Extraskeletal Osteosarcomas in Dogs:

A Retrospective Study of 169 Cases

(1986–1996)
Extraskeletal osteosarcomas (EOSs) are rare tumors that arise in various soft-tissue
sites (e.g., gastrointestinal tract, subcutaneous tissue, spleen, liver, skin, kidney,
urinary bladder, muscle, thyroid gland, eye, and mammary glands). Soft-tissue
osteosarcomas (STOs) occur in older dogs with no sex predilection; beagles and
rottweilers are at higher risk. Mammary gland osteosarcomas (MGOs) occur in older
females; mixed-breed dogs, German shepherd dogs, and miniature poodles are at
higher risk. The median survival time for cases with STO was 26 days, and the major
cause of death was local recurrence (92%). The median survival time for cases with
MGO was 90 days, and the major cause of death was pulmonary metastasis
(62.5%). J Am Anim Hosp Assoc 1998;34:113–20.

Anke Langenbach, VM Introduction

Mark A. Anderson, DVM, MS,
Diplomate ACVS
Donna M. Dambach, VMD,
Diplomate ACVP
Karin U. Sorenmo, CMV,
Diplomate ACVIM
Frances D. Shofer, PhD
RS
Osteosarcoma is a malignant mesenchymal neoplasm, characterized
by the formation of osteoid. It is the most frequent primary bone
tumor in dogs, accounting for 85% of all reported bone tumors. 1,2 The
skeleton (appendicular and axial) is involved most commonly. 1–3
Extraskeletal osteosarcoma (EOS) is a malignant, osteoid-producing,
mesenchymal neoplasm without primary periosteal or bone involve-
ment. Extraskeletal osteosarcoma has been described less frequently.4–23
Four retrospective studies have been performed previously; three of
the studies described characteristics of 32 cases with splenic EOS
exclusively, and the other reviewed the histopathological features of
11 cases with EOS. 12–15 The results of these studies have offered only
limited information about this rare tumor and have neglected mam-
mary gland osteosarcoma (MGO). This retrospective study of 169
cases describes the behavior, epidemiology, and prognostic features
of canine EOS.

Materials and Methods

From the Departments of Clinical Studies
(Langenbach, Anderson, Sorenmo,
Shofer) and Pathobiology (Dambach),
School of Veterinary Medicine,
University of Pennsylvania,
Philadelphia, Pennsylvania 19104-6010.
Doctor Anderson’s current address is
1060 Harrison Street,
Florissant, Missouri 63031.
Case material was obtained from biopsy records of the Surgical Pa-
thology Service at the Veterinary Hospital of the University of Penn-
sylvania (VHUP). The records from all biopsies with a diagnosis of
canine osteosarcoma for a 10-year period (September 1986 through
February 1996) were reviewed. Cases with a histological diagnosis of
osteosarcoma that had skeletal involvement were excluded. Cases
with EOS that had concurrent periosteal or skeletal osteosarcoma at
the time of diagnosis also were excluded. Information about size, age,
breed, and sex of the dog and tumor location was obtained from the
biopsy reports. Additional information, such as body weight (kg),
clinical signs prior to presentation, presence of lymph-node or pul-
monary metastasis, treatment, and survival time, was obtained from
telephone interviews with referring veterinarians and owners, the
VHUP clinical records, or both. Data was summarized using means
and medians for continuous data and frequency and percentages for
categorical data. Data was analyzed by the Student’s t-test for con-

