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Osteosarcoma presentation

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Presentation on Canine Appendicular Osteosarcoma

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Osteosarcoma presentation

  1. 1. Elli the Rottie Lucy Taylor – Grand Rounds Osteosarcoma
  2. 2. “Elli” – History and Presentation  6 year old FN Rottweiler.  Intermittently lame on left hindlimb for several months.  2 weeks ago fell out of car.  Pain unresponsive to analgesia.  Particularly stiff after rest.
  3. 3. “Elli” - Examination  3/5 lame on left hind.  Firm swelling left distal tibia medially.  No other abnormalities detected.
  4. 4. “Elli” - Investigations Blood Sample  All haematology and biochemistry results within normal limits. Radiography of the Lesion Thoracic Radiography  Radiographs sent from the referring veterinary surgeons non-diagnostic.
  5. 5. “Elli” – Differential Diagnoses  Primary neoplasm  Osteosarcoma  Chondrosarcoma, fibrosarcoma, liposarcoma  Bone metastases  Commonly from mammary / prostatic tumours (unlikely in this case!)  Osteomyelitis
  6. 6. Osteosarcoma – Overview  Most common bone tumour in dogs (85%)  “Away from the elbow, towards the knee”  Middle aged and older large breeds  Locally invasive  Early metastasis
  7. 7. Osteosarcoma – History & Presentation  Present lame  Often severe, acute onset  Pain due to microfractures or osteolysis  Swelling at the primary site
  8. 8. Osteosarcoma - Investigations  Radiography of the lesion  “sunburst appearance”  “Codman’s triangle”  Thoracic Radiography  2 lateral views  Lung metastases  Abdominal Ultrasound  Core Biopsy
  9. 9. “Elli” Investigations (continued) CT of the Lungs
  10. 10. “Elli” Investigations (continued) Sample of the lesionAbdominal Ultrasound
  11. 11. Osteosarcoma – Treatment Options  Euthanasia  Palliative Treatment  Pharmacological (NSAIDs, bisphosphonates)  Radiotherapy  Amputation  Limb Salvage Surgery  Chemotherapy  Carboplatin  (Cisplatin)  (Doxorubicin)
  12. 12. “Elli” - Treatment  Analgesia  Previcox & Famotidine  Amputation  Chemotherapy  Carboplatin  Starting ~2 weeks following surgery
  13. 13. Prognosis  Treatment not curative  Palliative Treatment 4 months  With chemotherapy 11 months
  14. 14. Take Home Messages - Osteosarcoma  Common bone tumour  Large breed dogs predisposed  Many treatment options  Choose on individual basis  Treatment not curative
  15. 15. References  Blackwood, L., 1999. Bone Tumours in small animals. In Practice, 21(1), 31-37  Chun, R., Garrett, L.D., Henry, C., Wall, M., Smith, A., Azene, N.M. 2005. Toxicity and Efficacy of Cisplatin and Doxorubicin Combination Chemotherapy for the Treatment of Canine Osteosarcoma. Journal of the American Animal Hospital Association, 41(6) 382-387  Dernell, W.S., Ehrhart, N.P., Straw, R.C., Vail, D.M. (2007). Tumours of the Skeletal System. In: Withrow, S.J., Vail, D.M. Withrow and MacEwen's Small Animal Clinical Oncology. 4th ed. Missouri: Elsevier. 540-567.  Dobson, J., 1998. Options for the use of chemotherapy in small animals Part 2. Indications. In Practice. 20(9) 487-493  Elliot, J., 2014. Clinical evaluation of small animal cancer patients. In Practice, 36(5), 218-222  Naruse, T., Nishida, Y., Hosono, K., Ishiguro, N. 2005. Meloxicam inhibits osteosarcoma growth, invasiveness and metastisis by COX-2-dependent and independent routes. Carcinogenesis : Integrative Cancer Research, 27(3) 584-592  Polton, G., 2012. Chemotherapy protocols used in veterinary practice. In Practice, 34(7) 382-391  Phillips, B., Powers, B.E., Dernell, S., Straw, R.C., Khanna, C., Hogge, G.S., Vail, D.M. 2009. Use of Single-Agent Carboplatin as Adjuvant or Neoadjuvant Therapy in Conjunction With Amputation for Appendicular Osteosarcoma in Dogs. Journal of the American Animal Hospital Association. 45(1) 33-38

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