Thoracoscopic pericardiectomy associated with fully implantable catheter via thoracoscopy in the management of mesothelioma in a bitch

Our plain-English summary of Thoracoscopic pericardiectomy associated with fully implantable catheter via thoracoscopy in the management of mesothelioma in a bitch, by H.F. Hartmann, M.T. DE Oliveira, J.P.S. Feranti, et al (The Journal of Veterinary Medical Science, 2019).

The study

• Authors: H.F. Hartmann, M.T. DE Oliveira, J.P.S. Feranti, G.P. Coradini, S.L. Abati, B.Z. Pierezan, V.Z. Sarturi, M.T. Linhares, Á.J.C. Silva, F.M. Sánchez-Margallo, A.S. DO Amaral, M.V. Brun
• Journal: The Journal of Veterinary Medical Science
• Published: 2019;81(6):946-948
• Type of article: Case report
• Cited by: 5 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Mesothelioma is a very aggressive malignant tumor with low survival rates that is often diagnosed belatedly. Pericardial effusion is a common consequence in cases of mesothelioma, with pericardiocentesis and pericardiectomy indicated; therefor thoracocentesis is necessary to drain the contents no longer retained in the pericardium. The present report describes a mesothelioma-carrying dog with a history of cardiac tamponade that underwent thoracoscopic pericardiectomy and, later, thoracoscopic implantation of a fully implantable catheter to function as a thoracic drain. In the consulted literature, there is no use of a fully implantable catheter for this purpose. The authors consider that there was an improvement in the quality of life.

In plain English

This case report describes one dog, a 13-year-old female, treated for mesothelioma. It does not mention asbestos or any other cause of the tumor. The dog first had breathing difficulty and lethargy. Fluid around the heart was drained three times (220, 440 and 295 ml); the second sample suggested cancer. On day 27, surgeons removed part of the sac around the heart using keyhole chest surgery (thoracoscopy). Biopsies confirmed mesothelioma in the pericardium, a growth on the heart surface and the pleura. The dog then received carboplatin chemotherapy. Fluid built up in the chest by day 121. On day 167 a catheter with a port under the skin was implanted, allowing drainage about every seven days. Tumor tissue blocked it 90 days later, and a second catheter was placed. On day 333 the dog showed signs compatible with aortic thromboembolism and was euthanized; necropsy was not authorized. Total survival was 332 days from first care. The authors concluded that the case demonstrates a new possibility for managing fluid-producing chest tumors in dogs not responsive to clinical treatment.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: case report (single dog, veterinary surgery note)
• Who was studied: One 13-year-old female dog. The article does not state the place or dates of treatment; the authors are affiliated with institutions in Brazil, Spain and Nicaragua.
• Exposure: The article reports no asbestos or other exposure. It describes treatment: thoracoscopic partial pericardiectomy, carboplatin and doxorubicin chemotherapy, and fully implantable catheters used as chest drains.
• Main results:
  • The first drainage of fluid from around the heart removed 220 ml of bloody fluid.
  • The second drainage removed 440 ml, and analysis of this fluid suggested neoplasia.
  • A third drainage on day 23 removed 295 ml.
  • Ultrasound did not detect the tumor in this dog.
  • Histology confirmed mesothelioma in the pericardium, in the growth on the heart surface (epicardial neoformation) and in the pleural biopsies.
  • Carboplatin chemotherapy began on day 37; six sessions were given.
  • Fluid in the chest (pleural effusion) caused breathing difficulty, after which weekly chest drainage began.
  • On day 167 a fully implantable 6 Fr catheter was placed as a chest drain.
  • Drainage continued about every seven days through the port under the skin; the authors described this as more comfortable for the animal.
  • A second course of chemotherapy, alternating carboplatin and doxorubicin, was stopped after two sessions at the owners' request.
  • The first catheter became blocked 90 days after implantation, on day 287, by tumor tissue; a second catheter (9 Fr) was then placed.
  • The blockage was caused by tumor tissue, and the tumor had spread extensively.
  • On day 333 the dog showed signs compatible with aortic thromboembolism.
  • The dog was euthanized and the owners did not authorize a necropsy.
  • Total survival was 332 days from the first clinical visit.
• The authors' conclusion: The authors, together with the dog's owners, considered that the treatment gave the dog more time and better quality of life. The authors found no earlier record of a fully implantable catheter being used this way. They concluded that the case demonstrates a new possibility for managing fluid-producing chest tumors in dogs that do not respond to clinical treatment.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Lung cancer, Mesothelioma.

Medical terms in this study, explained in our Lexicon: Pericardiectomy, Thoracoscopy, Mesothelioma, Pericardial Effusion, Pericardiocentesis, Pericardium, Cardiac Tamponade, Quality of Life.

Related studies

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• Pericardiectomy for treatment of neoplastic constrictive pericarditis — F. Buyukbayrak, E. Aksoy, et al. (2014)
• Pericardial malignant mesothelioma diagnosed in a dog by immunocytochemistry of the pericardial fluid: a case report — E.W. Choi (2023)
• MesoTRAP: a feasibility study that includes a pilot clinical trial comparing video-assisted thoracoscopic partial pleurectomy decortication with indwelling pleural catheter in patients with trapped lung due to malignant pleural mesothelioma designed to address recruitment and randomisation uncertainties and sample size requirements for a phase III trial — C. Matthews, C. Freeman, et al. (2019)
• Medical thoracoscopic talc pleurodesis for chylothorax due to lymphoma: a case series — D.C. Mares, P.N. Mathur (1998)
• Early and late morbidity and mortality and life expectancy following thoracoscopic talc insufflation for control of malignant pleural effusions: a review of 400 cases — N. Barbetakis, C. Asteriou, et al. (2010)

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