JOURNAL of the American Animal Hospital Association 113

114 JOURNAL of the American Animal Hospital Association March/April 1998, Vol. 34

Distribution of Dogs with

Extraskeletal Osteosarcomas

36%
Soft-tissue
Osteosarcoma

64%
Mammary Gland
Figure 1—Number of cases with extraskeletal osteosarcoma Osteosarcoma
(EOS) compared to cases with osteosarcoma (OS), with mam-
mary gland tumors, and with the general biopsy population in Figure 2—Subcategories of extraskeletal osteosarcoma (EOS).
the same time period (Y-axis: logarithmic scale). Soft-tissue osteosarcoma (STO) is the smaller subcategory
(n=61). Mammary gland osteosarcoma (MGO) is the larger
subcategory (n=108).
tinuous data (e.g., age) and by the chi-square (χ 2 ) test
for categorical data. Statistical analysis of the data
was based on cases with complete follow-up informa- Table 1
tion. Where applicable, odds ratios and 95% confi-
dence intervals were calculated. To test for differences Tumor Location of 61
in survival distribution, the Kolmogorov-Smirnov test Soft-Tissue Osteosarcomas (STOs)
was used. The general canine biopsy population, cases
diagnosed with skeletal osteosarcoma, and cases with Tumor Location No. of Cases
mammary gland tumors other than MGO for the same Gastrointestinal tract 13
study period were used as reference populations for Jejunum (n=5)
appropriate subcategories of EOS. Mesentery (n=5)
Esophagus (n=1)
Results Omentum (n=1)
Tongue (n=1)
During the 10-year study period, 130,754 biopsies
Subcutaneous 13
were submitted to the Pathology Service at VHUP. Trunk (n=11)
Mammary gland tumors accounted for 10,433 sub- Extremities (n=2)
missions, skeletal osteosarcomas for 1,345 submis- Spleen 10
sions, and extraskeletal osteosarcomas (EOSs) for 169 Urinary tract 7
submissions [Figure 1]. Of the 169 EOS, 61 (36%) Kidney (n=5)
were soft-tissue osteosarcomas (STOs) and 108 (64%) Urinary bladder (n=2)
were MGOs [Figure 2]. These two subcategories Liver 6
showed some distinctive differences in behavior; Skin 6
therefore, they are presented separately. Trunk (n=4)
Extremities (n=2)
Soft-Tissue Osteosarcomas Muscle (trunk) 2
Soft-tissue osteosarcomas were identified in 61 cases. Eye 2
Tumors were located as shown in Table 1. The tumor Thyroid gland 2
size range was 2.5 to 30 cm in diameter with a mean
size of 12.7 cm (n=22). The age of affected cases
ranged from two to 15 years (mean age, 9.7 years;
n=43). This is similar to the mean age of 9.4 years for an increased number (16 of 61 cases) of Labrador and
the 1,345 cases diagnosed with skeletal osteosarco- golden retrievers had STOs. There was no statistical
mas in the same time period (p of 0.9). The body difference in the latter two breeds and the general
weight of cases with STOs ranged from 3 to 47 kg biopsy population. Fifty-seven percent of the affected
(mean, 23 kg; n=28). cases were female and 43% were male. These find-
Although 25 breeds developed STO, the beagle ings were similar to the sex distribution for all os-
and rottweiler were at higher risk when compared to teosarcoma cases and the general biopsy population
the general biopsy population [Table 2]. In addition, (p of 0.4 and p of 0.9, respectively).
March/April 1998, Vol. 34 Extraskeletal Osteosarcomas 115

Table 2
Breed Risk for Dogs to Develop Soft-Tissue Osteosarcoma or Mammary Gland Osteosarcoma

Soft-Tissue Skeletal Mammary Mammary Gland

Osteosarcoma Osteosarcoma Osteosarcoma Carcinoma
(n=61) (n=1,345) (n=108) (n=3,458)

No. of No. of No. of No. of

Breed Cases OR* 95% CI† Cases OR 95% CI Cases OR 95% CI Cases OR 95% CI
Beagle 4 3.8 1.4–10.7 — — — — — — — — —
Rottweiler 3 3.6 1.1–11.7 79 4.6 3.6–5.8 — — — — — —
Mixed- — — — — — — 37 1.8 1.2–2.7 865 0.9 0.86–1.0
breed
dog
German — — — — — — 10 2.2 1.1–4.2 224 2.6 1.2–1.6
shepherd
dog
Miniature — — — — — — 9 2.7 1.3–5.3 228 2.5 2.3–2.9
poodle

