Stereotactic radiotherapy outcomes for intraventricular brain tumours in 11 dogs.

Published radiotherapy data for canine intraventricular tumours are limited. In this retrospective, longitudinal study (9/2011-2018), 11 dogs with intraventricular masses were treated with stereotactic radiotherapy (SRT). Pathologic diagnosis was available from surgery or necropsy in 6/11 cases, revealing choroid plexus papilloma (3) or carcinoma (2), and ependymoma (1). The remainder were magnetic resonance imaging (MRI)-diagnosed as suspected choroid tumours or ependymomas. Tumours were located in the third or lateral ventricle (8), fourth ventricle (2), and cerebellopontine angle (1). Surgery was performed in three dogs prior to radiotherapy, and all showed gross residual/recurrent disease at treatment. Dogs received 8 Gray × 3 fractions (7), or 15 Gray × 1 fraction (4). Ten dogs were deceased at analysis, and one was living. The estimated median overall survival time (OS) from first SRT treatment was 16.9 months (515 days, 95% CI 33-1593 days). The survival time for two pathology-diagnosed carcinoma dogs were 24 and 133 days, respectively, and survival time for dogs with moderate to marked ventriculomegaly (4/11) ranged from 24 to 113 days. A total of 10/11 showed clinical improvement per owner or clinician, but two had short-lived benefits and were euthanized within 6 weeks of SRT. Limited conclusions on radiation-specific complications are possible due to the small dataset and limited follow-up imaging. This study provides preliminary evidence that radiotherapy outcomes are variable with intraventricular tumours, and some long-term survivors are noted.

Solitary intraventricular tumors in dogs and cats treated with radiotherapy alone or combined with ventriculoperitoneal shunts: A retrospective descriptive case series.

BACKGROUND: Intraventricular tumors are rare, optimal treatment is not defined. Symptomatic patients often exhibit life-threatening hydrocephalus. With several months time-to-effect after radiotherapy (RT), increased intracranial pressure is concerning. This increase in pressure can be overcome by ventriculoperitoneal shunting (VPS). OBJECTIVES: Retrospective evaluation of outcome and complications in dogs and cats with intracranial tumors treated with either RT or VPS/RT. ANIMALS: Twelve client-owned cats and dogs. METHODS: Dogs and cats with symptomatic intraventricular tumors treated with definitive-intent RT or VPS/RT were included in a retrospective, descriptive case series. Complications, tumor volume evolution, time-to-progression, and survival time were determined. RESULTS: Twelve animals were included: 1 cat and 5 dogs treated with single-modality RT and 4 cats and 2 dogs treated with VPS/RT. Neurological worsening seen in 4/6 animals during single-modality RT and 2/6 died during RT (suspected brain herniation). All dogs with VPS normalized clinically by the end of RT or earlier. Complications occurred in 4/6 animals, all but 1 were successfully managed surgically. Imaging follow-up in 8 animals surviving RT showed a marked decrease in tumor volume. Median survival time was 162 days (95% confidence interval [CI]: 16; infinity) for animals treated with RT and 1103 days (95%CI: 752; infinity) for animals treated with VPS/RT. Median time-to-progression was 71 days (95%CI: 7; infinity) and 895 days (95%CI: 704; infinity) for each group, respectively. Two dogs died because of intraventricular metastasis 427 and 461 days after single-modality RT. CONCLUSIONS AND CLINICAL IMPORTANCE: Ventriculoperitoneal shunting led to rapid normalization of neurological signs and RT had a measurable effect on tumor volume. Combination of VPS/RT seems to be beneficial.

IMAGING DIAGNOSIS -ANTEMORTEM DETECTION OF OLIGODENDROGLIOMA "CEREBROSPINAL FLUID DROP METASTASES" IN A DOG BY SERIAL MAGNETIC RESONANCE IMAGING.

An English Bulldog underwent radiation therapy of an intracranial, left lateral ventricle mass. Following resolution of the primary mass, an intraventricular fourth ventricle lesion developed. Subsequently, multiple lesions developed from the cervical central canal and leptomeninges. Serial magnetic resonance imaging documented the propagation of lesions along the cerebrospinal fluid (CSF) pathways, known as "CSF drop metastasis." Histopathology confirmed multifocal intraventricular and leptomeningeal oligodendroglioma. Oligodendroglioma should be included in the differential diagnosis for an intraventricular tumor exhibiting apparent CSF drop metastasis.

