Imaging Diagnosis—imaging and Histopathologic Characteristics of a Vertebral Hamartoma in a Cat

Abstract

A 9-month-old domestic shorthair cat had progressive ambulatory paraparesis, proprioceptive ataxia, and thoracolumbar hyperesthesia. An extradural mass affecting the left pedicle and lamina of the second lumbar vertebra (L2) causing marked spinal cord impingement was identified in magnetic resonance (MR) images. The mass was predominantly calcified in computed tomographic (CT) images. A hemilaminectomy was performed to resect the mass. Clinical signs were greatly improved at 12-month follow-up. The histopathologic diagnosis was vascular hamartoma. To our knowledge, this is the first report describing the MR characteristics of a vascular hamartoma associated with the vertebral column.

Mandibular vascular hamartoma in a cat

“…From previous reports, the age of the diagnosis may depend on the location of the lesion. If the lesion causes clinical signs, it might be diagnosed at early stages of life: for example, at 3 years old for nasal lesions [ 2 ], 15 months old for spinal lesions [ 11 ], 8 months or 1 year old (two separate cases) for skin lesions [ 4 ], and 9 months old for vertebral lesions [ 15 ]. In contrast, gastric [ 13 ] and cerebral [ 9 ] hamartomas are both typically diagnosed at 11 years old; in these locations, the size may increase gradually without exhibiting any clinical signs and be difficult to discern merely by appearance, resulting in a delayed diagnosis, as in the present case.…”

Neurological signs and imaging findings in three cats with multiple articular process hypertrophy

“…As seen in case 2, a focal area of intramedullary hyperintensity might be present on T2-weighted MRI, compatible with spinal cord edema secondary to the compression. Important differential diagnoses for APH include hamartomas (Taylor-Brown et al, 2018), angiomatosis (Schur et al, 2010;Hans et al, 2018) and neoplastic processes (Besalti et al, 2016). These differential diagnoses can be differentiated on the basis of histopathological features.…”

“…The clinical signs are mainly related to spinal cord compression, commonly resulting in chronic progressive myelopathy. The main differential diagnosis for APH in cats include angiomatosis (Schur et al, 2010;Hans et al, 2018), intervertebral disc disease (De Decker et al, 2017;Crawford et al, 2018), spinal arachnoid diverticulum (Adams et al, 2015), hamartoma (Taylor-Brown et al, 2018), vertebral malformation (Havlicek et al, 2009), spinal dural ossification (Antila et al, 2013), myelomeningocele (Ricci et al, 2011), neoplastic processes (Besalti et al, 2016) and inflammatory or infectious diseases (Marioni-Henry et al, 2004). Information about APH affecting cats, typical imaging characteristics, treatment and outcome is sparse, with only one recent case report about two cats showing single bilateral APH (T11-T12 in case 1 and T3-T4 in case 2) (Carletti et al, 2019).…”

Cerebral Vascular Hamartoma In a Campeiro Bulldog

“…Despite the multifocal VH in the brain tissues of the dog, possibly the anomalous vascular growth did not cause significant injury in the surrounding tissues to produce neurological impairment. Vascular hamartomas have been diagnosed most frequently in symptomatic young patients [3,5,16,21,25,27], such as reported in cats with cerebellar and cervical cord vascular hamartomas [16,21]. The development of clinical signs is attributed to hemorrhage observed in and around the lesions, as well as its ability to act occupying space [7,13,16,20], which may lead to compression of the surrounding brain parenchyma and obstructive hydrocephalus secondary to the injury [13,20].…”

“…Vascular hamartomas (VH) are considered developmental anomalies, that represent an endothelial tissue disorganization and non-neoplastic proliferation in any region of the body [1,5,8,9,20,22,23,25]. VH may usually present low aggression to surrounding tissues depending on the location and also do not produce clinical signs, which lead to underdiagnoses [1].…”