Histiocytic sarcoma – a malignant tumor

Behind this complicated name lies an aggressive form of cancer in dogs, also known as malignant histiocytosis. This hereditary condition occurs primarily in Bernese Mountain Dogs, Retrievers, and Rottweilers. In Bernese Mountain Dogs, it is the leading cause of death. It primarily affects male dogs between the ages of two and eight. The disease is relatively rare in other dog breeds.

INHALT
Causes, Development, and Classification Symptoms Diagnosis Treatment Forecast Prevention
Causes, Development, and Classification

Histiocytes are cells of the immune system that are found primarily in connective tissue, but also in all other organs; as phagocytes, they engulf and break down microorganisms, cellular debris, and dead cells. A mutation leads to a pathological proliferation of the degenerated cells in one or more organs. There is a marked tendency toward metastasis (=formation of secondary tumors). The secondary tumors spread rapidly and, due to their invasive growth, cause severe organ damage and ultimately lead to the dog’s death.

The cause of the degeneration is currently unknown. However, a genetic predisposition has been identified in the Bernese Mountain Dog.

In terms of presentation, a distinction is made between whether the disease is localized as a cutaneous form or spreads throughout the entire organism as a disseminated form. Another particularly aggressive form is hemophagocytic (i.e., blood-eating) histiocytoma, which frequently affects the bone marrow. The tumor cells "eat" the red blood cells of the affected dog, causing the dog to develop anemia.

Symptoms

Since histiocytoma is a tumor of the hematopoietic system, virtually any organ in the body can be affected. In the disseminated form, the skin is usually not involved. In most cases, the lungs, liver, spleen, lymph nodes, and bone marrow are affected. Depending on the tumor’s location, the clinical presentation of the disease can therefore vary widely and be non-specific. Affected dogs typically exhibit nonspecific symptoms such as weakness, lethargy, loss of appetite, fever, and weight loss. If the lungs are involved, breathing difficulties and coughing may occur. In rare cases, ataxia (impaired coordination), paralysis, or epileptic seizures may also occur. The disseminated form progresses rapidly and, in most cases, leads to death within less than six months.

The cutaneous form manifests as nodules and plaques on the skin, with the nasal mucosa, conjunctiva of the eyes, and, in male dogs, the scrotum being particularly affected. The skin lesions often occur in episodes, are difficult to define, and tend to become ulcerated. The disease worsens with each episode and metastasizes particularly to the lymph nodes, spleen, and bone marrow.

In the case of hemophagocytic histiocytoma, the uptake of red blood cells by the tumor cells leads to anemia, resulting in pale mucous membranes and weakness. If you notice any such changes in your dog, please take him to your veterinarian immediately.

Diagnosis

Based on your preliminary report and a thorough clinical examination, your veterinarian will already have indications of a tumorous condition. Enlarged lymph nodes and swelling of the liver or spleen are usually present. Unfortunately, by the time symptoms appear, the disease is already quite advanced.

This initial suspicion can be further confirmed with an X-ray or ultrasound examination. However, X-rays or ultrasound images can only show enlargements. The exact type of tumor can only be determined by taking a tissue sample. In a procedure known as fine-needle aspiration, the tumor is punctured with a thin, long needle, and a cell sample is extracted. This sample is then examined in the laboratory. Based on the cell type and its changes, the nature of the tumor can be more precisely determined. However, depending on the tumor’s location—such as in the lungs—the procedure can only be performed at high risk to the patient and must therefore be carefully weighed. Diagnosis becomes more difficult for your veterinarian in the case of a hemophagocytic histiocytoma, as while enlarged livers and spleens can be detected on X-rays or ultrasound, no actual tumors are visible.

Treatment

There is no cure for this type of cancer. Treatment involves the use of chemotherapy drugs (agents designed to kill tumor cells) or radiation therapy. However, these treatments merely improve the dog’s quality of life and delay the progression of the disease. Surgical intervention is also rarely feasible or likely to be successful due to the location of the tumors. In cases of severe, treatment-resistant symptoms, such as severe shortness of breath caused by tumor masses in the lungs, the dog should be euthanized given the hopeless prospects for a cure (see article on Euthanasia).

Forecast

The prognosis for this aggressive form of cancer is generally poor. Despite a wide range of treatment options, a cure is not possible. Depending on the type of tumor, the type of treatment, and the dog’s response to treatment, life expectancy after diagnosis ranges from a few weeks to a few months.

Prevention

Since the cause of the cellular degeneration remains unknown, true prevention is not possible.

Due to the genetic predisposition of the Bernese Mountain Dog, a genetic test has been developed. This test provides breeders with information on the risk that their breeding dog will develop histiocytoma. This enables responsible breeders to avoid risky matings and thus reduce the incidence of the disease.