Turkish Journal of Veterinary and Animal Sciences

Turk J Vet Anim Sci

(2014) 38: 77-81
TBTAK
doi:10.3906/vet-1301-42

http://journals.tubitak.gov.tr/veterinary/

Research Article

A retrospective study of cardiac hemangiosarcoma in dogs

1

1,

Agnieszka NOSZCZYK-NOWAK , Marcin NOWAK , Urszula PASLAWSKA , Alicja CEPIEL *, Adrian JANISZEWSKI ,
1
1
Maciej STASZCZYK , Jozef NICPON
1
Department of Internal Medicine and Clinic of Horses, Dogs and Cats, Faculty of Veterinary Medicine, Wroclaw University of
Environmental and Life Sciences, Wroclaw, Poland
2
Department of Pathology, Faculty of Veterinary Medicine, Wroclaw University of Environmental and Life Sciences, Wroclaw, Poland
Received: 14.01.2013

Accepted: 04.07.2013

Published Online: 18.12.2013

Printed: 20.01.2014

Abstract: Cardiac tumors account for a small proportion of all canine tumors, but hemangiosarcoma represents the most frequent
cardiac tumor in many species. Hemangiosarcoma occur intrapericardially with pericardial effusion. In this case report, a retrospective
study was conducted on 9 cases of canine hemangiosarcoma. In all the dogs the presence of a pericardial exudate was noted and in 5
cases it was the only lesion detected during the examination. All animals were subjected to necropsy and histopathology was performed
in the heart, spleen, liver, kidney, and lung. In 5 cases the tumor was present exclusively in the atrial wall. In 4 cases it was present in
the lumen of the right atrium. In 5 cases metastases were detected: in 2 cases to the lungs, in 2 cases to the spleen, and in a one case
to the pericardium. The surgical procedure is difficult and may be effective in dogs in which no metastases have developed yet. In the
remaining cases palliative therapy is the only option.
Key words: Dog, heart, hemangiosarcoma, tumor

1. Introduction
Hemangiosarcoma, a malignant neoplasm of endothelial
cells, occurs more frequently in dogs than in other domestic
animals. The etiology of hemangiosarcoma remains
incompletely understood (1,2). It is the most frequently
diagnosed primary tumor of the canine heart, but, because
of low prevalence, only a few reviews about manifestation
of this and other cardiac tumors are available (3). In
cats, only single cases of hemangiosarcoma have been
described to date (4). While hemangiosarcoma represents
a frequent primary tumor of the spleen and skin, it has
also been diagnosed in kidneys (5). The tumor occurs
most frequently in older (more than 10 years old) dogs.
Manifestation of the tumor exhibits no racial or gender
preferences, although there are reports suggesting higher
prevalence in large-breed dogs such as German Shepherds
and Golden Retrievers (2,67).
We aimed to evaluate supravital and postmortem
characteristics of cardiac hemangiosarcoma in dogs.
2. Materials and methods
The studies were performed on 9 dogs (5 bitches, 4
males), 6 to 13 years of age, of various breeds (1 American
Stafford, 2 German Shepherds, 3 mongrel dogs, 1 small
* Correspondence: [email protected]

bulldog, 1 Border Collie, 1 Labrador), weighing 9 to 56 kg.

In all animals, supravital tests included blood morphology
and biochemistry, cytological analysis of pericardial
exudate, abdominal ultrasonography, chest X-ray, ECG,
and ultrasonography of the heart. Morphological blood
tests were performed using an Animal Blood Center abc
VET analyzer. Biochemical tests included evaluation of
activities of alanine aminotransferase (ALT), aspartate
aminotransferase (AST), and alkaline phosphatase, and
contents of urea, creatinine, bilirubin, total protein,
albumins, Na+ and K+ ions, and total Ca level. The tests were
performed using a MaxMat Pl analyzer. The supravitally
sampled pericardial exudate was centrifuged in EDTAcontaining tubes at 1500 rpm for 5 min. After decantation
of the supernatant, a drop of sediment was applied to a
microscope slide, smeared, and the preparation was
fixed in Cytofix. Then the preparation was stained with
hematoxylin and eosin.
All animals were subjected to necropsy and
histopathology was performed in heart, spleen, liver,
kidney, and lung. Sample tissue sections were fixed in 10%
buffered formalin, dehydrated, and embedded in paraffin
blocks. The sections were stained by hematoxylin and
eosin. THe sections were examined under a microscope.

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3. Results
Morphological examinations of blood samples revealed
significant alterations in dogs with metastases to the spleen
and an elevated level of leukocytes in a dog with metastases
to the lungs (Table 1). In all the dogs the presence of a
serosanguineous pericardial exudate was noted. In 8
(88.9%) cases it was the main reason for weakening and
asphyxia. In 5 cases presence of pericardial exudate was
the only lesion detected during the examination. In none
of the cases did the pericardial exudates contain neoplastic
cells. In 2 cases sudden death of the dogs occurred due to
rupture of the atrial wall, infiltrated by the tumor. Sizes of
the tumors in all the dogs ranged from a few millimeters to
6 cm in diameter (Figures 1 and 2).
In 5 cases the tumor was present exclusively in the
atrial wall. In 4 cases it was present in the lumen of the

right atrium. In 5 cases (55.5%) metastases were detected:

in 2 cases to the lungs, in 2 cases to the spleen, and in 1 case
to the pericardium. In 2 dogs with metastases to the lungs,
chest X-ray examination failed to confirm metastases. In
3 (33.3%) dogs supraventricular arrhythmia was detected.
In 2 cases, ultrasonographic examination of abdominal
cavity demonstrated tumors in the spleen.
Histopathological examination of the isolated tumors
demonstrated that the tumor structure consisted of
various-sized bands and nests of pleomorphic tumor cells,
separated by fine septa of connective tissue. In several sites,
neoplastic cells enclosed spaces of various size, filled with
vast numbers of erythrocytes and formed slit-like blood
vessels (Figure 3). A high proportion of the cells manifested
an elongated, spindle-like shape, pronounced atypia, and
low degree of differentiation. In many places numerous

Table 1. Character of supravital alterations and necropsy data in the studied group of dogs.

