Primary Uterine Hemangiosarcoma in a Thoroughbred: A Case Report.
Authors: Segabinazzi Lorenzo G T M, Apolonio Emanuel V P, Tongu Eriky A, Paccola Walnei, Vianna Denise, Fonseca-Alves Carlos E, Alvarenga Marco A
Journal: Journal of equine veterinary science
Summary
# Editorial Summary: Primary Uterine Hemangiosarcoma in a Thoroughbred Haemangiosarcoma of the uterus represents an extraordinarily rare neoplasm in mares, with this 2021 case report documenting the first documented occurrence in an equine patient—a 1.8-year-old maiden Thoroughbred presenting with sanguineous vaginal discharge and acute abdominal pain. Transrectal ultrasonography proved diagnostically valuable, identifying an 8.3 cm heterogeneous mass adjacent to the cervix with characteristic trabeculated architecture and hyperechoic margins, alongside smaller satellite lesions; the diagnosis was confirmed through histological and immunohistochemical analysis (CD31 and Factor VIII immunostaining) of tissue spontaneously expelled through the vulva and subsequently removed via hysterectomy. Although the surgical specimen confirmed primary uterine origin—with necropsy revealing no secondary neoplasms—the mare developed fatal postoperative complications (intestinal adhesions at the incision site) and required euthanasia within two weeks. For equine practitioners, this case underscores the diagnostic challenge posed by uncommon reproductive neoplasms in young, non-breeding stock and highlights both the clinical utility of transrectal ultrasound in identifying uterine pathology and the substantial perioperative risks associated with hysterectomy, even when primary diagnosis is successfully managed.
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Practical Takeaways
- •Young mares with unexplained hemorrhagic vaginal discharge and severe abdominal pain warrant immediate transrectal ultrasound examination to rule out uterine neoplasia
- •Hemangiosarcoma should be added to the differential diagnosis list for uterine masses in equines, though this remains an extremely rare condition
- •Surgical management of uterine hemangiosarcoma carries significant postoperative complication risk; careful perioperative monitoring and adhesion prevention strategies are critical
Key Findings
- •First documented case of primary uterine hemangiosarcoma in an equine species
- •1.8-year-old maiden filly presented with sanguineous vaginal discharge and severe abdominal pain
- •Transrectal ultrasonography identified an 8.3 cm heterogeneous mass near the cervix with smaller surrounding masses
- •Histological and immunohistochemical examination (CD31 and Factor VIII positive) confirmed hemangiosarcoma diagnosis
- •Therapeutic hysterectomy was performed but mare died 2 weeks later from postoperative intestinal adhesions