Vogel Susan R, Desrochers André, Lanthier Isabelle, Strina Marion, Babkine Marie
Department of Clinical Sciences, Faculté de Medicine Vétérinaire, Université de Montréal, Saint-Hyacinthe, QC J2S 7C6, Canada.
J Am Vet Med Assoc. 2012 Feb 15;240(4):454-8. doi: 10.2460/javma.240.4.454.
A 6-year-old Holstein cow was examined because of chronic lameness and swelling near the stifle joint of the left pelvic limb.
A mass was palpated in the soft tissues lateral to the proximal aspect of the left tibia. Multiple attempts to obtain a biopsy specimen of the mass resulted in acute compartment syndrome of the femoral compartment (tensor fasciae latae and biceps femoris muscles) and lateral tibial compartment (cranial tibial and peroneus tertius muscles) with associated sciatic nerve paralysis.
Surgical decompression via tensor fasciae latae and biceps femoris incision resolved the sciatic nerve paralysis. On the fifth day following surgery, the cow began to develop signs of increased respiratory effort. Thoracic radiography revealed a pulmonary metastatic micronodular pattern. The cow was euthanized because its condition deteriorated. Metastatic hemangiosarcoma was confirmed at necropsy, and the primary tumor was the mass that was lateral to the tibia and within the biceps femoris muscle.
Hemangiosarcoma should be considered a differential diagnosis for lameness in cattle when no orthopedic cause can be identified. Close patient surveillance is strongly recommended in the event that a vascular tumor is present because catastrophic consequences are possible. To our knowledge, this is the first report of acute compartment syndrome in a pelvic limb of a bovine patient and the only report of hemangiosarcoma in the skeletal muscle of cattle.
一头6岁的荷斯坦奶牛因左后肢膝关节附近慢性跛行和肿胀而接受检查。
在左胫骨近端外侧的软组织中触诊到一个肿块。多次尝试获取该肿块的活检标本导致股部（阔筋膜张肌和股二头肌）和胫外侧部（胫骨前肌和第三腓骨肌）出现急性骨筋膜室综合征，并伴有坐骨神经麻痹。
通过阔筋膜张肌和股二头肌切口进行手术减压解决了坐骨神经麻痹问题。术后第5天，奶牛开始出现呼吸费力增加的迹象。胸部X线检查显示肺部有转移性微结节样病变。由于病情恶化，奶牛被实施安乐死。尸检确诊为转移性血管肉瘤，原发肿瘤是位于胫骨外侧和股二头肌内的肿块。
当无法确定骨科病因时，血管肉瘤应被视为牛跛行的鉴别诊断之一。如果存在血管肿瘤，强烈建议密切监测患畜，因为可能会产生灾难性后果。据我们所知，这是牛后肢急性骨筋膜室综合征的首例报告，也是牛骨骼肌血管肉瘤的唯一报告。
