© 2003 American College of Veterinary Ophthalmologists

Veterinary Ophthalmology

(2003)

6

, 1, 85–87

Blackwell Science, Ltd

CASE REPORT

Primary ocular osteosarcoma in a dog

Susan Heath,* Amy J. Rankin† and Richard R. Dubielzig*

*

Department of Pathobiological Sciences, School of Veterinary Medicine, University of Wisconsin–Madison, 2015 Linden Drive West, Madison, WI 53607–1102, USA,

†

Department of Clinical Sciences, School of Veterinary Medicine, Purdue University, 1248 Lynn Hall, West Lafayette, IN 47907, USA

Abstract

An adult male Rottweiler presented to the veterinary medical teaching hospital at Purdue University with a 1-month history of hyphema. On physical examination conjunctivitis, episcleral hyperemia, corneal edema, hyphema, mild glaucoma and loss of vision were observed in the left eye. No other abnormalities were found. The left globe was surgically removed because of the high likelihood of neoplasia and it was fixed in 10% buffered formalin and submitted for pathology. A histologic diagnosis of primary osteosarcoma of the eye was made. Radiographic evaluation did not reveal any evidence of other tumors or pulmonary metastasis. This is the fourth canine case of primary intraocular osteosarcoma to be documented.

Key Words:

canine, extraskeletal osteosarcoma, eye

Address communications to:

Dr Richard R. Dubielzig

Tel.: (608) 263–9805Fax: (608) 265–6748e-mail: dubielzr@svm.vetmed.wisc.edu

INTRODUCTION

Extraskeletal osteosarcoma (EOS) has been described in theliterature as a malignant osteoid-producing mesenchymaltumor without bone or periosteal involvement.

1

Accordingto one author, EOS accounts for 3.7–4.6% of all osteosar-coma in humans.

1

Extraskeletal osteosarcoma in the dogprimarily develops in the internal organs, but has been reportedto occur in the eye.

1,2

Heterotopic bone formation resultsfrom osseous metaplasia in chronically diseased human andcanine eyes.

3,4

Similarly, osteosarcoma has been reported inchronically diseased human and feline globes.

5,6

Feline post-traumatic sarcoma has sometimes been presented as intra-ocular osteosarcoma; however, this syndrome has not beenrecognized in dogs.

7

This is the fourth case of canineintraocular extraskeletal osteosarcoma to be documentedand the only case where the specific effects on ocular tissuesare discussed.

1,2

CASE REPORT

An 8-year-old, male Rottweiler presented to the veterinarymedical teaching hospital at Purdue University with a1-month history of squinting and swollen, cloudy, red lefteye. On physical examination conjunctivitis, episcleral hype-remia, corneal edema, hyphema and loss of vision wereobserved in the left eye. The intraocular pressure in the

affected eye was 28 mmHg compared to 8 mmHg in thenormal eye. All other parameters of the physical exam werewithin normal limits. Ocular ultrasound was not per-formed because of expense. Thoracic and abdominal surveyradiographs were completed and revealed no abnormalities.The left globe was surgically removed because it was blind,painful, unsightly and it was considered at high risk forintraocular neoplasia; fixed in 10% buffered formalin andsubmitted to the Comparative Ocular Pathology Laboratoryof Wisconsin. The globe was sectioned in the vertical planeand the anterior uvea was distorted by a firm but not grittywhite mass which was seen on both sides of the lens. Sub-sequent to the histologic diagnosis, skeletal survey radiographshave failed to detect any lesions. The dog continues to dowell 121 days following surgery.

Histopathology

The left globe was imbedded in paraffin, sectioned at 5microns, and stained with hematoxylin and eosin (H&E). Amesenchymal neoplasm extended inward from the ciliarybody extending into the posterior chamber and over theanterior and posterior surfaces of the lens (Fig. 1). Distor-tion of the iris with preiridal fibrovascular membrane,ectropion uveae and peripherial anterior synechia was seen.Complete retinal detachment and hyphema were also noted.The anterior chamber hemorrhage and peripheral anteriorsynechia are believed to be secondary to the preiridal

86

H E A T H

E T

A L

.

© 2003 American College of Veterinary Ophthalmologists,

Veterinary Ophthalmology

,

6

, 85–87

fibrovascular membrane. The mass was composed ofpleomorphic spindle or stellate cells, occasional multinucleatecells resembling osteoclasts, and an abundance of extracellularcollagen matrix typical of osteoid (Fig. 2). Based on thesehistologic findings and lack of any radiographic lesions, adiagnosis of primary ocular osteosarcoma was made. Noevidence of lens rupture, inflammation, or metaplastic osteoidwas found histologically. Sections of optic nerve showedgliosis but not cupping. The retina had decreased ganglioncells. Both of these changes suggest glaucoma.

