Angioleiomyosarcoma in the Nasal Vestibule of a Dog: Surgical Excision via a Modified Lateral Approach

Abstract

This case report describes an 11 yr old spayed female German shepherd dog weighing 42 kg that presented with intermittent epistaxis from the left nostril. A nonulcerated pale irregular polypoid mass was visualized within the left nares. Computed tomography revealed a pedunculated mass arising from the ventrolateral nasal mucosal of the left nasal cavity with no evidence of involvement or invasion of adjacent soft tissues or bony structures. Histological and immunohistochemical examination of rhinoscopic biopsies returned a diagnosis of an angioleiomyosarcoma. The mass was excised using a modified lateral approach to the nasal cavity. Fulguration of the wound bed was performed. Clean surgical margins were identified on histopathology. The dog remained clinically free of recurrence 28 mo postsurgically. Angioleiomyosarcomas are rare tumors originating from the smooth muscle cells of blood vessel walls and are included in the spectrum of perivascular wall tumor, a subgroup of soft-tissue sarcomas.

Nasal angioleiomyoma in 2 dogs

“…Diagnosis must always be made histopathologically. McGhie et al [15] reported a case of a nasal angioleiomyosarcoma in a dog recently, which is a differential diagnosis to ALM. In both, histology shows abundant thick-walled blood vessels and smooth muscle cells that are associated with the vessel walls [8].…”

Leiomyoma in the nasal cavity of a dog

“…The division between angioleiomyoma and leiomyoma is based on the degree of vascularity, with the latter lesion being less vascular (Meher & Varshney 2007). Carpenter & Hamilton (1995) reported a case of angioleiomyoma in the nasopharynx of a dog, and there are only two cases in the veterinary literature of angioleiomyosarcoma observed in the head area (Kheirandish et al 2010, McGhie et al 2015.…”

“…Leiomyomas are benign mesenchymal tumours of myogenic origin (Tsobanidou 2006). They are rarely found in the nose because of the paucity of smooth muscle fibres in this location apart from in the wall of blood vessels (Horie et al 2001, Vincenzi et al 2002, Tsobanidou 2006, Gurung et al 2009, McGhie et al 2015. Their exact origin is not yet known (Gurung et al 2009) and three hypotheses have been proposed: leiomyoma arises from the smooth muscle wall of blood vessels or from multipotential mesenchymal cells (Vincenzi et al 2002) or from both (Horie et al 2001).…”

“…Tumours of the nasal cavity account for approximately 1% of all neoplasms in dogs and are diagnosed primarily in older large breed dolichocephalic dogs (Tsobanidou 2006, Turek and Lana 2013, McGhie et al 2015. Leiomyomas are benign mesenchymal tumours showing smooth muscle differentiation (Gurung et al 2009, Kamra et al 2013.…”