osteosarcoma presentation

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  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 Codmans 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