Biopsy of an intracardiac paraganglioma in a dog using a fluoroscopically guided endovascular technique.

Raleigh, Joseph S; Culp, William T N; Brady, Rachel; Al-Nadaf, Sami; Kent, Michael S; Kaplan, Joanna L; Stern, Joshua A; Visser, Lance C; Niedringhaus, Kevin D; Wolf, Tatiana G; Choi, Eunju; Affolter, Verena K

A 10-year-old female spayed mixed breed dog was evaluated for diarrhea and vomiting. Diagnostic imaging demonstrated the presence of an intracardiac mass. A modified Seldinger technique was used to access the right jugular vein, and an endomyocardial biopsy forceps was introduced through a sheath to obtain several biopsies. Histopathology and immunohistochemistry demonstrated a paraganglioma. The dog underwent 1 fraction of radiotherapy and l-asparaginase chemotherapy and was discharged. The dog developed a pulmonary thromboembolism 2 days after radiotherapy and chemotherapy, and the owner elected humane euthanasia. Although long-term assessment of treatment response was unable to be performed, this novel diagnostic option could be considered for similar cases due to success in obtaining a histopathologic diagnosis, which is essential in developing a disease-specific treatment plan. This report also describes the use of radiotherapy for primary treatment of an intracardiac neoplasm, which can be a consideration in the future.