Kawamura Animal Hospital, Niigata, Niigata, Japan.
Department of Radiology, Division of Diagnostic Radiology, Faculty of Medicine, Yamagata University, Yamagata, Japan.
Vet Med Sci. 2023 May;9(3):1062-1068. doi: 10.1002/vms3.1089. Epub 2023 Feb 6.
A 16-year-old intact female Miniature Dachshund (dog 1) and a 13-year-old intact female American Cocker Spaniel (dog 2) presented with a chief complaint of bleeding from a mammary gland tumour ulceration. Dog 1 was transferred to hospital from a local hospital in a haemorrhagic shock state with uncontrolled continuous bleeding. Thoracic radiographs revealed multiple nodular shadows suspected to be pulmonary metastasis. Dog 2 presented with intermittent bleeding from a mass lesion in the right fifth mammary gland. Due to high anaesthetic risk secondary to severe mitral valve insufficiency (ASA status III), the owner declined surgical excision of the tumour. Therefore, microwave ablation (MWA) under local anaesthesia was chosen in order to achieve adequate haemostasis. Both dogs received local anaesthesia around the bleeding mass lesion, and the disintegrated site was microwave-ablated; dog 1 underwent MWA after blood transfusion to improve the haemorrhagic shock. The ablation site was protected using a non-adhesive dressing. Scarring of the ulcerated site led to complete haemostasis in both cases. Dog 1 underwent tumorectomy on the 31st hospital day to prevent rebleeding; histopathology results were consistent with mammary adenocarcinoma with the ablation site covered by a capsule structure. To the authors' knowledge, this is the first case report describing the use of MWA to stop bleeding from mammary tumours in veterinary medicine. MWA is a feasible and potentially effective palliative treatment modality to stop bleeding from disintegrated mammary tumours in dogs under local anaesthesia.
一只 16 岁的未绝育雌性迷你腊肠犬(犬 1)和一只 13 岁的未绝育雌性美国可卡犬(犬 2)因乳腺肿瘤溃疡出血前来就诊。犬 1 从当地医院转入我院时处于失血性休克状态,持续出血无法控制。胸部 X 光片显示多个疑似肺转移的结节阴影。犬 2 间歇性地从右侧第五个乳腺的肿块病变处出血。由于二尖瓣严重关闭不全导致的高麻醉风险(ASA 分级 III),主人拒绝了肿瘤的手术切除。因此,选择了局部麻醉下的微波消融(MWA)以达到充分止血的目的。两只狗都在出血肿块周围接受了局部麻醉,并对已分解的部位进行微波消融;犬 1 在输血以改善出血性休克后接受了 MWA。用非粘性敷料保护消融部位。溃疡部位的疤痕在两种情况下都导致完全止血。犬 1 在第 31 天住院时接受了肿瘤切除术以防止再次出血;组织病理学结果与乳腺腺癌一致,消融部位被胶囊结构覆盖。据作者所知,这是第一例描述在兽医中使用 MWA 停止乳腺肿瘤出血的病例报告。MWA 是一种可行且潜在有效的姑息治疗方法,可在局部麻醉下停止犬乳腺肿瘤的分解出血。