MAGNETIC RESONANCE IMAGING FEATURES OF INTRAVENTRICULAR EPENDYMOMAS IN Five CATS.

Intraventricular ependymoma is a rare type of feline intracranial neoplasia and published information on magnetic resonance imaging (MRI) characteristics is currently lacking. The purpose of this retrospective case series study was to describe the clinical and MRI characteristics of histopathologically confirmed intraventricular ependymomas in a group of cats. Five cats met inclusion criteria. In relation to normal gray matter, ependymomas appeared hyperintense on T2W, T2W-FLAIR, PD, and DW-EPI images; isointense on ADC images; and had subtle to strong contrast enhancement. Some variability was seen on T2*GRE and on T1W images with masses being isointense to hyperintense. Four ependymomas were small and homogeneous, and one was centrally cavitated. All cats had obstructive hydrocephalus, transtentorial herniation, and foramen magnum herniation. Perilesional edema was identified in most cats but was questionable in one. Intraventricular ependymoma should be considered as a differential diagnosis for cats with this combination of MRI signs.

Glioblastoma with oligodendroglioma component in a ewe.

Herein we describe a glioblastoma partially occupying the telencephalic portion of the left cerebral hemisphere of a Sardinian (syn. Sarda) breed ewe. Microscopically, the mass consisted of a pleomorphic spindle-shaped cell component organized as bundles and numerous small areas of round cells displaying an oligodendroglioma-like aspect. A high number of mitotic figures, large areas of necrosis surrounded by pseudopalisading glial cells, and multiple foci of dystrophic mineralization were also observed. The neoplasm was highly vascularized with glomerular vascular proliferation. Immunohistochemically, neoplastic cells proved to be strongly positive for nestin, vimentin, and olig-2, whereas they were invariably negative for synaptophysin. Few neoplastic cells and reactive astrocytes, mainly located at the edge of necrotic foci, proved to be positive for glial fibrillary acidic protein, whereas glomerular vascular proliferation was clearly positive for factor VIII and vascular endothelial growth factor. Gene sequencing analysis demonstrated homozygous p53 tumor suppressor gene (TP53) point mutations in the DNA-binding domain located in exon 8. The presence of round cells immunoreactive for olig-2 demonstrated that this tumor is a glioblastoma with oligodendroglioma component. Our pathologic, immunohistochemical, and molecular findings largely overlap those previously reported in humans and dogs.

Cerebral oligodendroglioma mimicking intraventricular neoplasia in three dogs.

Oligodendroglioma is one of the most common primary central nervous system neoplasms of dogs. It is often diagnosed in older, brachycephalic breeds, and although its typical clinical features and neuroanatomic location have been well described, less common presentations may hinder its diagnosis. We describe 3 cases of canine cerebral oligodendroglioma that clinically and grossly present as intraventricular tumors. Histologic findings in all cases were typical of oligodendroglioma. Neoplastic cells were uniformly immunoreactive for Olig2 and negative for neuron-specific enolase, neurofilament, and glial fibrillary acidic protein. In addition to the immunopositivity for Olig2, a cluster of morphologically distinct neoplastic cells in one of the cases was immunoreactive for synaptophysin, and the case was diagnosed as an oligodendroglioma with neurocytic differentiation. Based on these findings, oligodendroglioma should be included as a differential diagnosis for intraventricular neoplasia in dogs. Furthermore, oligodendroglioma with ventricular involvement should be differentiated from central neurocytoma by immunohistochemistry.

Ventricular and extraventricular ependymal tumors in 18 cats.

