Scapula fracture secondary to metastatic pulmonary carcinoma in a horse: Clinical, sonographic, radiographic, computed tomographic, and pathologic findings.
Abstract: A 20-year-old Quarter horse gelding was referred for evaluation of an acute onset non-weight-bearing right forelimb lameness. Marked soft tissue swelling was apparent over the right scapula and shoulder region; no crepitus was palpable. A complete transverse fracture of the scapular neck was suspected based on ultrasonography and radiographs were obtained to confirm the presumptive diagnosis. A complete, oblique fracture of the right scapular neck with mild cranial and proximal displacement of the distal fragment was detected. Computed tomography of the upper right forelimb was performed post-mortem; lytic bony destruction of the scapular neck with a secondary pathologic fracture was observed. The lesion was considered most likely neoplastic. At necropsy a complete, comminuted fracture of the right scapula was confirmed, secondary to neoplastic invasion of the bone. A solitary, dorsally located, neoplastic mass was also observed within the parenchyma of the right caudal lung. Histopathologically, the lung and scapula lesions were similar, characteristic of a well-differentiated pulmonary carcinoma. . Un cheval hongre Quarter horse âgé de 20 ans fut référé pour évaluation d’une boiterie de non-appui de la patte avant droite d’apparition aiguë. Une enflure marquée des tissus mous était apparente par-dessus l’omoplate droite et la région de l’épaule; aucun crépitement n’était palpable. Une fracture transverse complète du col de l’omoplate était suspectée sur la base de l’échographie et des radiographies furent obtenues pour confirmer le diagnostic présomptif. Un examen par tomodensitométrie de la portion supérieure du membre droit fut effectué post-mortem; une destruction osseuse lytique du col de l’omoplate avec une fracture pathologique secondaire fut observée. La lésion fut considérée comme fort probablement néoplasique. Lors de la nécropsie, une fracture comminutive complète de l’omoplate droite fut confirmée, secondaire à l’invasion néoplasique de l’os. Une masse néoplasique solitaire, localisée dorsalement fut également observée dans le parenchyme du poumon caudal droit. À l’examen histopathologique, les lésions du poumon et de l’omoplate étaient similaires, caractéristiques d’un carcinome pulmonaire bien différencié.(Traduit par D Serge Messier).
Copyright and/or publishing rights held by the Canadian Veterinary Medical Association.
Publication Date: 2020-03-14 PubMed ID: 32165747PubMed Central: PMC7020627
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Summary
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The research article discusses the case of a 20-year-old horse that developed severe lameness in its right forelimb due to a fracture in the scapula (shoulder blade), which was subsequently found to be a result of a metastatic pulmonary carcinoma – a type of lung cancer that had spread to the bone.
Case presentation and initial findings:
- The article begins by discussing the initial evaluation of a 20-year-old Quarter horse gelding that was non-weight-bearing on its right forelimb.
- The horse was found to have significant soft tissue swelling over the right shoulder, but there was no noticeable grating sound or sensation when the area was palpated.
- Given these symptoms, the veterinarians suspected a complete fracture across the neck of the scapula, an area of the shoulder blade that connects it to the rest of the skeleton. This was confirmed through ultrasonography and radiographs.
Diagnostic procedures:
- Further examination revealed that the scapular fracture was “oblique” and not straight across, with the distal fragment (the part farther from the body’s midline) displaced slightly forward and upwards.
- The patient underwent computed tomography (CT scan) of the right forelimb after death, resulting in an unexpected finding: the scapula neck had undergone lytic bony destruction (where bone tissue breaks down), and there was a secondary pathological fracture.
- The lesion, or abnormal tissue, was suspected to be a neoplastic growth (a tumor or mass caused by abnormal cell growth), which was confirmed during a post-mortem examination. The fracture was due to this neoplastic invasion of the bone.
Further findings and conclusion:
- During the post-mortem examination or necropsy, the researchers confirmed a complete fracture of the right scapula, and discovered a single neoplastic mass in the right lung’s tissue.
- Upon comparing the lung and scapula lesions under the microscope (histopathological examination), they found both were characteristics of a well-differentiated pulmonary carcinoma. This meant that the cancer started in the lung and spread, or metastasized, to the scapula, causing the destructive fracture.
This case study provides valuable insights into equine metastatic carcinoma and the resultant effects on the skeletal system, contributing to a deeper understanding of such conditions in horses and providing a foundation for future research and treatment strategies.
Cite This Article
APA
Pye J, Kilcoyne I, Roy M, Vaughan B, Ormond C, Spriet M.
(2020).
Scapula fracture secondary to metastatic pulmonary carcinoma in a horse: Clinical, sonographic, radiographic, computed tomographic, and pathologic findings.
Can Vet J, 61(3), 251-256.
Publication
Researcher Affiliations
- William R. Pritchard Veterinary Medical Teaching Hospital (Pye, Roy), Department of Surgical and Radiological Sciences (Kilcoyne, Vaughan, Spriet), School of Veterinary Medicine, University of California at Davis, One Shields Avenue, Davis, California 95616, USA; Oak Hill Veterinary Services, PO Box 898, Orinda, California 94563, USA (Ormond).
- William R. Pritchard Veterinary Medical Teaching Hospital (Pye, Roy), Department of Surgical and Radiological Sciences (Kilcoyne, Vaughan, Spriet), School of Veterinary Medicine, University of California at Davis, One Shields Avenue, Davis, California 95616, USA; Oak Hill Veterinary Services, PO Box 898, Orinda, California 94563, USA (Ormond).
- William R. Pritchard Veterinary Medical Teaching Hospital (Pye, Roy), Department of Surgical and Radiological Sciences (Kilcoyne, Vaughan, Spriet), School of Veterinary Medicine, University of California at Davis, One Shields Avenue, Davis, California 95616, USA; Oak Hill Veterinary Services, PO Box 898, Orinda, California 94563, USA (Ormond).
- William R. Pritchard Veterinary Medical Teaching Hospital (Pye, Roy), Department of Surgical and Radiological Sciences (Kilcoyne, Vaughan, Spriet), School of Veterinary Medicine, University of California at Davis, One Shields Avenue, Davis, California 95616, USA; Oak Hill Veterinary Services, PO Box 898, Orinda, California 94563, USA (Ormond).
- William R. Pritchard Veterinary Medical Teaching Hospital (Pye, Roy), Department of Surgical and Radiological Sciences (Kilcoyne, Vaughan, Spriet), School of Veterinary Medicine, University of California at Davis, One Shields Avenue, Davis, California 95616, USA; Oak Hill Veterinary Services, PO Box 898, Orinda, California 94563, USA (Ormond).
- William R. Pritchard Veterinary Medical Teaching Hospital (Pye, Roy), Department of Surgical and Radiological Sciences (Kilcoyne, Vaughan, Spriet), School of Veterinary Medicine, University of California at Davis, One Shields Avenue, Davis, California 95616, USA; Oak Hill Veterinary Services, PO Box 898, Orinda, California 94563, USA (Ormond).
MeSH Terms
- Animals
- Fractures, Bone / veterinary
- Horse Diseases
- Horses
- Lung Neoplasms / veterinary
- Male
- Scapula
- Tomography, X-Ray Computed
- Ultrasonography
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