No.

Breed

American
Stafford

Age
(years)

Sex

Body
weight
(kg)

26

Echo

ECG

pericardial
exudate

premature
supraventricular
beat

USG

no lesions

X-ray
chest

no lesions

Blood analysis

Necropsy pattern

normal

tumor 4 cm 6 cm,
strictly linked to
epicardium of right
atrium and pericardium
bloody lesion in wall of
right atrium

German
Shepherd

34

pericardial
exudate

normal

no lesions

no lesions

normal

atrial rupture resulting

in death of the dog
numerous tumors in
spleen, tumor in right
atrium

German
Shepherd

42

pericardial
exudate

normal

no lesions

no lesions

normal

tumor in wall of right

atrium

Mongrel
dogs

13

pericardial
exudate

normal

tumors in
spleen

no lesions

anemia
(Hb = 6.1
mmol/L;
RBC = 4.4 T/L)

bloody lesion in wall of

right atrium

Mongrel
dogs

11

56

tumor in
right
atrium

premature
supraventricular
beat

no lesions

no lesions

normal

tumor in right atrium,

strictly linked to
myocardium

Mongrel
dogs

17

pericardial
exudate

normal

no lesions

no lesions

normal

atrial rupture causing

death of the dog
numerous tumors in
spleen, single tumor in
right atrium

Boxer

29

pericardial
exudate

normal

no lesions

no lesions

WBC = 17.1 G/L

tumor in right atrium

Border
Collie

10

27

pericardial
exudate

normal

no lesions

no lesions

normal

tumor in right atrium

31

tumor in
right
atrium

premature
supraventricular
beat

tumors in
spleen

no lesions

anemia
(Hb = 431
mmol/L;
RBC = 3.6 T/L)

tumor in right atrium

and in spleen

78

Labrador

NOSZCZYK-NOWAK et al. / Turk J Vet Anim Sci

(Figure 4). In many places, extensive fields of hemorrhage

were noted, with accumulation of hemosiderin grains,
foci of necrosis and inflammatory infiltrates, with
dominant content of neutrophilic granulocytes, individual
lymphocytes, and macrophages (Figure 5). In 2 cases the
presence of metastases was detected in the lungs (Figure 6)
and spleen (Figure 7), in which neoplastic cells manifested
a lower degree of differentiation as compared to that in the
primary tumor.

Figure 1. Hemangiosarcoma. Tumor mass located out of the

right atrium.

4. Discussion
Hemangiosarcoma represents a tumor manifested in older
dogs (3). The dogs studied in this case report were 9.1 years
old. Diagnosis of cardiac hemangiosarcoma is difficult.
False-negative results can be obtained in radiographic
examination of the chest in more than half of the cases
(8), as also confirmed by this study. The most frequent
sign associated with the cardiac tumor was reported to

Figure 2. Note strict connection between tumor mass and muscle

of right atrium (arrow).

Figure 4. Neoplastic cells infiltrating wall of the right cardiac

atrium (arrows).

Figure 3. Neoplastic cells forming slit-like blood vessels (arrows).

figures of usually pathological mitotic divisions could be

noted, although in some parts of the tumor, mitotic activity
was very low. In certain peripheral zones of the tumor,
aggressive infiltration of tumor cells into the myocardium
was observed, linked to destruction cardiomyocytes

Figure 5. Massive hemorrhages in the center of the tumor

(arrow).

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Figure 6. Metastasis of hemangiosarcoma cells to the right

adcaudal lobe of lungs (arrow).

Figure 7. Metastasis of hemangiosarcoma cells to spleen (arrow).

involve pericardiac exudate (6), which was also seen in

all the dogs of this study. Pericardiocentesis was used to
improve clinical condition of the patient, but the pericardial
exudate re-appears in all cases, as reported before (6,9).
Unfortunately, results of the cytological examination of the
exudate, which was obtained during the pericardiocentesis,
proved to be negative, which has been confirmed in this
study. In echocardiographic examination, occasionally the
tumor can be visualized, most frequently originating from
the right atrium (1,6). The tumor is always strictly linked
to myocardium and its structure is nonhomogeneous.
However, small tumors are unable to be visualized by the
trans-chest echocardiographic examination frequently, and
the only sign of their existence is the presence of pericardial
exudate. Cardiac tamponade or atrial rupture is frequently
the cause of death in dogs with cardiac hemangiosarcoma.
Atrial rupture was the cause of sudden death in 2 dogs
(22.2%) in this study. Following an ECG examination,
atrial tachycardia or supraventricular arrhythmia is most
frequently noted. In our study, rhythm disturbances were
seen in 3 dogs (33.3%). Treatment of the malignant tumor
involves surgery and chemotherapy (913). The surgical
procedure is difficult and may be effective in dogs in which
no metastasis has developed yet. In the remaining cases,
palliative therapy represents the only option. Chemotherapy
extends survival of dogs with hemangiosarcoma by a few
months and the most effective schemes of chemotherapy
are those that include doxorubicin. In the opinion of Ogilvie
et al., complex therapy with vincristine, doxorubicin, and
cyclophosphamide may extend survival of dogs with cardiac
hemangiosarcoma by a mean of 316 days (12).
The main idea of the present study was to determine
the prevalence and associated supravital and postmortem
characteristics in cardiac hemangiosarcoma in dogs and
compare the results with the available literature.

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