A neurological presentation caused by brain metastases in a dog with interventricular septal hemangiosarcoma

Abstract

Background Brain metastases are well known for disseminated hemangiosarcoma involving the right atrium/auricle. Case report An 8‐year‐old male Australian Shepherd Dog presented with a 3‐day history of circling to the left. A neurological examination revealed obtunded mentation, right hemi‐inattention, bilateral strabismus towards the left side and absent physiological nystagmus. In addition, the dog had muffled heart sounds on auscultation and exercise‐induced weakness. Laboratory findings included hypercoagulability and marked elevation in the C‐reactive protein concentration. Electrocardiography detected a sinus rhythm with right bundle‐branch block and ventricular bigeminy. Echocardiography revealed an extensive interventricular septal mass. Due to the grave prognosis, the owners elected for euthanasia, and a complete necropsy was performed. The main pathological findings were an interventricular septal and left ventricular hemangiosarcoma, with metastases in the brain, lungs, spleen and adrenal glands. No evidence of tumour infiltration was found in the right atrium. Conclusion To the authors' knowledge, this is the first report of neurological signs due to confirmed brain metastases in a dog with interventricular septal hemangiosarcoma. Although the right atrium is the main location for cardiac hemangiosarcoma, the interventricular septum should be evaluated in all cases.

Diagnosis, Prognosis, and Treatment of Canine Hemangiosarcoma: A Review Based on a Consensus Organized by the Brazilian Association of Veterinary Oncology, ABROVET

“…The main routes of dissemination are hematogenous and intracavitary and are usually related to tumor rupture [ 1 ]. The target organs are the lungs, liver, and spleen; less frequently, the kidneys, mesentery, intestines, omentum, central nervous system, adrenal glands, peritoneum, visceral lymph nodes, and diaphragm [ 15 , 180 , 186 ]. Metastases to the pericardium and other cardiac chambers have also been observed [ 15 , 87 , 180 ], with reports of metastases to multiple organs [ 15 ].…”

“…HSA can also occur in an extracardiac intrathoracic location, mainly in large vessels and in the pericardium, with a similar clinical manifestation but with punctual differences, such as the manifestation of a murmur [ 178 , 190 , 192 , 193 , 194 , 195 ]. Atypical symptomatology, such as neurological conditions, can also occur in relation to the presence of distant metastases [ 186 ].…”

Second degree AV block in a dog with cardiac hemangiosarcoma in the interventricular septum

“…Conduction disturbances can occur secondary to interventricular septal hemangiosarcoma, including bundle branch block with 13 and without ventricular bigeminy, 4 and ventricular tachycardia 14 . One case details a dog with infiltrative hemangiosarcoma in the interatrial and interventricular septum at the level of the AV node, leading to third‐degree AV block 15 .…”