Decambron Adeline, Manassero Mathieu, Thibaud Jean-Laurent, Reyes-Gomez Edouard, Viateau Véronique
Adeline Decambron, DMV, PhD, Université Paris-Est, Ecole Nationale Vétérinaire d'Alfort, Centre Hospitalier Universitaire Vétérinaire d'Alfort (CHUVA), 7 avenue du général De Gaulle, 94704 Maisons-Alfort Cedex, France, Phone: +33 (0) 6 24 67 72 10, E-mail:
Vet Comp Orthop Traumatol. 2017 Sep 12;30(5):371-376. doi: 10.3415/VCOT-17-01-0002. Epub 2018 Aug 1.
This case report describes for the first time a bone haemophilic pseudotumour in a dog.
A seven-month-old German Shepherd male dog was presented with the complaint of a forelimb weight-bearing lameness with major swelling that expanded dramatically after fine needle aspiration. Radiographs showed a large, well-defined ulnar diaphyseal cystic-like osteolytic lesion. Based on prolonged activated partial thromboplastin time (aPTT) and low factor VIII activity, haemophilia A was diagnosed. Bone scintigraphy, computed tomography, magnetic resonance imaging, and histological findings definitely ruled out malignant neoplasia or inflammation and strongly supported a bone haemophilic pseudotumour over an aneurysmal bone cyst. Segmental ulnar resection and replacement by a polymethylmethacrylate spacer combined with perioperative bleeding management resulted in a successful outcome.
This case provided evidence that a bone haemophilic pseudotumour may be the sole presenting clinical sign of haemophilia A in dogs. Early diagnosis, based on history and magnetic resonance imaging findings, is imperative for prompt treatment leading to successful outcome. It is challenging as fine needle aspiration or biopsy is contraindicated. As described in humans, surgical excision of the lesion combined with management of severe postoperative bleeding was associated with successful outcome in the present case.
A bone haemophilic pseudotumour should be considered in the differential diagnosis of expanding mass associated with osteolysis, especially in young male dogs. Perioperative monitoring of the bleeding disorder and subsequent FVIII replacement therapy was of paramount importance in the present case.
本病例报告首次描述了犬骨嗜血性假瘤。
一只7个月大的德国牧羊犬公犬因前肢负重跛行伴严重肿胀前来就诊，细针穿刺后肿胀急剧扩大。X线片显示尺骨干有一个大的、边界清晰的囊性溶骨性病变。基于活化部分凝血活酶时间（aPTT）延长和因子VIII活性降低，诊断为甲型血友病。骨闪烁显像、计算机断层扫描、磁共振成像和组织学检查结果明确排除了恶性肿瘤或炎症，并强烈支持骨嗜血性假瘤而非动脉瘤样骨囊肿。尺骨节段切除并用聚甲基丙烯酸甲酯间隔物置换，结合围手术期出血管理，取得了成功的结果。
本病例证明骨嗜血性假瘤可能是犬甲型血友病唯一的临床表现。基于病史和磁共振成像结果进行早期诊断对于及时治疗并取得成功结果至关重要。由于细针穿刺或活检是禁忌的，因此具有挑战性。如人类病例所述，在本病例中，手术切除病变并处理严重的术后出血与成功结果相关。
在鉴别诊断与骨质溶解相关的肿块时，应考虑骨嗜血性假瘤，尤其是在年轻公犬中。在本病例中，围手术期监测出血性疾病并随后进行因子VIII替代治疗至关重要。