DISCUSSION

Canine extraskeletal osteosarcoma is a rare mesenchymaltumor. The cause of extraskeletal tumors has not beendetermined. In dogs, EOS has previously been reported in

many tissues including: skin (

n

= 7)

2,8

subcutaneous tissue(

n

= 14)

2,9

soft tissue over the scapula (

n

= 1),

10

muscle (

n

= 5)

1,2

soft tissue over the thorax (

n

= 1),

11

meninges (

n

= 1),

12

eye(

n

= 3)

1,2

mandibular salivary gland (

n

= 1),

13

esophagus(

n

= 4)

2,14–16

tongue (

n

= 1),

2

gastric ligament (

n

= 1),

1

jejunum(

n

= 8)

2,17–19

ileum (

n

= 1),

1

intestines (

n

= 1),

1

mesenteric root(

n

= 1),

8

mesentery (

n

= 5),

2

omentum (

n

= 1),

2

thyroid (

n

=2),

2

larynx (

n

= 1),

20

trachea (

n

= 1),

20

lungs (

n

= 10),

8,21–23

intracardiac (

n

= 1),

24

spleen (

n

= 28),

1,2,8,19,25,26

adrenal gland(

n

= 1),

1

retroperitoneum (

n

= 1),

27

kidney (

n

= 6),

1,2

liver (

n

=10),

1,2,28–30

axilla (

n

= 2),

8,31

thigh (

n

= 1),

32

synovium (

n

= 1),

33

urinary bladder (

n

= 2),

2

(

n

= 1) testicle,

1

vagina (

n

= 2),

1

andanal sac (

n

= 1).

34

EOS occurs most commonly in the mam-mary gland.

2

Primary mammary sarcomas are uncommon indogs; however, the most prominent tumor type is osteosar-coma. Langenbach

et al

.

2

reported that 108 out of 10 345mammary gland tumors collected over a 10-year span at theveterinary hospital at the University of Pennsylvania wereclassified as mammary gland osteosarcomas (MGO).

Patients with nonmammary EOS have a longer survivaltime than those with MGO. Intra-abdominal tumors ortumors cranial in the mammary chain have the worst prog-nosis.

2

Like appendicular osteosarcoma, the major cause ofdeath in MGO is pulmonary metastasis.

2

Local reoccurrencewas reported to be the major cause of death in patientsdiagnosed with soft tissue osteosarcoma, with the mediansurvival time of 23–26 days following diagnosis.

1,2

Survivaltimes in the literature review range from 0 days to 43 monthspostsurgical excision of the tumor.

1,2,8–24,26–34

Extraskeletalosteosarcoma behaves aggressively with reoccurrence ormetastasis occurring in 64–80% of dogs and 62–80% ofhumans affected.

1,2,8,33,34

Dogs with soft tissue osteosarcomatend to be older, large breed dogs, with average ages beingreported between 9 and 11.5 years of age.

1,2,8

In the authors’review of the literature, the affected dogs tended to be largebreed dogs with an average age of onset of 9.8 years (

n

= 45).The average survival time to euthanasia and to naturaldeath for the dogs in which information was available for was118.32 days (

n

= 25) and 89.6 days (

n

= 13), respectively. Therecommended course of therapy is surgical excision, with widemargins, followed by chemotherapy.

8

Only three out of 127 cases of extraskeletal osteosarcomain the literature reviewed were diagnosed as primaryosteosarcoma of the eye.

1,2

No information was availableregarding the two cases mentioned by Langenbach

et al

.

2

The clinical findings in Patnaik

et al

.

1

were described as: aright eye with chronic glaucoma, panophthalmitis, andcorneal opacity. Histologically, the right eye contained smallto medium sized spindle cells producing osteoid.

There are several theories to attempt to explain intraocularosteosarcoma. In the author’s (R.R.D) experience osseousmetaplasia appears either in the choroid or adjacent to aruptured lens capsule. Osseous metaplasia in the eye is seenin eyes subject to chronic disease and trauma in the human,dogs, and cats. A similar distribution of osteoid was observedby Monselize in the human literature.

35

Figure 1. Photomicrograph showing neoplastic tissue (arrows) extending out from the anterior uvea. There is extensive infiltration into the posterior chamber and extending over the surface of the lens. (H&E), ×25.

Figure 2. Photomicrograph showing neoplastic mesenchymal cells and extracellular osteoid (arrows). (H&E) ×200.

© 2003 American College of Veterinary Ophthalmologists,

Veterinary Ophthalmology

,

6

, 85–87

87

CONCLUSION

Primary ocular osteosarcoma was diagnosed in this dogbecause of the finding of an osteoid producing, mesenchy-mal neoplasia of the anterior uvea in a dog with no otherprimary tumor. The tumor was not related to lens rupture,trauma, or metaplastic osteoid deposition. The dog remainsdisease free 121 days following enucleation. Extraskeletalosteosarcoma is a highly aggressive disease with reoccur-rence or metastasis in 77.77% of 117 canines reviewed inwhich reoccurrence could be assessed.

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