* OR=odds ratio
†
CI=confidence interval

The clinical signs were variable and related to the
site of tumor development. Cases with dermal, subcu-
taneous, or muscular STO were presented for pal-
pable masses. Three cases with STOs in the cervical
region were observed to have bark change (n=2),
coughing (n=3), and gagging (n=2). Cases with STOs
in other sites often had more nonspecific clinical signs
such as depression/lethargy (n=9), distended abdo-
men (n=6), difficulty breathing (n=3), weight loss
(n=3), anorexia (n=3), pyrexia (n=3), polyuria and
polydipsia (n=2), vomiting (n=2), constipation (n=2),
and adipsia (n=1). The duration of clinical signs var-
ied from 24 hours to months. The duration of clinical
signs was shortest in cases with splenic, hepatic, or
gastrointestinal osteosarcoma. In these cases, clinical
signs ranged from one to 14 days with the exception
(30 days) of one case. The duration of clinical signs
ranged from four to 61 days in cases with subcutane-
ous or intramuscular osteosarcoma and from 30 to
183 days in cases with dermal osteosarcoma.
Thoracic radiography was performed in 32 (52.5%)
of 61 cases, and three of these cases had evidence of
pulmonary metastatic disease at the time of diagnosis.
This was confirmed at necropsy in two of the three
cases. The remaining 29 cases had no staging performed.
Mammary Gland Osteosarcomas
Mammary gland osteosarcomas were identified in 108
cases. Two of these cases had no information avail-
able about tumor location. Of the remaining 106 cases,
nine (8.5%) tumors were in the first set of mammary
glands, 13 (12.3%) tumors were in the second set of
mammary glands, and 19 (17.9%) tumors were found
in the third set of mammary glands. The caudal two
mammary glands were affected most frequently, with
37 (35%) tumors involving the fourth mammary gland
and 28 (26.4%) involving the fifth mammary gland.
There was no statistically significant difference in
involvement between glands of the right (n=36) and
left (n=38) sides, and most cases (53.8%; 57 of 106
cases) had only one mammary gland affected. In 29
(27.4%) of 106 cases, a single MGO extended to
involve the adjacent glands. All MGOs were invasive
and not encapsulated on histological evaluation. Tu-
mor size ranged from 2.5 to 32 cm in diameter, with a
mean of 10.6 cm (n=65).
The age of cases with MGO ranged from three to
16 years (mean, 10.6 years; n=65). This is similar to
the mean age of 11.8 years for 10,433 cases with
mammary gland tumors diagnosed in the same time
period. The body weight ranged from 3 to 53 kg
(mean, 20.2 kg; n=75). A total of 33 breeds were
diagnosed with MGO. Breeds found to be at higher
risk to develop MGO were mixed-breed dogs, Ger-
man shepherd dogs, and miniature poodles [Table 2].
Furthermore, the latter two breeds also were at risk to
develop mammary gland carcinoma [Table 2]. Sex
was recorded in 97 cases, and all were female. Sev-
enty-five percent were intact and 25% were neutered.
This distribution is similar to that seen in cases diag-
nosed with other mammary gland tumors in the same
time period (p of 0.4).
The only clinical sign associated with these tumors
was the appearance of variably sized masses (n=53)
116 JOURNAL of the American Animal Hospital Association
Figure 3—Survival times of cases with soft-tissue osteosar-
coma (STO) versus mammary gland osteosarcoma (MGO). The
survival distribution between these two subcategories differed
significantly (p less than 0.02). Cases with STO had a very early
peak and a smaller later peak. Cases that died early were mainly
those with intra-abdominal STO. Mammary gland osteosar-
coma tended to cluster around the mean survival time.
one week to three years prior to treatment. The major-
ity of the MGOs were firm or hard on palpation.
Ulceration or necrosis was seen in 25% of the MGOs.
Thirty-five percent of these tumors were observed to
grow slowly over months to years, followed by rapid
enlargement over two-to-four weeks prior to and
prompting surgery.
At the time of initial surgery, 38 (35%) of 108
cases had thoracic radiography performed, and three
