Abstract
A 10-year-old intact female Rottweiler dog weighing 29 kg presented with 2 days history of vomiting, anorexia, and lethargy to KonKuk University Teaching Hospital, Seoul, South Korea. Ultrasonography and computed tomography (CT) scannings revealed a well-demarcated, large mass (29 × 19 × 11 cm) with numerous fluid-filled cavities. Metastases to adjacent lymph nodes were also identified on CT. This large mass and the affected intestinal segments were excised for palliative purposes. Postoperatively, the dog recovered uneventfully without any complications. The cut surface of the mass showed an exophytic growth pattern of multiloculated cystic lesions filled with serosanguineous fluid, large cavities filled with necrotic exudate, and fistulous connections between the intestinal lumen and the necrotic cavity in the mass. On histopathology, the mass was a spindle cell neoplasm expanding from the jejunal muscular layer and with pseudocystic changes. Additional immunohistochemical analysis using antibodies against smooth muscle actin, desmin, and CD-117 demonstrated that the mass was consistent with a leiomyosarcoma. Six months post-operatively, plain radiography revealed an abdominal mass, suspected to be recurrence from jejunal leiomyosarcoma. The owner decided to euthanize the dog due to financial constraints. This case report describes the atypical morphology and clinical progression of a large canine jejunal leiomyosarcoma, which had similar clinical features as those of human leiomyoma and leiomyosarcoma.
Highlights
Leiomyosarcomas (LMS) are malignant mesenchymal neoplasms that originate from smooth muscle tissue and, can arise from any organ containing smooth muscle, such as the gastrointestinal tract, respiratory, urinary tract, genital tract, skin, liver, spleen, and other abdominal organs [1, 2].Intestinal LMS account for around 30% of canine nonangiogenic, nonlymphogenic intestinal mesenchymal tumors [2,3,4,5,6]
The typical macroscopic morphology of LMS is characterized by large single formation tumors that are larger than 5 cm, with imprecise boundaries that invade the mucosa, muscular layer, and adjacent tissues [16, 17]
The giant mass was completely removed with the adjacent mesentery and the affected jejunal segments via jejunal resection and end-to-end anastomosis with a 5-cm surgical margin in both oral and aboral directions (Figure 2C)
Summary
Leiomyosarcomas (LMS) are malignant mesenchymal neoplasms that originate from smooth muscle tissue and, can arise from any organ containing smooth muscle, such as the gastrointestinal tract, respiratory, urinary tract, genital tract, skin, liver, spleen, and other abdominal organs [1, 2]. With regard to various morphological characteristics that have been previously studied, the size of LMS is considered an important prognostic factor because it has been found that larger tumor size is independently correlated with decreased survival in human beings [19, 20] This case report describes an atypical morphology and clinical progression of jejunal canine LMS, which was characterized by being large, multiloculated, pseudocystic and fistulated. Based on CT findings, the mass was suspected to be a small intestinal tumor, and the decision was made to surgically remove the tumor and attach the jejunum via jejunal resection and anastomosis. The giant mass was completely removed with the adjacent mesentery and the affected jejunal segments via jejunal resection and end-to-end anastomosis with a 5-cm surgical margin in both oral and aboral directions (Figure 2C). The owner declined further treatments and opted to euthanize the patient due to financial constraints and concerns for the patient’s quality of the life
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