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Hemangiomas And Hemangiosarcomas

Hemangiomas and hemangiosarcomas are tumors that arise from vascular endothelial cells and may develop on the skin or within the internal organs of chickens.

Hemangiomas are benign tumors that typically present as dark red to purple, soft, nodular masses ranging from 1 to 15 cm in size. These lesions are often blood-filled, friable, and resemble blood blisters on the skin or within the subcutaneous tissue. Because of their appearance, they can be mistaken for malignant melanomas and should be differentiated from arteriovenous fistulas, aneurysms, hematomas, and highly vascular granulation tissue. In chickens, hemangiomas have been associated with avian leukosis virus subgroup J (ALV-J).

Hemangiosarcomas are the malignant counterpart to hemangiomas. While they may appear similar to hemangiomas or hematomas, they are more aggressive and are often accompanied by ulceration and areas of necrosis. Chronic inflammation or repeated trauma may contribute to their development. These tumors carry a significant risk of rupture, which can result in severe blood loss, hypotensive shock, and death. Differential diagnoses include hemangiomas, hematomas, and other malignant tumors such as squamous cell carcinomas, fibrosarcomas, and melanomas.

Both tumor types may occur in the dermal or epidermal layers and can develop anywhere on the body, though they are most commonly found on the legs, feet, cloaca, neck, wings, and beak.
Hemangiomas found on chickens
Due to their fragile, vascular nature, they are prone to rupture and may cause life-threatening hemorrhage.

Treatment


Cutaneous hemangiomas are often successfully treated with surgical excision. Management of hemangiosarcomas typically involves surgical removal combined with radiation therapy and/or chemotherapy; however, recurrence is common and tumors may reappear within days to months. Supportive care includes protecting lesions from trauma to reduce the risk of rupture and bleeding.

Clinical Signs

Dark red to purple, soft, nodular mass
Subcutaneous swelling
Ulceration and necrosis

Diagnosis

  • Physical exam
  • CBC
  • Radiography
  • Histopathology
  • Immunohistochemistry (IHC) markers such as FVIII-related antigen (FVIII-RA) or CD31 may be used to confirm endothelial origin

Reported Cases

  • Case 1: Hemangiosarcoma in a Budgie. A swelling on the right metacarpal area of a male budgerigar was diagnosed as hemangiosarcoma. Diagnosis of this malignant endothelial tumor was based on gross and histopathologic findings. The bird was treated with local irradiation of the wing three times weekly for a total of 10 400-cGy fractions. The tumor completely regressed after local irradiation and the budgerigar tolerated the treatment well; however, the bird died 8 weeks later as a result of disseminated disease. Ref
    Primary tumor site: metacarpalSites of Metastases: none

  • Case 2: Hemangiosarcoma in a Parrot. A 25-year-old female orange-winged Amazon parrot presented for a 2-week history of straining to defecate, lethargy, open-beak breathing, decreased vocalization, and ruffled feathers. On physical examination, the parrot had a heart murmur, increased air sac and lung sounds, open-beak breathing, increased respiratory rate and effort, and coelomic distension. An ultrasound revealed intracoelomic fluid, and hemorrhagic fluid was aspirated from the coelom. Cytologic analysis indicated hemocoelom. Pericardial effusion was observed during the sonogram, and pericardiocentesis was performed. The bird was euthanatized upon the owner's request because of a poor prognosis. At necropsy, several masses that involved the ovary and oviduct were observed, as well as a thickened pericardium and a thickened, fibrinous epicardium. Results of a histopathologic examination of the masses that involved the reproductive tract revealed ovarian hemangiosarcoma, which was confirmed by immunohistochemical staining. Ref
    Primary tumor site: ovarySites of Metastases: none

  • Case 3: Hemangiosarcoma in a Pheasants. A 13-year-old male golden pheasant was examined for a hemorrhagic mass on the leading edge of the right propatagial area of 1 day's duration. Physical examination revealed a scabbed mass that bled easily when manipulated. Hemorrhage and cellulitis were observed from 2 incisional biopsies. The mass was removed under general anesthesia, and histopathology demonstrated a hemangiosarcoma. Assays on white blood cells for avian leukosis/sarcoma viruses, Marek disease viral serotypes 1, 2, and 3, and reticuloendotheliosis virus were negative. The bird recovered uneventfully, but the tumor recurred within 10 days after removal. Upon clinical deterioration 3 months later, the bird was euthanized. Ref
    Primary tumor site: propatagial areaSites of Metastases: none

