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research-article2017
JFM0010.1177/1098612X17736658Journal of Feline Medicine and SurgeryTamura et al
Letter to the Editor
Recurrence of spinal anaplastic
astrocytoma in a cat after surgical
treatment and long-term follow-up
Dear Editors,
We previously reported the case of a 10-year-old spayed
Chinchilla cat with spinal anaplastic astrocytoma.1 The
intramedullary tumour was removed surgically, and a
3.5 year follow-up revealed neither recurrence of clinical
signs nor a mass on MRI (Figure 1a,b). However, an
unexpected clinical course was observed subsequently.
The cat presented at our clinic with a sudden-onset
tetraplegic episode 4 years and 11 months after the
first surgery. Neurological examination revealed
non-ambulatory tetraparesis, absence of proprioception and normal-to-heightened spinal reflexes in all
four limbs, with all other neurological findings being
normal. Neuroanatomically, the tumour was suspected to be localised to the C1–C5 spinal cord segments. MRI revealed an elliptical intramedullary
mass at the C4 level (Figure 1c). The localisation and
signal intensities of this mass were identical to those
of the previously removed tumour.
A second surgery was performed with a surgical
microscope (OPMI PROergo; Carl Zeiss Meditec).
Following midline incision of the dura, the pial membrane and spinal cord were incised at the midline
because the mass was not visible through the dura, as
in the first surgery. The mass was dissected from the
parenchyma by using a combination of gentle traction and blunt dissection. The border between the
mass and spinal cord appeared clearly demarcated.
Journal of Feline Medicine and Surgery
1­–2
© The Author(s) 2017
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https://doi.org/10.1177/1098612X17736658
DOI: 10.1177/1098612X17736658
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This letter was handled and processed
by the European Editorial Office (ISFM)
for publication in JFMS
On the basis of histological findings, we diagnosed
the mass as anaplastic astrocytoma. The cat was
ambulatory 2 weeks after surgery with slight tetraparesis. Cutaneous itching, thought to be paresthesia
caused by surgical invasion to the dorsal funiculus,
developed after surgery, but was controlled with pregabalin (2 mg/kg twice daily [Lyrica; Pfizer]). The
cat developed seizures 4 months after the second surgery, and died following a seizure 8 months after the
second surgery (5 years and 7 months after the first
surgery, at the age of 16 years). Unfortunately, the
cause of death remains unknown because an autopsy
was not performed.
In the present case, a tumour of the same pathological type occurred at the same site 4 years and 11
months after surgical resection. Because anaplastic
astrocytoma is a malignant tumour with a highly invasive nature, it is reasonable to assume that the second
tumour was a recurrence, even though it appeared to
have been removed completely during the first surgery and had not recurred during the 3.5 year followup period. This clinical course suggests that an absence
of imaging findings of recurrence 3.5 years after spinal
anaplastic astrocytoma surgery does not necessarily
suggest that the surgery was curative. Although the
timing of recurrence of feline spinal tumours is unclear
because of the rarity of such cases, a long postoperative follow-up period is necessary for evaluating the
prognosis.
Figure 1 Midsagittal contrast-enhanced T1-weighted images obtained on (a) the first day of the original presentation,1 and
(b) 3.5 years1 and (c) 4 years 11 months after the first surgery. Similar large elliptical intramedullary masses can be observed
at the fourth cervical vertebrae on images (a) and (c)
Journal of Feline Medicine and Surgery
2
Acknowledgements We would like to thank Editage (www.
editage.com) for English-language editing and p
­ublication
support.
Shinji Tamura1, Yumiko Tamura1
and Kazuyuki Uchida2
Corresponding author:
Shinji Tamura DVM, PhD, Tamura Animal Clinic, 7-16,
Yoshimien, Saeki-ku, Hiroshima, Hiroshima 731-5132,
Japan
Email: cqx03426@ms8.megaegg.ne.jp
1Tamura
Reference
2Department
1 Tamura S, Hori Y, Tamura Y, et al. Long-term follow-up
of surgical treatment of spinal anaplastic astrocytoma in a
cat. J Feline Med Surg 2013; 15: 921–926.
Animal Clinic, Hiroshima, Japan
of Veterinary Pathology, Graduate
School of Agriculture and Life Science, The University
of Tokyo, Tokyo, Japan
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