Ependymal tumors are reported rarely in domestic animals. The aims of this study were to examine the clinical and pathologic features of ventricular and extraventricular ependymomas and subependymomas in 18 domestic cats examined between 1978 and 2011. Parameters examined included age, sex, breed, clinical signs, and macroscopic and histopathologic features. The mean age of affected cats was 9 years, 4 months; median age, 8.5 years. There were 8 female and 4 male cats, and 6 cats for which sex was not recorded. Breeds included 10 domestic shorthaired, 2 domestic longhaired, 1 Persian, and 1 Siamese. Clinical signs included altered mentation or behavior, seizures, circling, propulsive gait, generalized discomfort, and loss of condition. The tumors often formed intraventricular masses and usually arose from the lining of the lateral or third ventricles, followed by the fourth ventricle, mesencephalic aqueduct, and spinal cord central canal. Three tumors were extraventricular, forming masses within the cerebrum and adjacent subarachnoid space. Histologically, 15 tumors were classified as variants of ependymomas (classic, papillary, tanycytic, or clear cell) and 3 as subependymomas. Tumors were generally well demarcated; however, 6 ependymomas focally or extensively infiltrated the adjacent neural parenchyma. Characteristic perivascular pseudorosettes were observed in all ependymomas; true rosettes were less common. Some tumors had areas of necrosis, mineralization, cholesterol clefts, and/or hemorrhage. This cohort study of feline ependymal tumors includes subependymoma and primary extraventricular ependymoma, variants not previously described in the veterinary literature but well recognized in humans.

Ventricular ependymoma in a German Shepherd dog.

Using magnetic resonance imaging (MRI) together with clinical, pathomorphological and immunohistological methods, a ependymoma is described in a 9-year-old German Shepherd dog, which presented with behavioural and oculocephalic responses and generalised ataxia. The ependymoma, 9 x 6 x 5mm in size, was localised intra-axially in the right interventricular foramen and hydrocephalus was observed by MRI. Microscopically, the tumour was composed of pseudorosettes, and immunohistochemical examination revealed vimentin and glial fibrillary acidic protein immunoreactivity in the neoplastic cells.

Oligodendroglioma in a French bulldog.

A 5-year-old, male French bulldog with bradycardia, dyspnea, and decerebrate rigidity was necropsied. Macroscopic findings were restricted to the brain, and a single mass, 1.5 x 2.0 x 1.5 cm in size, was observed mainly at the right cingulum with prominently protruding into the dilated right lateral ventricle. The mass was grayish white in color, soft and gelatinous, but not clearly delineated. Microscopically, the mass consisted of diffuse proliferated neoplastic oligodendroglial cells characterized by small, round, and hyperchromatic nuclei with clear cytoplasm and the cells aggressively invaded into the adjacent parenchyma. Immunohistochemistry demonstrated that most of the neoplastic cells were positive for S-100 protein, vimentin, neuron specific enolase (NSE), and neurofilament protein (NFP). From these findings, the mass was diagnosed as oligodendroglioma.

Surgical removal of an ependymoma from the third ventricle of a cat.

A 10-year-old spayed domestic shorthaired cat was presented for behavioural changes, signs suggestive of visual deficits and aimless circling. Neuro-ophthalmological examination suggested the cat had central blindness. CT scans following administration of iohexol demonstrated a contrast-enhancing mass in the vicinity of the third ventricle resulting in obstructive hydrocephalus. Following rostral tentorial craniotomy and incision through the cerebral cortex, the third ventricle was approached via the dilated left lateral ventricle. An ependymoma was seen through a dorsocaudolateral incision into the third ventricle, and removed by gentle manipulation and suction. The cat recovered unremarkably, regaining normal vision and behaviour.

Histological characterization of an ependymoma in the fourth ventricle of a cat.

A tumour occupying the fourth ventricle in a 3-year-old cat was removed surgically and characterized as a tanycytic ependymoma on the basis of histological features of low cellularity, inconspicuous perivascular pseudorosettes and fascicular architecture. Immunohistochemical analysis of sections revealed that the neoplastic cells were immunoreactive for glial fibrillary acidic protein (GFAP), vimentin and S-100. The histological and immunohistochemical findings were similar to those of human tanycytic ependymoma, a subclassification of ependymoma not previously described in domestic species.

Polyclonal lymphoid tumor of the choroid plexus presenting as an intraventricular mass in a young gorilla.