  • Case 4: Hemangiosarcoma in a Parrotlet. A 2-month-old Pacific parrotlet was presented for assessment following a traumatic injury to the right wing that resulted in persistent swelling and inflammation. Six weeks postinjury the bird underwent surgical resection of a large hemorrhagic cavitated mass that had formed at the site of the original injury and a second, smaller mass on the body in direct contact with the wing mass. Histopathology of the wing mass confirmed a diagnosis of hemangiosarcoma. Ref
    Primary tumor site: wingSites of Metastases: none

  • Case 5: Hemangiosarcoma in a Parrot. A 13-year-old female double yellow-headed Amazon parrot was examined for respiratory distress and partial anorexia. Radiographs, ultrasonography, and computed tomography revealed a soft-tissue opacity in the right cranial coelom with a necrotic or fluid-filled center. Endoscopy was used to visualize the mass, collect diagnostic samples, and treat the patient by cyst ablation and fistula formation. The symptoms returned within weeks after each treatment, and the bird died 36 days after initial presentation. Gross and histopathologic examination revealed the mass was a hemangiosarcoma that was attached to the right internal carotid artery. Ref
    Primary tumor site: carotid arterySites of Metastases: none

  • Case 6: Hemangiosarcoma in a Budgie. A swelling on the right metacarpal area of a male budgerigar was diagnosed as hemangiosarcoma. Diagnosis of this malignant endothelial tumor was based on gross and histopathologic findings. The bird was treated with local irradiation of the wing three times weekly for a total of 10 400-cGy fractions. The tumor completely regressed after local irradiation and the budgerigar tolerated the treatment well; however, the bird died 8 weeks later as a result of disseminated disease. Ref
    Primary tumor site: metacarpalSites of Metastases: none

  • Case 7: Hemangiosarcoma in a Parrot. A 25-year-old intact female orange-winged Amazon parrot presented for a 2-week history of straining to defecate, lethargy, open-beak breathing, decreased vocalization, and ruffled feathers. On physical examination, the parrot had a heart murmur, increased air sac and lung sounds, open-beak breathing, increased respiratory rate and effort, and coelomic distension. An ultrasound revealed intracoelomic fluid, and hemorrhagic fluid was aspirated from the coelom. Cytologic analysis indicated hemocoelom. Pericardial effusion was observed during the sonogram, and pericardiocentesis was performed. The bird was euthanatized upon the owner's request because of a poor prognosis. At necropsy, several masses that involved the ovary and oviduct were observed, as well as a thickened pericardium and a thickened, fibrinous epicardium. Results of a histopathologic examination of the masses that involved the reproductive tract revealed ovarian hemangiosarcoma, which was confirmed by immunohistochemical staining. Ref
    Primary tumor site: ovarySites of Metastases: none

  • Case 8: Hemangiosarcoma in a Pheasant. A 13-year-old male golden pheasant was examined for a hemorrhagic mass on the leading edge of the right propatagial area of 1 day's duration. Physical examination revealed a scabbed mass that bled easily when manipulated. Hemorrhage and cellulitis were observed from 2 incisional biopsies. The mass was removed under general anesthesia, and histopathology demonstrated a hemangiosarcoma. Assays on white blood cells for avian leukosis/sarcoma viruses, Marek disease viral serotypes 1, 2, and 3, and reticuloendotheliosis virus were negative. The bird recovered uneventfully, but the tumor recurred within 10 days after removal. Upon clinical deterioration 3 months later, the bird was euthanized. Ref
    Primary tumor site: propatagial areaSites of Metastases: none

  • Case 9: Hemangiosarcoma in a Parrotlet. A 2-month-old Pacific parrotlet was presented for assessment following a traumatic injury to the right wing that resulted in persistent swelling and inflammation. Six weeks postinjury the bird underwent surgical resection of a large hemorrhagic cavitated mass that had formed at the site of the original injury and a second, smaller mass on the body in direct contact with the wing mass. Histopathology of the wing mass confirmed a diagnosis of hemangiosarcoma. Ref
    Primary tumor site: wingSites of Metastases: none

Treatment

NameSummary
Supportive careTry to protect lesions from injury.
Surgery
Radiation therapy
Chemotherapy

Support

Prevention

Biosecurity, to prevent the introduction of avian leukosis virus into the flock.

Scientific References

Risk Factors

  • History of avian leukosis virus in the flock.
  • Chronic trauma

Etiology

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