Boston S, Singh A, Murphy K, Nykamp S
Ontario Veterinary College, University of Guelph, Department of Clinical Studies, Guelph ON, N1G 2W1, Canada.
Vet Comp Orthop Traumatol. 2010;23(5):366-71. doi: 10.3415/VCOT-10-01-0016. Epub 2010 Aug 25.
This clinical report describes a 10-year-old female spayed German Shepherd dog cross that was presented with cellulitis of the left proximal forelimb and osteomyelitis of the left proximal humerus, and was ultimately diagnosed with metastatic osteosarcoma.
The diagnosis of cellulitis and osteomyelitis was made using ultrasound, radiography, cytology and histopathology, all of which were consistent with cellulitis and osteomyelitis. Cultures were negative.
The patient was treated using two surgical debridements and long-term broad-spectrum antibiotic drugs. Despite surgical and medical treatment, the dog's condition progressed. A lytic lesion of the left proximal humerus was identified radiographically.
One hundred forty-one days after initial presentation, the dog was presented with a non-weight bearing lameness of the left forelimb. An amputation was scheduled. Preoperative computed tomography scan of the thorax revealed gross metastatic disease to the lungs. The patient was euthanatized and a post-mortem examination revealed osteosarcoma of the left proximal humerus with widespread metastasis.
To our knowledge, this case is the first reported case of osteomyelitis masking osteosarcoma in a dog. It serves as a reminder to maintain a high index of suspicion when managing cases with a signalment, history and radiographic lesion that are consistent with a primary bone tumour.
本临床报告描述了一只10岁已绝育的德国牧羊犬杂交犬，该犬出现左前肢近端蜂窝织炎和左肱骨近端骨髓炎，最终被诊断为转移性骨肉瘤。
通过超声、放射摄影、细胞学和组织病理学诊断为蜂窝织炎和骨髓炎，所有结果均与蜂窝织炎和骨髓炎相符。培养结果为阴性。
对该患者进行了两次手术清创和长期广谱抗生素治疗。尽管进行了手术和药物治疗，但犬的病情仍在进展。放射摄影发现左肱骨近端有溶解性病变。
初次就诊141天后，该犬出现左前肢非负重性跛行。计划进行截肢手术。术前胸部计算机断层扫描显示肺部有明显的转移性疾病。对该患者实施了安乐死，尸检显示左肱骨近端骨肉瘤并伴有广泛转移。
据我们所知，该病例是首例报道的犬骨髓炎掩盖骨肉瘤的病例。它提醒我们，在处理具有与原发性骨肿瘤相符的体征、病史和放射学病变的病例时，要保持高度的怀疑指数。