An unusual lymphoid lesion with reactive germinal centers, occurring in the choroid plexus of a young gorilla, is reported. It presented as a large mass in the lateral ventricle with hydrocephalus and neurological symptoms. A work-up did not reveal any underlying cause for this lesion. No similar lesion of the choroid plexus has been reported in either human or veterinary literature. Histological work-up, including flow cytometry, gene rearrangement studies and T and B cell markers, favored the lesion being a non-neoplastic lymphoid proliferation of unknown etiology. The prognosis is unknown, although, following complete removal, the animal is well and free of tumor at the time of this report.

Epithelioma of the fourth ventricle in a goat.

We describe an epithelial neoplasm arising from the fourth ventricle of a goat and extending into the subjacent cerebellum along the spaces of Virchow-Robin. The neoplastic cells are consistent with squamous epithelium based upon light microscopic morphology and cytokeratin immunoreactivity. The lack of overt keratin formation and the lack of an exophytic component distinguishes this neoplasm from intracranial epidermoid cysts, resulting in the classification of this caprine tumor as an epithelioma.

Choroid plexus carcinoma in a dog.

Choroid plexus carcinoma was diagnosed in a 5-year-old female mixed breed dog which was euthanized due to progressive neurologic disease. Diagnosis of the tumour was based on gross and light microscopic findings following a complete necropsy. The chemical staining patterns in the case are compared with human choroid plexus tumours. The criteria for the distinction between benign and malignant variants of choroid plexus tumours are discussed.

A histologic and immunocytochemical study of choroid plexus tumors of the dog.

Sixteen choroid plexus (CP) tumors in 12 male and four female adult dogs were analyzed microscopically. Tumors were in the lateral (six), third (six), and fourth (four) ventricles. The average age of the dogs was 6 years. Tumors were classified by the following criteria: 1) choroid plexus papilloma (CPP), which resembled normal choroid plexus and had low mitotic activity; 2) choroid plexus papilloma (CPP), which resembled normal choroid plexus and had low mitotic activity; 2) choroid plexus papilloma with atypical features (atypical CPP), which had increased cellular density, nuclear atypia, two to four mitoses per 40x microscopic field, necrosis, and infiltration of the brain parenchyma and/or leptomeninges; and 3) choroid plexus carcinoma (CPC), which had marked nuclear atypia, poorly formed papillae, greater than four mitoses per 40x microscopic field, abnormal mitotic figures, and/or extraneural metastasis. The 16 tumors were classified either as CPP or atypical CPP (none as CPC). Statistically significant associations between brain infiltration and necrosis and atypical CPP were identified. Immunohistochemical studies in 11 tumors demonstrated staining for keratin in three tumors, two of which also reacted with carcinoembryonic antigen (CEA). There was no immunoreactivity with glial fibrillary acidic protein or epithelial membrane antigen. Choroid plexus from one of three control dogs stained focally for cytokeratin only. It is concluded that normal choroid plexus and CP tumors in the dog express epithelial, but not glial differentiation.

Ependymoma in a rat.

Pathological examination was performed on a male 196-day-old Sprague-Dawley rat with hindrance of the motility. A tumor was found to locate in the right lateral ventricle. It was poorly demarcated, and was reddish gray in color. The tumor cells were pleomorphic, fusiform or polygonal in shape and varied in size, sometimes with formation of pseudorosettes. The tumor was diagnosed as ependymoma.

Computed tomographic characteristics of primary brain tumors in 50 dogs.

Fifty histologically identified primary brain tumors in the dog were analyzed by computed tomography to establish criteria for identifying tumor types by computed tomography characteristics. Meningiomas could be distinguished from tumors within the brain parenchyma because they usually were broad-based, peripherally located masses that were enhanced homogeneously with contrast material. Among parenchymal tumors, astrocytomas were not distinguished easily from oligodendrogliomas because both tumors had similar features of ring-like and nonuniform enhancement, and poorly defined tumor margins. Choroid plexus tumors were seen as well-defined, hyperdense masses that had marked, uniform contrast enhancement. Pituitary tumors were distinguished readily by their location, minimal peritumoral edema, uniform contrast enhancement, and well-defined margins. Distinguishing features of other less frequently seen tumors (ependymoma, primitive neuroectodermal tumor, glioma, and neoplastic reticulosis) were not identified.