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Leiomyosarcoma in an Adult Llama

Leiomyosarcoma in an Adult Llama. Jarrod Ludwig RD. Tyler Jr., D. Righter, K. Potter, KH. Baum, GK. Saunders Virginia-Maryland Regional College of Veterinary Medicine. Signalment. 12-year-old neutered male llama. Subsequently the llama was found dead.

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Leiomyosarcoma in an Adult Llama

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  1. Leiomyosarcoma in an Adult Llama Jarrod Ludwig RD. Tyler Jr., D. Righter, K. Potter, KH. Baum, GK. Saunders Virginia-Maryland Regional College of Veterinary Medicine Presented at SEVPAC 2008 – Permission granted for use on SEVPAC website only

  2. Signalment • 12-year-old neutered male llama Presented at SEVPAC 2008 – Permission granted for use on SEVPAC website only

  3. Subsequently the llama was found dead Presented to the referring veterinarian with acute: Lethargy Anorexia Ptyalism Tachypnea History and Clinical Signs Presented at SEVPAC 2008 – Permission granted for use on SEVPAC website only

  4. Gross Lesions Liver • Ruptured 15cm hepatic mass with a blood clot adherent to the serosal surface Presented at SEVPAC 2008 – Permission granted for use on SEVPAC website only

  5. Gross Lesions Lung • 3-5cm, mottled, white-red nodules scattered throughout the liver and lung Presented at SEVPAC 2008 – Permission granted for use on SEVPAC website only

  6. Microscopic Description • Hepatic mass and pulmonary nodules • Extensive hemorrhage, fibrin, edema, and necrosis • Normal hepatic architecture is obliterated and replaced by a densely cellular mass of pleomorphic spindle cells arranged in streams and bundles • Marked anisocytosis, anisokaryosis, occasional multinucleated cells, and 2-4 mitotic figures per 400x field • These findings are consistent with a neoplasm of mesenchymal origin (sarcoma) Presented at SEVPAC 2008 – Permission granted for use on SEVPAC website only

  7. Microscopic Description Presented at SEVPAC 2008 – Permission granted for use on SEVPAC website only H&E histopathology of the hepatic nodule

  8. Microscopic Description Presented at SEVPAC 2008 – Permission granted for use on SEVPAC website only H&E histopathology of the hepatic nodule

  9. Immunohistochemistry • Neoplastic cells are positive for: • 60-85% Vimentin immunoreactivity • 10-15% Muscle-specific actin immunoreactivity • 15-20% α-smooth muscle actin immunoreactivity • Neoplastic cells are negative for: • Mac 387 • Desmin • Cytokeratin Presented at SEVPAC 2008 – Permission granted for use on SEVPAC website only

  10. Immunohistochemistry - Markers • Vimentin - demonstrates that the neoplasm was of mesenchymal origin (sarcoma) • Muscle-specific actin - recognizes all of the alpha actins (skeletal, cardiac, and smooth muscle) as well as gamma smooth muscle actin • α-smooth muscle actin - recognizes only alpha smooth muscle actin Presented at SEVPAC 2008 – Permission granted for use on SEVPAC website only

  11. Immunohistochemistry Presented at SEVPAC 2008 – Permission granted for use on SEVPAC website only Liver - Muscle actin

  12. Immunohistochemistry Presented at SEVPAC 2008 – Permission granted for use on SEVPAC website only Liver - α-smooth muscle actin

  13. Case Summary • The large hepatic mass is suspected to be the primary neoplasm • The mass likely originated from the smooth muscle of either a hepatic blood vessel or biliary duct • Immunohistochemistry and histopathology support a diagnosis of leiomyosarcoma • Sudden death was the result of hypovolemic shock secondary to acute hemoabdomen caused by the rupture of the large hepatic mass Presented at SEVPAC 2008 – Permission granted for use on SEVPAC website only

  14. References • Cooper BJ, Valentine, BA: Tumors of the muscle. In: Tumours in Domestic Animals, ed. Mueten DJ, 4th ed., pp 319-340, Iowa State Press, IA 2002 • Shapiro JL, Watson P, McEwen B, Carman S: Highlights of camelid diagnoses from necropsy submissions to the Animal Health Laboratory, University of Guelph, from 1998 to 2004. Can Vet J 46:317–318., 2005 • Valentine BA, Martin, JM: Prevalence of neoplasia in llamas and alpacas (Oregon State University, 2001–2006). J Vet Diagn Invest 19:202-204, 2007 • Valero R, et al.: Leiomiosarcoma hepatico: Reporte de un caso y revision de la literature. Casos Clinicos de Gastroenterologia, Casos Clinicos de Oncologia 2006: http://www.portalesmedicos.com/publicaciones/articles/256/2/Leiomiosarcoma-hepatico.-Caso-Clinico 2006 Presented at SEVPAC 2008 – Permission granted for use on SEVPAC website only

  15. Questions? Presented at SEVPAC 2008 – Permission granted for use on SEVPAC website only

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