(8%) of these cases had evidence of pulmonary me-
tastasis. Pulmonary metastasis was confirmed in one
case at necropsy. Seven other cases had lymph-node
biopsies at the time of MGO removal. Histopatho-
logical diagnosis included lymphoid hyperplasia
(n=3), metastatic MGO (n=2), and metastatic mam-
mary carcinoma (n=2). The latter two cases had mam-
mary carcinomas removed in other mammary glands
at the time of MGO removal. Clinical staging was not
performed on the remaining 63 cases.
Soft-Tissue and Mammary Gland Osteosarcomas
Some similarities were shared between both subcat-
egories. There were no statistically significant differ-
ences between the STO and MGO subcategories with
regard to age (p of 0.07), tumor size (p of 0.2), or
body weight (p of 0.4). Cases in this study were,
however, significantly older than the general biopsy
population (p of 0.006).
No surgical treatment was recorded for 59 of the
combined 169 cases. Treatment information was
available only in 110 cases. Of these, 84 cases had
excisional biopsies performed. Seven other cases with
MGOs underwent radical unilateral or bilateral mas-
tectomies which had no effect on survival time. These
March/April 1998, Vol. 34
seven cases either had multiple glands involved or
extension of one MGO to involve the adjacent glands.
Eleven cases with MGOs were spayed at the time of
surgical biopsy or mastectomy. Ovariohysterectomy
had no significant effect on survival time. In the re-
maining eight cases, incisional biopsies were per-
formed, but these cases were euthanized on the
surgery table due to unresectable tumors.
Six cases received chemotherapy after surgery.
Treatment included doxorubicin, cisplatin, and cy-
clophosphamide. Follow-up information was avail-
able for two cases. Unfortunately, the case number is
too small to make any conclusions concerning sur-
vival time with regard to chemotherapy.
Some cases included in the study had other tumors
present or removed two-to-48 months before or dur-
ing initial presentation. In the STO subcategory, a
case with omental osteosarcoma had a Wilms’ tumor,
and another case had recurrent, benign, mixed mam-
mary tumors. Nine cases with MGOs had previous
histories of mammary gland tumors, of which four
tumors were diagnosed as mixed mammary tumors
and five tumors were not biopsied. Twenty cases had
other mammary gland tumors concurrently with MGO.
Thirteen of these 20 tumors were diagnosed as mixed
mammary adenomas, six as mammary carcinomas,
and one as a cystadenoma.
Follow-up information was available in 83 (49.1%)
of the 169 cases. Seventy-two of these were euthanized
or died for reasons related to EOS. The median sur-
vival times were 26 and 90 days for the STO and
MGO subcategories, respectively. The major cause of
death was local recurrence in the STO group (92%),
whereas it was pulmonary metastasis in the MGO
group (62.5%). Eleven of the 83 cases died or were
euthanized due to nonspecific signs, such as seizures
(n=3), acute collapse (n=3), endocarditis and throm-
bophlebitis, anorexia, lethargy, constipation, paraple-
gia due to intervertebral disk disease, acute renal
failure, and hemorrhagic cystitis. Necropsies were
performed on only nine cases. However, no further
conclusions can be drawn of tumor metastatic activity.
Even though the median survival times between
the STO and MGO subcategories did not differ sig-
nificantly, there was a significant difference in the
distribution of the individual survival times between
both subcategories (p less then 0.02) [Figure 3].
Therefore, the following factors were evaluated as
prognostic determinants: primary site (STO versus
MGO), site of the MGO, single or multiple MGO,
stage of disease, size of the tumor, and duration of
clinical signs. Results are presented in Table 3. The
negative prognostic indicators were intra-abdominal
tumor location for the STO subcategory and cranial
mammary gland involvement for the MGO subcat-
egory. There was no difference in survival time be-
March/April 1998, Vol. 34 Extraskeletal Osteosarcomas 117

