Chondrosarcoma in the humerus of a goat

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Year: 2010

Chondrosarcoma in the humerus of a goat Schmid, T; Hilbe, M; Ohlert, S; Nuss, K

Schmid, T; Hilbe, M; Ohlert, S; Nuss, K (2010). Chondrosarcoma in the humerus of a goat. Veterinary and Comparative Orthopaedics and Traumatology (V.C.O.T.), 23(4):273-276. Postprint available at: http://www.zora.uzh.ch Posted at the Zurich Open Repository and Archive, University of Zurich. http://www.zora.uzh.ch Originally published at: Veterinary and Comparative Orthopaedics and Traumatology (V.C.O.T.) 2010, 23(4):273-276.

Case Report

© Schattauer 2010

Chondrosarcoma in the humerus of a goat T. Schmid1; M. Hilbe2; S. Ohlert3; K. Nuss1 1Department

of Farm Animals, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland; 2Institute of Veterinary Pathology, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland; 3Division for Diagnostic, Imaging and RadioOncology, Department of Small Animals, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland

Keywords Goat, lameness, tumour, chondrosarcoma, humerus

Summary The clinical, radiographical and histopathological findings of a chondrosarcoma in the humerus of a goat are discussed. An 11-year-old female Saanen goat was admitted for evaluation of chronic, progressive left forelimb lameness. Clinical examination revealed signs of pain in the shoulder region. Radiographs of the scapulohumeral joint showed a large lytic lesion of the proximal third of the humerus with cortical destruction, intralesional calcification and marked periosteal reactions. Differential diagnoses included aggressive bone lesions as seen with osteomyelitis or a primary bone tumour, such as osteosarcoma, chondrosarcoma or fibrosarcoma. The goat was euthanatized for humane reasons because of the poor prognosis. On the basis of the histopathological findings, the lesion was diagnosed as grade II chondrosarcoma. The tumour had already spread to the lungs and the left prescapular lymph node at the time of diagnosis.

Correspondence to: Tanja Schmid, Dr MedVet Vetsuisse Faculty University of Zurich Winterthurerstrasse 260 8057 Zurich Switzerland Phone: +41 44 635 82 37 Fax: +41 44 635 89 04 E-mail: [email protected] Vet Comp Orthop Traumatol 2010; 23: 273–276 doi:10.3415/VCOT-09-11-0116 Received: November 11, 2009 Accepted: March 30, 2010 Pre-published online: June 21, 2010

Introduction There is little published information on the occurrence of cartilaginous tumours in animals. The case presented here is, to our knowledge, the first description of a chondrosarcoma in a goat. Of all domestic animal species, dogs have the highest frequency of primary bone tumours; osteosarcoma has the highest incidence, followed by chondrosarcoma, which accounts for approximately 10% of all primary bone tumours. They are most common in middle-aged to old large-breed dogs. In sheep, chondrosarcoma is considered to occur more frequently than osteosarcoma, but it remains a rare tumour in this species. In other domestic animals, primary bone tumours are also rare (1–3). In abattoir surveys, the frequency of malignant or benign cartilaginous neoplasms in cattle has been found to be less than one percent of all neoplasms (4, 5).

Case description An 11-year-old female Saanen goat was admitted to our clinic for evaluation of left forelimb lameness. The goat was in good body condition and weighed 80 kg. The lameness was first noted four to five months before admission and had become progressively worse. There had not been any previous episodes of lameness, nor any history of trauma or swelling of the limb. The goat had been bright and alert and had a good appetite but spent extended periods of time lying down. Yearly testing for caprine arthritis encephalitis virus was negative. A clinical examination was unremarkable except for forelimb abnormalities. A grade 4/5 lameness of the left forelimb was present; the limb was only partially weight

bearing (6). Muscular atrophy of all parts of the left forelimb was visible. The left prescapular lymph node was enlarged. Examination of the claws and palpation of the distal joints of left forelimb did not reveal any abnormalities. The region of the proximal epiphysis of the humerus was painful to palpation. Extension of the scapulohumeral joint appeared to be slightly painful, while flexion of the scapulohumeral joint elicited signs of severe pain. Effusion of the scapulohumeral joint could not be detected, but the range-of-motion was decreased. The right front leg showed signs of chronic overload; specifically hyperextension of the fetlock joint, a slight carpus varus and an increased temperature of the skin of the digits and the claws. Based on these findings, radiographs of the left scapulohumeral joint were made. On the mediolateral view, a large lytic lesion of the proximal third of the humerus could be seen (씰Fig. 1). Cortical destruction, intralesional calcification and marked tentacular periosteal reactions were the most particular findings. The scapula had no radiographic abnormalities. The lesions of the proximal epiphysis of the humerus were classified as aggressive and were suggestive of osteomyelitis or a primary bone tumour, such as osteosarcoma, chondrosarcoma or fibrosarcoma. For humane reasons and because of a poor prognosis, the owner declined further diagnostic tests and the goat was euthanatized and a post-mortem examination carried out. The proximal part of the left humerus was increased in size and had a diameter of 16 centimetres. Sectioning the humerus longitudinally revealed a nodular tumour with a cauliflower-like appearance, which involved the proximal third of the bone, including the head of the humerus (씰Fig. 2). The tumour had invaded and in some areas completely replaced the cortex Vet Comp Orthop Traumatol 4/2010

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A)

B)

Fig. 1 Radiographical findings in an 11-year-old, female Saanen goat. Mediolateral (A) and caudocranial (B) projection of the left shoulder joint. An aggressive bone lesion of the proximal third of the humerus is seen: bone lysis including cortical destruction, intralesional calcification and marked periostal reactions is noted.

of the proximal epiphysis of the humerus and protruded into the articular space. The glenoid of the scapula was not affected by the tumour. Despite careful handling, the humerus fractured during dissection. The left prescapular lymph node had a diameter

of 9 cm and a soft to firm texture with a reddish-brown cut surface. In the parenchyma of the right caudal lung lobe were multiple, randomly distributed, dense-elastic, whitereddish nodules with a diameter of 0.5 to 2 cm and a pale blue cut surface.

