Case of the week 2.19.18
Publication Date: 2018-02-19
History
9 year old mixed breed dog, female spayed. Soft tissue swelling right stifle.
7 images
Findings
Pelvis, 2 views: There are large aggressive lesions associated with the ischial table bilaterally, the left ilium, the sixth lumbar through third sacral vertebrae and both proximal tibiae. All lesions are characterized by spiculated to amorphous periosteal new bone formation with multifocal punctate lysis. There is also faint mineralization associated with the soft tissues caudal to the left greater trochanter on the VD view which may represent an additional aggressive lesion associated with the left femur. Marked degenerative joint disease of the right stifle joint is noted which is incidental at this point.
Thorax, 3 views: There are multiple variable size up to approximately 1.5 cm diameter soft tissue opacity nodules throughout the lung fields. Additionally, there are aggressive proliferative lesions associated with the costochondral junctions of the left eighth and ninth costochondral junctions as well as possibly the 10th left and right sixth costochondral junction. The cardiovascular structures are within normal limits. There is incidental bilateral scapulohumeral degenerative joint disease.
Right stifle: As seen on pelvic radiographs there is a large aggressive lesion characterized by spiculated periosteal reaction and a long transition zone to normal bone associated with the proximal tibia. Overlying soft tissue swelling is evident. Additionally, severe degenerative joint disease is associated with the distal femur which is incidental.
Diagnosis
Aggressive polyostotic lesions associated with pelvis, bilateral tibia, possibly left femur, lumbosacral spine and multiple ribs. Pulmonary nodules. All findings are consistent with metastatic disease from an unidentified primary tumor, likely carcinoma.
Discussion
FNAs of the right stifle were performed and were conclusive for carcinoma, likely metastatic in origin. A primary tumor was not definitively identified.
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