Hemangiosarcoma is a mesenchymal neoplasm originating in the endothelial cells of blood vessels; they can be classified as non-visceral and visceral types. Non-visceral hemangiosarcomas can affect the skin, subcutaneous tissues, and muscle tissues; visceral hemangiosarcomas can affect the spleen, liver, heart, lungs, kidneys, oral cavity, bones, bladder, uterus, tongue, and retroperitoneum. Among domestic species, dogs are most affected by cutaneous HSA. Cutaneous HSA represents approximately 14% of all HSA diagnosed in this species and less than 5% of dermal tumors, according to North American studies. However, Brazilian epidemiological data demonstrate a higher prevalence, which may represent 27 to 80% of all canine HSAs and 13.9% of all skin neoplasms diagnosed in this species. Cutaneous HSA most commonly affects middle-aged to elderly dogs (between 8 and 15 years old), with no gender predisposition for either the actinic or non-actinic forms. The higher prevalence of cutaneous HSA in some canine breeds is related to lower protection from solar radiation, as low skin pigmentation and hair coverage lead to greater sun exposure. Actinic changes, such as solar dermatosis, are frequent in these patients, confirming the influence of solar radiation on the development of this neoplasm. There are multiple clinical manifestations of hemangiosarcoma in canines. The diagnostic approach and staging classification of cutaneous HSAs are similar between the different subtypes. The definitive diagnosis is obtained through histopathological analysis of incisional or excisional biopsies. Cytology can be used as a presurgical screening test; however, it has little diagnostic utility in cases of HSA because there is a high risk of blood contamination and sample hemodilution. Surgery is generally the treatment of choice for dogs with localized non-visceral HSA without evidence of metastatic disease. Recently, electrochemotherapy (ECT) has emerged as an alternative therapy for the local ablative treatment of different neoplastic types; the use of radiotherapy for the treatment of dogs with cutaneous HSA is uncommon. There is greater consensus in the literature regarding the indications for adjuvant chemotherapy in subcutaneous and muscular HSA; doxorubicin is the most frequently used antineoplastic agent for subcutaneous and muscular subtypes and can be administered alone or in combination with other drugs. Other therapies include antiangiogenic therapy, photodynamic therapy, the association of chemotherapy with the metronomic dose, targeted therapies, and natural products. The benefits of these therapies are presented and discussed. In general, the prognosis of splenic and cardiac HSA is unfavorable. As a challenging neoplasm, studies of new protocols and treatment modalities are necessary to control this aggressive disease.

BackgroundTrypanosoma cruzi is the causative agent of Chagas disease, which is endemic to subtropical and tropical Americas. The disease treatment remains partially ineffective, involving therapies directed to the parasite as well as palliative strategies for the clinical manifestations. Therefore, novel candidates for disease control are necessary. Additionally, strategies based on parasite inhibition via specific targets and application of compounds which improve the immune response against the disease is welcomed. Ghrelin is a peptide hormone pointed as a substance with important cardioprotective, vasodilatory, anti-apoptotic, anti-oxidative and immune modulatory functions. The aims of this study were to evaluate the immunomodulatory effects of ghrelin in male Wistar rats infected with the Y strain of T. cruzi.MethodsIn order to delineate an immune response against T. cruzi mediated by ghrelin, we evaluated the following parameters: quantification of blood and cardiac parasites; analysis of cell markers (CD3+, CD8+, NK, NKT, CD45RA+, macrophage and RT1B+); nitric oxide (NO) production; lymphoproliferation assays; splenocyte apoptosis; and INF-γ, IL-12 and IL-6 quantification in sera.ResultsThe animals infected with T. cruzi and supplemented with ghrelin demonstrated an upregulated pattern in macrophage and NO production, whereas an anti-inflammatory response was observed in T cells and cytokines. The low response against T. cruzi mediated by T cells probably contributed to a higher colonization of the cardiac tissue, when compared to infected groups. On the other side, the peptide decreased the inflammatory infiltration in cardiac tissue infected with T. cruzi.ConclusionsGhrelin demonstrated a dual function in animals infected with T. cruzi. Further studies, especially related to the decrease of cardiac tissue inflammation, are needed in order to determine the advantages of ghrelin supplementation in Chagas disease, mostly for populations from endemic areas.

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Background: In dogs pheochromocytoma usually compress and invade into the adjacent vessels and structures, which may lead to the occurrence of caudal vena caval tumor thrombi. The surgical approach in these cases requires adrenalectomy with caval thrombectomy. Conventionally, tourniquets and partial occlusion clamp are used to reduce intraoperative blood loss, but in dogs with a large thrombus associated to a great local tumor invasion, the traditional technique may be hindered. The aim of this study was to report the use of a purse-string suture during venotomy of the caudal vena cava for thrombectomy, as an alternative to tourniquet and partial occlusion clamp.Case: An 11-year-old male Daschound breed dog, was referred for evaluation because of the appearance of small blackened nodules in the ventral abdomen. During a search for metastatic lesions with abdominal ultrasound, the right adrenal was identified with significant volume increase, and presence of tumor-associate circular formation that appeared to invade the caudal vena cava, suggestive of neoplastic invasion or thrombus. Abdominal computed tomography showed caudal vena cava in its hepatic portion presenting considerable increase in diameter, with caudal dilation and presence of hypoattenuating material in its lumen. Right adrenal gland with rounded appearance and regular borders, heterogeneous parenchyma and juxtaposed caudal vena cava suggesting invasion of this, confirming the sonographic findings. During exploratory celiotomy, adherence of the adrenal mass to the right renal vessels and invasion of the caudal vena cava were observed, leading to the need of nephrectomy and venotomy for thrombectomy. To perform the venotomy, a Rumel tourniquet was placed loosely around the vena cava only caudal to the invasion point of the tumor thrombus, cranially, tourniquet application was not possible due to the presence of a large thrombus extending into the intrahepatic cava. Therefore, a purse-string suture was applied around the invasion point of the vena cava tumor thrombi. Thus, during the thrombectomy, while dissecting with the scalpel blade, the purse-string suture was gently tightened, minimizing hemorrhage and allowing the venotomy to close immediately after thrombi removal. Histopathological mass analysis allowed the diagnosis of malignant pheochromocytoma with intravascular extension of the tumor, and the patient remained without clinical changes for 18 months.Discussion: When caval invasion by the adrenal mass is present, the application of Rumel tourniquets around the vena cava cranial and caudal to the tumor thrombus invasion point is recommended to reduce intraoperative hemorrhage during thrombectomy. However, due to the presence of a large thrombus extending into the intrahepatic cava in the presente report, it was not possible to apply the cranial tourniquet, just the caudal one. Thus, the technique adapted using a purse-string suture during venotomy of the caudal vena cava for thrombectomy was extremely efficient in controlling hemorrhage, while allowing rapid venotomy closure without the need for partial occlusion vascular clamp, reducing the surgical time. A tumor thrombus in the vena cava associated with adrenal gland tumors are amenable to adrenalectomy and thrombectomy without significantly increasing perioperative morbidity and mortality rates, assuming the surgeon is experienced in appropriate techniques. Moreover, the presence of tumor invasion does not seem to be predictive of the outcome of the cases, in agreement with what happened in this case.