Osteosarcoma presentation

Elli the RottieLucy Taylor – Grand Rounds

Osteosarcoma

“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.

“Elli” - Examination

3/5 lame on left hind.

Firm swelling left distal tibia medially.

No other abnormalities detected.

“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.

“Elli” – Differential Diagnoses

Primary neoplasm Osteosarcoma

Chondrosarcoma, fibrosarcoma, liposarcoma

Bone metastases Commonly from mammary / prostatic tumours (unlikely in

this case!)

Osteomyelitis

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

Osteosarcoma – History & Presentation

Present lame Often severe, acute onset

Pain due to microfractures or osteolysis

Swelling at the primary site

Osteosarcoma - Investigations

Radiography of the lesion “sunburst appearance”

“Codman’s triangle”

Thoracic Radiography 2 lateral views

Lung metastases

Abdominal Ultrasound

Core Biopsy

“Elli” Investigations (continued)

CT of the Lungs

“Elli” Investigations (continued)

Sample of the lesionAbdominal Ultrasound

Osteosarcoma – Treatment Options

Euthanasia Palliative Treatment

Pharmacological (NSAIDs, bisphosphonates)

Radiotherapy

Amputation Limb Salvage Surgery

Chemotherapy Carboplatin

(Cisplatin)

(Doxorubicin)

“Elli” - Treatment

Analgesia Previcox & Famotidine

Amputation Chemotherapy

Carboplatin

Starting ~2 weeks following surgery

Prognosis

Treatment not curative Palliative Treatment

4 months With chemotherapy

11 months

Take Home Messages - Osteosarcoma

Common bone tumour Large breed dogs predisposed Many treatment options

Choose on individual basis

Treatment not curative

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