Fig. 2 Longitudinal section of the proximal part of the left humerus showing a cauliflower-shaped cut surface. The tumour demonstrates the typical symmetric expansile growth of a central chondrosarcoma.

On histological examination, the bone tumour, prescapular lymph node and nodules in the lung were composed of pleomorphic chondrocytes, which formed nodules with distinct borders (씰Fig. 3). The tumour masses were characterised pri-

Fig. 3 Histological images. A) Primary tumour. In-between the bone trabeculae (T) in the bone marrow cavity and focally infiltrating the trabecula (I), pleomorphic cartilage cells (P) are visible. B) Metastasic lesions of the lung. Compressing the lung parenchyma, expansile growing nodules composed out of neoplastic cartilage cells (N) can be seen. Haematoxylin-eosin, x 20. Vet Comp Orthop Traumatol 4/2010

© Schattauer 2010


marily by expansive growth, although there was also infiltrative growth in the humerus. The nuclei of the cartilage cells were stellate to elongate and no nucleoli were visible. The cells had little eosinophilic cytoplasm and produced large amount of bluish extra cellular matrix. No mitotic figures were seen. Based on this morphology, a grade II chondrosarcoma with metastases into the left prescapular lymph node and into the lung was diagnosed.

Discussion In all species of domestic animals, chondrosarcoma involve flat bones far more often than long bones. In sheep the most frequent primary site of this tumour were found to be the cartilages of the sternocostal complex. In tumours originating from the appendicular skeleton, the scapular cartilage was most frequently affected (3, 7). The proximal part of the humerus is a common location for a cartilaginous tumour in humans, but not in animals (8). A primary chondrosarcoma arises either within a bone (central or medullary chondrosarcoma) or from the periosteum (peripheral chondrosarcoma). In animals, most chondrosarcomas are considered primary bone tumours of medullary origin (3, 9). In a retrospective study, 40 cases with cartilaginous tumours, either chondroma or chondrosarcoma, were described: 32 in sheep, six in cattle and two in horses. Approximately one-third of the tumours had metastasized. The most common location of the metastatic lesions was the lungs (7). Recently, other reports of chondrosarcoma in cattle and horses have also been published (4, 10–13). Cortical destruction, periosteal reaction and focal mineralization of the cartilaginous matrix caused by the tumour result in a radiographic pattern referred to as snowflake or popcorn appearance, and is characteristic of chondrosarcoma in humans and dogs (14, 15). Cortical destruction and periosteal reaction are signs of malignancy and may result in pathological fractures (8). The grade of the tumour is clearly a determining factor for the prognosis. Histological grading of chondrosarcomas is as© Schattauer 2010

signed on the basis of the matrix composition, the presence of nuclear atypia and the mitotic rate (16, 17). Grade I chondrosarcoma are composed of rather uniform tumour cells with small, often multiple nuclei and lacking of mitotic figures. Grade II tumours are composed of pleomorphic cartilage cells, with the proportion of nucleoli in a moderate size and a low rate of mitotic figures. Compared to grade III, no regions of undifferentiated spindle-shaped cells are present. In humans, grade I chondrosarcomas are not metastatic, whereas 10–33% of grade II and approximately 70% of grade III chondrosarcomas metastasize (17). The association between grade and metastasis is similar in dogs (3, 16). The histological findings in the examined region as well as the biologic behaviour of the tumour in this case correspond with a grade II chondrosarcoma. In humans, surgical excision is the current treatment of choice for chondrosarcoma because radiation and chemotherapy are not effective (8, 18, 19). Cartilaginous tumours of the axial skeleton and the long bones must be extirpated surgically in an early and radical fashion, particularly if there are radiographic signs of proliferation (8, 19, 20). A wide margin of surgical resection provides a low prevalence of local recurrence of the tumour, which in turn affects the rates of both metastasis and death (18). In the present case, chronic arthritis of the left scapulohumeral joint was the most likely clinical diagnosis. Common causes for arthritis in goats are various bacteria, including Mycoplasma spp. and caprine arthritis encephalitis virus. Traumatic joint injury, including luxation of the scapulohumeral joint, is also common in goats because of their disposition for fighting and climbing. Degenerative osteoarthritis may be seen in goats with a poor conformation or very old goats (21). In the described case, arthritis was ruled out by radiography because the lesions were confined to the proximal third of the humerus. Osteomyelitis and primary or secondary tumours of long bones were other radiographic differential diagnoses (22–25). Both are rare conditions in goats and may cause similar non-specific signs of disease such as fever, weight loss and lethargy. Bone

neoplasia may develop as a sequel to a previous bone disorder (1). However, there was no history of this, and the goat did not show any other clinical problems than lameness. The definitive diagnosis was based on the histological examination. This case demonstrates that bone tumours, including chondrosarcoma, should be considered in the differential diagnosis of chronic lameness in goats.

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