa. Ya know
Nice image melissa. Ya know we rarely get histopath at all on these but we know what does this and in all likelihood its hsa given the position, breed and echogenicity of the tumor. Other dx would be chemodectoma primarily but that is more echogenic and is usually at the aortic root.
So treating with adriamycin, which is nearly as good as more elaborate protocols for hemangio but simpler and much cheaper and maybe with a cox-2 inhibitor on top of it for anti angiogenic properties whats it going to hurt?? You may have to perform a pericardiocentesis here and there but quality of life is what we are about right?
Check out this case of the month available to all from February 2010 where we did exactly what I am describing.
Nice image melissa. Ya know
Nice image melissa. Ya know we rarely get histopath at all on these but we know what does this and in all likelihood its hsa given the position, breed and echogenicity of the tumor. Other dx would be chemodectoma primarily but that is more echogenic and is usually at the aortic root.
So treating with adriamycin, which is nearly as good as more elaborate protocols for hemangio but simpler and much cheaper and maybe with a cox-2 inhibitor on top of it for anti angiogenic properties whats it going to hurt?? You may have to perform a pericardiocentesis here and there but quality of life is what we are about right?
Check out this case of the month available to all from February 2010 where we did exactly what I am describing.
The fact that there is
The fact that there is already pulmonary metastasis makes the prognosis poor and Eric states it boils down to quality of life. Not sure how beneficial chemotherapy would be but would go with cox-2 inhibitor. As there is no cardiac tamponade probally no need for pericardiocentesis and in fact it may worsen hemorrhage as often the pressure within the pericardial sac keeps the tumor from bleeding.
The fact that there is
The fact that there is already pulmonary metastasis makes the prognosis poor and Eric states it boils down to quality of life. Not sure how beneficial chemotherapy would be but would go with cox-2 inhibitor. As there is no cardiac tamponade probally no need for pericardiocentesis and in fact it may worsen hemorrhage as often the pressure within the pericardial sac keeps the tumor from bleeding.
Thank you both for your
Thank you both for your suggestions.
Thank you both for your
Thank you both for your suggestions.