血管肉瘤是起源于血管内皮细胞的间充质肿瘤;它们可以分为非内脏和内脏类型。非内脏血管肉瘤可影响皮肤,皮下组织,和肌肉组织;内脏血管肉瘤可以影响脾脏,肝脏,心,肺,肾脏,口腔,骨头,膀胱,子宫,舌头,和腹膜后.在家养物种中,狗最容易受到皮肤HSA的影响。皮肤HSA约占该物种诊断的所有HSA的14%,不到5%的真皮肿瘤。根据北美的研究。然而,巴西的流行病学数据显示其患病率较高,可能占所有犬科HSA的27%至80%,占该物种诊断的所有皮肤肿瘤的13.9%。皮肤HSA最常见于中老年犬(8至15岁),对光化或非光化形式没有性别倾向。在一些犬种中,皮肤HSA的患病率较高与太阳辐射防护较低有关。因为低皮肤色素沉着和头发覆盖导致更大的阳光暴露。光化变化,如日光性皮肤病,在这些患者中很常见,证实太阳辐射对这种肿瘤发展的影响。犬血管肉瘤有多种临床表现。不同亚型之间皮肤HSA的诊断方法和分期分类相似。通过切开或切除活检的组织病理学分析获得明确的诊断。细胞学可以用作术前筛查测试;然而,在HSA的病例中,它几乎没有诊断效用,因为存在血液污染和样品血液稀释的高风险。对于没有转移性疾病证据的具有局部非内脏HSA的狗,手术通常是选择的治疗。最近,电化学疗法(ECT)已成为不同肿瘤类型的局部消融治疗的替代疗法;使用放射疗法治疗患有皮肤HSA的狗并不常见。关于皮下和肌肉HSA辅助化疗的适应症,文献中有更多的共识;阿霉素是皮下和肌肉亚型最常用的抗肿瘤剂,可以单独或与其他药物联合使用。其他疗法包括抗血管生成疗法,光动力疗法,化疗与节拍剂量的关联,靶向治疗,和天然产品。提出并讨论了这些疗法的益处。总的来说,脾和心脏HSA的预后不良。作为一种具有挑战性的肿瘤,有必要研究新的治疗方案和治疗方式来控制这种侵袭性疾病.
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.