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Should you put stromal sarcoma on your differential for splenic masses?
VRU 2024
Rachel M. Sullivan, Elyshia J. Hankin
Background
Splenic stromal sarcoma, a rare and under-researched splenic neoplasm in dogs, includes fibrosarcoma, myxosarcoma, leiomyosarcoma, and related tumors. Diagnosing splenic masses via ultrasonography remains challenging due to overlapping characteristics with other neoplasms such as hemangiosarcoma. This study aimed to evaluate the ultrasonographic features of splenic stromal sarcoma in 13 dogs, aiming to differentiate it from other splenic pathologies.
Methods
This retrospective study analyzed 13 dogs diagnosed with splenic stromal sarcoma at Friendship Hospital for Animals (2015-2023). Inclusion criteria required cytological or histopathological confirmation and availability of ultrasonographic images. Data on patient demographics, tumor characteristics, and outcomes were collected. Ultrasonographic evaluations focused on tumor size, location, echogenicity, and associated findings such as peritoneal effusion or hepatic lesions.
Results
The average age of dogs was 12.2 years, with masses predominantly located in the splenic mid-body (9/13). Tumors were solid, mostly of mixed echogenicity, and all cases showed capsule deformation. Peritoneal effusion, often mild and nonhemorrhagic, was present in 6 dogs. Hepatic lesions were identified in 11 dogs, with confirmed metastases in 3 cases. Histological mitotic counts >9 correlated with more aggressive disease. Survival from diagnosis to euthanasia averaged 139 days.
Limitations
The study’s retrospective design and reliance on varying pathologists limited consistency. Some presumptive metastases lacked histological confirmation. Additionally, no fluid samples were collected from peritoneal effusions, and CT or MRI comparisons were absent.
Conclusions
Solid, noncavitary splenic masses with specific ultrasonographic features should raise suspicion for splenic stromal sarcoma, although definitive diagnosis requires histopathology. These findings assist in differentiating this rare malignancy from other splenic diseases, informing prognosis and therapeutic planning.
Examples of ultrasonographic images of splenic masses identified in six dogs with a confirmed diagnosis of splenic stromal sarcoma. Cross calipers denote lesion margins. All masses are capsule-deforming and predominantly solid masses with mixed heterogenicity. C, D, Examples of masses that also had small, well-circumscribed anechoic, cystic-like foci without the appearance of cavitation.
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