Meningiomas intracranianos no cão
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2017-10-09
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O meningioma é o tumor intracraniano mais comum no cão. Esse tipo de neoplasia é extra-axial, mas pode invadir diretamente o tecido nervoso. Os principais subtipos histológicos são o meningotelial, transicional, fibroblástico, psamomatoso, angiomatoso, microcístico, cordóide, atípico, maligno e papilar. Os sinais clínicos irão depender da localização da lesão. O objetivo desse estudo é relatar dois casos clínicos de meningiomas intracranianos. No primeiro caso clínico, o cão encontrava-se deprimido com andar em círculos, inclinação de cabeça, deficit em reação a ameaça, reflexo pupilar, resposta oculovestibular e proprioceção. O exame de tomografia computadorizada mostrou massa no diencéfalo e mesencéfalo direitos, edema vasogénico e assimetria dos ventrículos laterais. Esse animal foi tratado com terapia paliativa. Após 30 dias, desde a primeira consulta, sem melhora clínica, foi indicada a eutanásia. O exame histopatológico diagnosticou um meningioma meningotelial no diencéfalo mesencéfalo direitos. O segundo caso clínico tratava-se de um a cão com marcha em círculos, inclinação de cabeça, nistagmo, déficit no reflexo corneal, palpebral e proprioceção, assimetria facial e atrofia dos músculos temporal e masséter. O exame de ressonância magnética mostrou massa em ângulo cerebelopontino direito. Foi iniciado quimioterapia (Hidroxiureia, 30 mg/kg, PO, três vezes na semana) e tratamento paliativo. Após aproximadamente três meses e meio de tratamento, o animal apresentou piora neurológica e foi indicada a eutanásia. O exame histopatológico diagnosticou um meningioma transicional entre o cerebelo e a ponte no lado direito. Os exames neurológicos assim como os de imagem foram fundamentais no diagnóstico presuntivo. Os exames histopatológicos revelaram subtipos de meningiomas comuns no cão. A localização dos tumores dos dois animais indicou um prognóstico reservado. O cão tratado com quimioterapia teve um tempo de sobrevida ligeiramente melhor que o animal tratado somente com terapia paliativa.
Meningioma is the most common intracranial tumour in the dog. This neoplasm is extra-axial, but it can affect directly the nervous tissue. The most important histological subtypes are meningothelial, transitional, fibrous, psammomatous, angiomatous, microcystic, chordoid, atypical, malignant, and papillary. Clinical signs depend on the location of the tumour. The aim of this study is to report two clinical cases of intracranial meningiomas. In the first case report, the dog was depressed, had circling, head tilt, deficit in menace response, pupillary light reflex, oculocephalic response, and proprioceptive positioning. Computed tomography findings showed a mass in the right side of the diencephalon and midbrain, vasogenic edema, and asymmetric lateral ventricles. This dog received palliative therapy. After 30 days from the first appointment, dog had no neurological improvement, so the euthanasia was suggested. On histopathological examination, the meningioma was the meningothelial subtype in the right diencephalon and midbrain. In the second case report, the dos had circling, head tilt, nystagmus, deficit in the corneal reflex, palpebral reflex, and proprioceptive positioning, facial asymmetry, temporal and masseter muscles atrophy. Magnetic resonance imaging showed a mass in the right side of the cerebellopontine angle. The dog was treated with chemotherapy (Hydroxyurea, 30 mg / kg, PO, three times a week) and palliative treatment. After about three and a half months of treatment, the dog had neurological worsening, so the euthanasia suggested. On histopathological examination, the meningioma was the transitional subtype founded between right side of the cerebellum and the pons. Neurological and imaging features were important in the presumptive diagnosis. The histopathological examination diagnosed common subtypes of meningiomas in the dog. The two dogs had reserved prognosis, correlated with the neuroanatomical location of the tumours. The dog treated with chemotherapy had a little better survival time than the dog treated only with palliative therapy.
Meningioma is the most common intracranial tumour in the dog. This neoplasm is extra-axial, but it can affect directly the nervous tissue. The most important histological subtypes are meningothelial, transitional, fibrous, psammomatous, angiomatous, microcystic, chordoid, atypical, malignant, and papillary. Clinical signs depend on the location of the tumour. The aim of this study is to report two clinical cases of intracranial meningiomas. In the first case report, the dog was depressed, had circling, head tilt, deficit in menace response, pupillary light reflex, oculocephalic response, and proprioceptive positioning. Computed tomography findings showed a mass in the right side of the diencephalon and midbrain, vasogenic edema, and asymmetric lateral ventricles. This dog received palliative therapy. After 30 days from the first appointment, dog had no neurological improvement, so the euthanasia was suggested. On histopathological examination, the meningioma was the meningothelial subtype in the right diencephalon and midbrain. In the second case report, the dos had circling, head tilt, nystagmus, deficit in the corneal reflex, palpebral reflex, and proprioceptive positioning, facial asymmetry, temporal and masseter muscles atrophy. Magnetic resonance imaging showed a mass in the right side of the cerebellopontine angle. The dog was treated with chemotherapy (Hydroxyurea, 30 mg / kg, PO, three times a week) and palliative treatment. After about three and a half months of treatment, the dog had neurological worsening, so the euthanasia suggested. On histopathological examination, the meningioma was the transitional subtype founded between right side of the cerebellum and the pons. Neurological and imaging features were important in the presumptive diagnosis. The histopathological examination diagnosed common subtypes of meningiomas in the dog. The two dogs had reserved prognosis, correlated with the neuroanatomical location of the tumours. The dog treated with chemotherapy had a little better survival time than the dog treated only with palliative therapy.
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Dissertação de Mestrado Integrado em Medicina Veterinária
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Neoplasias meníngeas , Encéfalo , Cão