Can Blood Biomarkers Differentiate Between Hemangioma and Hemangiosarcoma?

Hemangiosarcoma (HSA) and hemangioma (HMA) are both tumors that develop in canines from blood vessel cells. As similar as these two are in specifics, hemangiosarcoma develops as an aggressive cancer that tends to spread quickly, while hemangioma is critical but benign in composition and doesn't extend to other regions.

A definitive diagnosis of HSA requires testing steps that the nature of the disease can complicate. Histopathology through tissue sampling techniques may lead to uncontrolled bleeding; visceral hemangiosarcoma can be life-threatening when producing a state of emergency that leads to surgery, and the blood-filled tumors often rupture on their own and can lead to hemorrhagic shock even before a proper diagnosis. Additionally, these tumors can cause complex blood clotting issues that can lead to multiple organ failure. 

Early detection of both neoplasms remains challenging due to the lack of specific diagnosis tests, while thorough laboratory screenings are currently limited. This retrospective study used a noninvasive and affordable routine blood test as a practical specimen to enquire into general signals, anatomic locations, and clinicopathological abnormalities of dogs to try conceiving predictive models for the early detection of these canine vascular growths. 

Using medical records from Chulalongkorn University's Small Animal Hospital between 2017 and 2023, this study's findings differs from others on the subject of breed, as they spotted a high prevalence of both HMA and HSA in mix-breed dogs compared to Golden Retrievers, Boxers, and German Shepherds. They note that a rising population of mixed-breed dogs in the surveyed regions may influence results. Age difference, on the other hand, agreed with previous studies that indicated a higher risk of vascular tumors in dogs around 10 or 12 years old without a predisposition to a particular sex.  

Hemangiomas presented approximately 73% of all skin tumors observed, against 27% diagnosed with cutaneous hemangiosarcoma. Spleen hemangiosarcoma had the highest prevalence of diagnoses, again aligning with other studies that recognize the organ as the frequent primary site of said tumors; on the contrary, they remark that cardiac hemangiosarcoma wasn't observed in the diagnostics, being almost impossible to diagnose antemortem. Additionally, other visceral HSAs identified could be indicative of metastatic disease originating from cardiac HSA. 

The study remarked on the connection between canine vascular neoplasms and anemia. They saw that anemia defined by low RBC count and lymphopenia (lack of white blood cells) was associated with a diagnosis of HMA, whereas anemia by low hemoglobin concentration with lymphopenia and hyperfibrinogenemia (an abnormally high level of fibrinogen in the blood) was associated with a diagnosis of HSA.  

While the abnormalities the data found could correspond to various chronic diseases, and research was limited in information on disease stage or symptoms at diagnosis to interpret laboratory findings as predictive tools, the study did give a better insight on some values to look at when trying to define if a tumor is benign or cancerous, suggesting that future research should integrate additional specific biomarkers and establish cutoff values to enhance the accuracy of vascular tumor diagnosis.