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Hemangiomas And Hemangiosarcomas

Hemangiomas and hemangiosarcomas are benign or malignant vascular tumors which appear as masses in vascular spaces.

Hemangiomas: A benign tumor. Appears as raised, circular, blood-filled cystic masses (blood blisters). They obliterate pre-existent architecture, with adjacent channels separated only by a mature fibrous stroma without pericytes or smooth muscle.
Hemangiosarcomas: These are malignant tumors. They appear similar to hemangiomas except these tumors have a more solid aspect, with local aggressiveness, infiltrative growth and it frequently produces distant metastases. They tend to cause inflammation and necrosis. These tumors are composed of pleomorphic hyperchromatic spindle cells that gain diagnostic specificity by at least the occasional formation of a convincing vascular channel supported by hyalinized collagen beams.

The most frequent locations where hemangiomas and hemangiosarcomas occur on ducks are the legs and feet, cloaca, neck, wings, and beak. Hemangiomas and hemangiosarcomas can rupture easily, often leading to fatal blood loss.

Hemangiomas and hemangiosarcomas appear similar to malignant melanomas, hematomas, highly vascular granulation tissue, and vascular malformations such as arteriovenous fistulas and aneurysms.

Treatment Options

Cutaneous hemangiomas can usually be successfully removed surgically.

Symptoms

Darkened mass or necrotic area

Inflammation

Darkened skin lesions

Diagnosis

Physical exam
Biopsy
Necropsy

Treatment

Method	Method Summary
Supportive care	Try to protect lesions from injury.
Surgery	Cutaneous hemangiomas can usually be successfully removed surgically.

Reported Cases

Case 1: Hemangiosarcoma in a Parrot. A 13-year-old female double yellow-headed Amazon parrot was examined for respiratory distress and partial anorexia. Radiographs, ultrasonography, and computed tomography revealed a soft-tissue opacity in the right cranial coelom with a necrotic or fluid-filled center. Endoscopy was used to visualize the mass, collect diagnostic samples, and treat the patient by cyst ablation and fistula formation. The symptoms returned within weeks after each treatment, and the bird died 36 days after initial presentation. Gross and histopathologic examination revealed the mass was a hemangiosarcoma that was attached to the right internal carotid artery. Ref
Primary tumor site: right internal carotid arterySites of Metastases: none

Case 2: Hemangiosarcoma in a Budgie. A swelling on the right metacarpal area of a male budgerigar was diagnosed as hemangiosarcoma. Diagnosis of this malignant endothelial tumor was based on gross and histopathologic findings. The bird was treated with local irradiation of the wing three times weekly for a total of 10 400-cGy fractions. The tumor completely regressed after local irradiation and the budgerigar tolerated the treatment well; however, the bird died 8 weeks later as a result of disseminated disease. Ref
Primary tumor site: metacarpalSites of Metastases: none

Case 3: Hemangiosarcoma in a Parrot. A 25-year-old intact female orange-winged Amazon parrot presented for a 2-week history of straining to defecate, lethargy, open-beak breathing, decreased vocalization, and ruffled feathers. On physical examination, the parrot had a heart murmur, increased air sac and lung sounds, open-beak breathing, increased respiratory rate and effort, and coelomic distension. An ultrasound revealed intracoelomic fluid, and hemorrhagic fluid was aspirated from the coelom. Cytologic analysis indicated hemocoelom. Pericardial effusion was observed during the sonogram, and pericardiocentesis was performed. The bird was euthanatized upon the owner's request because of a poor prognosis. At necropsy, several masses that involved the ovary and oviduct were observed, as well as a thickened pericardium and a thickened, fibrinous epicardium. Results of a histopathologic examination of the masses that involved the reproductive tract revealed ovarian hemangiosarcoma, which was confirmed by immunohistochemical staining. Ref
Primary tumor site: ovarySites of Metastases: none

Case 4: Hemangiosarcoma in a Pheasant. A 13-year-old male golden pheasant was examined for a hemorrhagic mass on the leading edge of the right propatagial area of 1 day's duration. Physical examination revealed a scabbed mass that bled easily when manipulated. Hemorrhage and cellulitis were observed from 2 incisional biopsies. The mass was removed under general anesthesia, and histopathology demonstrated a hemangiosarcoma. Assays on white blood cells for avian leukosis/sarcoma viruses, Marek disease viral serotypes 1, 2, and 3, and reticuloendotheliosis virus were negative. The bird recovered uneventfully, but the tumor recurred within 10 days after removal. Upon clinical deterioration 3 months later, the bird was euthanized. Ref
Primary tumor site: propatagial areaSites of Metastases: none

Case 5: Hemangiosarcoma in a Parrotlet. A 2-month-old Pacific parrotlet was presented for assessment following a traumatic injury to the right wing that resulted in persistent swelling and inflammation. Six weeks postinjury the bird underwent surgical resection of a large hemorrhagic cavitated mass that had formed at the site of the original injury and a second, smaller mass on the body in direct contact with the wing mass. Histopathology of the wing mass confirmed a diagnosis of hemangiosarcoma. Ref
Primary tumor site: wingSites of Metastases: none