Journal of Veterinary Clinics (한국임상수의학회지)

The Korean Society of Veterinary Clinics (한국임상수의학회)
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Surgical Resection and Polypropylene Mesh Reconstruction for Canine Chest Wall Soft Tissue Sarcoma

  • Youngsoo Hong (Department of Veterinary Medicine, College of Veterinary Medicine and Veterinary Medical Research Institute, Jeju National University) ;
  • Youngrok Song (Department of Veterinary Medicine, College of Veterinary Medicine and Veterinary Medical Research Institute, Jeju National University) ;
  • Woojin Song (Department of Veterinary Medicine, College of Veterinary Medicine and Veterinary Medical Research Institute, Jeju National University) ;
  • Myung-Chul Kim (Department of Veterinary Medicine, College of Veterinary Medicine and Veterinary Medical Research Institute, Jeju National University) ;
  • Joo-Myoung Lee (Department of Veterinary Medicine, College of Veterinary Medicine and Veterinary Medical Research Institute, Jeju National University) ;
  • Hyunjung Park (Department of Veterinary Medicine, College of Veterinary Medicine and Veterinary Medical Research Institute, Jeju National University) ;
  • Jiwhan Moon (Eastern Animal Hospital) ;
  • Jongtae Cheong (Department of Veterinary Medicine, College of Veterinary Medicine and Veterinary Medical Research Institute, Jeju National University)
  • Received : 2023.11.01
  • Accepted : 2024.01.29
  • Published : 2024.02.28
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Abstract

A 6-year-old spayed female French Bulldog presented with a left-sided chest wall tumor. Physical examination revealed that the tumor was firmly adhered to the chest wall. A preoperative punch biopsy of the tumor revealed a grade 2 soft tissue sarcoma (STS). On computed tomography, the tumor's dimensions were assessed as 6.5 × 5.7 × 3.5 cm, and it exhibited invasiveness near the tissue surrounding the ninth rib. The tumor size was large in comparison to the dog's chest wall area. Hence, if the traditional wide-margin resection surgery were to be performed, primary wound closure seemed impractical and could potentially result in respiratory function complications. Therefore, considering the extent of tumor invasion and grade, deep margins were established to include the removal of the eighth to tenth ribs, and a 1-cm lateral margin was designated to enable primary wound closure. To reconstruct the chest wall, polypropylene mesh was attached to the adjacent ribs and the remaining muscles were sutured and covered over the mesh. The dog exhibited a rapid recovery beginning the day after the operation. Postoperative biopsy confirmed that the tumor was a grade 2 STS, and the surgical margins were evaluated as incomplete. The owner chose to pursue follow-up observation instead of chemotherapy. In this study, the surgical approach was chosen based on the importance of functional recovery after surgery. Recent research indicates that the tumor grade is more critical for postoperative prognosis than the extent of surgical margins when removing an STS.

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References

  1. Baines SJ, Lewis S, White RA. Primary thoracic wall tumours of mesenchymal origin in dogs: a retrospective study of 46 cases. Vet Rec 2002; 150: 335-339. https://doi.org/10.1136/vr.150.11.335
  2. Banks T, Straw R, Thomson M, Powers B. Soft tissue sarcomas in dogs: a study assessing surgical margin, tumour grade and clinical outcome. Aust Vet Practit 2004; 34: 142-147.
  3. Bray JP, Polton GA, McSporran KD, Bridges J, Whitbread TM. Canine soft tissue sarcoma managed in first opinion practice: outcome in 350 cases. Vet Surg 2014; 43: 774-782. https://doi.org/10.1111/j.1532-950X.2014.12185.x
  4. Chase D, Bray J, Ide A, Polton G. Outcome following removal of canine spindle cell tumours in first opinion practice: 104 cases. J Small Anim Pract 2009; 50: 568-574. https://doi.org/10.1111/j.1748-5827.2009.00809.x
  5. Ehrhart N. Soft-tissue sarcomas in dogs: a review. J Am Anim Hosp Assoc 2005; 41: 241-246. https://doi.org/10.5326/0410241
  6. Ettinger SN. Principles of treatment for soft-tissue sarcomas in the dog. Clin Tech Small Anim Pract 2003; 18: 118-122. https://doi.org/10.1053/svms.2003.36628
  7. Graham J, Usher FC, Perry JL, Barkley HT. Marlex mesh as a prosthesis in the repair of thoracic wall defects. Ann Surg 1960; 151: 469-479. https://doi.org/10.1097/00000658-196004000-00005
  8. Harati K, Lehnhardt M. The changing paradigm of resection margins in sarcoma resection. Innov Surg Sci 2017; 2: 165-170. https://doi.org/10.1515/iss-2017-0043
  9. Hazel K, Weyant MJ. Chest wall resection and reconstruction: management of complications. Thorac Surg Clin 2015; 25: 517-521. https://doi.org/10.1016/j.thorsurg.2015.07.013
  10. Hughes R, Gao F. Pain control for thoracotomy. Contin Educ Anaesth Crit Care Pain 2005; 5: 56-60. https://doi.org/10.1093/bjaceaccp/mki014
  11. Johnston SA, Tobias KM. Veterinary surgery: small animal expert consult. 2nd ed. London: Elsevier Health Sciences. 2017: 2001-2019.
  12. Kudnig ST, Seguin B. Veterinary surgical oncology. 2nd ed. Ames: Wiley-Blackwell. 2022: 446-455.
  13. Liptak JM, Dernell WS, Rizzo SA, Monteith GJ, Kamstock DA, Withrow SJ. Reconstruction of chest wall defects after rib tumor resection: a comparison of autogenous, prosthetic, and composite techniques in 44 dogs. Vet Surg 2008; 37: 479-487. https://doi.org/10.1111/j.1532-950X.2008.00413.x
  14. Liptak JM, Kamstock DA, Dernell WS, Monteith GJ, Rizzo SA, Withrow SJ. Oncologic outcome after curative-intent treatment in 39 dogs with primary chest wall tumors (1992-2005). Vet Surg 2008; 37: 488-496. https://doi.org/10.1111/j.1532-950X.2008.00415.x
  15. Matthiesen DT, Clark GN, Orsher RJ, Pardo AO, Glennon J, Patnaik AK. En bloc resection of primary rib tumors in 40 dogs. Vet Surg 1992; 21: 201-204. https://doi.org/10.1111/j.1532-950X.1992.tb00046.x
  16. McSporran KD. Histologic grade predicts recurrence for marginally excised canine subcutaneous soft tissue sarcomas. Vet Pathol 2009; 46: 928-933. https://doi.org/10.1354/vp.08-VP-0277-M-FL
  17. Stefanello D, Morello E, Roccabianca P, Iussich S, Nassuato C, Martano M, et al. Marginal excision of low-grade spindle cell sarcoma of canine extremities: 35 dogs (1996-2006). Vet Surg 2008; 37: 461-465. https://doi.org/10.1111/j.1532-950X.2008.00408.x