Table 3
Prognostic Factors for Dogs with Extraskeletal Osteosarcomas* (EOSs)

STO† Subcategory MGO‡ Subcategory

No. of Median Survival Time No. of Median Survival Time
Prognostic Factors Cases (days) Cases (days)
All tumor sites 26 25 57 90
Individual tumor sites:
Gastrointestinal 5 0 - -
Urogenital 2 28 - -
Spleen 4 50 - -
Liver 2 2 - -
Subcutaneous 9 240 - -
Skin 4 486 - -
Cranial mammary gland - - 20 90
Caudal mammary gland - - 37 225
Length of clinical signs (days):
0 7 21 0 -
1–14 7 2 6 75
15–60 8 137 3 90
>60 3 183 16 120
Presence of metastatic disease at diagnosis:
Metastatic disease absent 23 120 35 137
Metastatic disease present 3 15 5 0

* Survival time for dogs with EOS based on tumor site, length of clinical signs, and metastatic disease at time of
diagnosis
†
STO=soft-tissue osteosarcoma
‡
MGO=mammary gland osteosarcoma

tween single or multiple MGOs. Negative prognostic
indicators for both subcategories were thoracic me-
tastasis at the time of initial presentation, large tu-
mors, and a short clinical history of illness [Tables 3,
4]. Unexpectedly in the STO subcategory, cases with
tumors less than 5 cm in diameter had shorter sur-
vival times than cases with tumors 5 to 15 cm in
diameter.
Discussion
Canine EOS is a rare mesenchymal tumor. Case re-
ports and retrospective studies have identified only
53 cases of EOS in the last 30 years. 5–24 In the au-
thors’ study, EOS also was rare, accounting for only
0.13% of all biopsy submissions and 12.6% of all
osteosarcomas diagnosed in the study period. Extra-
skeletal osteosarcoma previously has been reported
to occur in older dogs (median age, 10 years), which
is similar to the median age of 11 years in this study.
A sex predilection for female dogs was found in a
retrospective study of 11 cases with EOS, but a re-
view of all previous literature revealed an even distri-
bution of male (n=26) and female (n=23) cases.14 In
this study, excluding MGO, no sex predilection could
be identified.
In the literature, the prognosis of canine EOS is
poor. Survival time was reported in 48 of 53 cases.
The median survival times for EOS previously re-
ported and for the authors’ cases of EOS were very
short (one month and two months, respectively).
Soft-Tissue Osteosarcomas
All previous reports of EOS solely consist of cases
with tumors in STO locations. 4–23 The distribution of
EOS in this study [Table 2] is similar to primary sites
for EOS reported in the previous literature, which
included spleen (n=25), gastrointestinal tract (n=7),
lung (n=5), subcutaneous tissue on the trunk (n=2),
muscle on the thigh and on the trunk (n=2), vagina
(n=2), testicle, kidney, larynx, trachea, heart, anal
sac, eye, and adrenal gland.
Cases with STOs tended to be older (mean age, 9.7
years) than cases with appendicular osteosarcomas. 24
With regard to breeds at risk, STO acts similarly to bony
osteosarcoma in that the rottweiler as a large-breed
dog also is at risk to develop bony osteosarcoma.1,2 In
addition, an increased number of golden and Labra-
dor retrievers representing large-breed dogs was noted.
In the STO subcategory in this study, there was a
similar distribution between male and female cases.
118 JOURNAL of the American Animal Hospital Association
Table 4
Tumor Number and Size as Prognostic Factors in Dogs with Extraskeletal Osteosarcomas
STO* Subcategory
No. of Median Survival Time
Prognostic Factors Cases (days)
Tumor number:
Multiple sites - -
Single sites - -
Tumor size (cm):
<5 5 93
5–15 17 240
>15 12 0 2
* STO=soft-tissue osteosarcoma
†
MGO=mammary gland osteosarcoma
Appendicular osteosarcoma is diagnosed 1.1 to 2.0
times more frequently in males than in females,
whereas axial osteosarcoma is seen twice as often in
females than in males. 3 With respect to sex, the STO
subcategory more closely resembles cases with EOS,
based upon previous reports.
Cases with STOs have a shorter median survival
time (25 days) than what is reported in the literature
for skeletal osteosarcomas (132 to 154 days) treated
with surgery alone. 2,3 Further analysis of survival
data with the help of prognostic factors revealed a
very poor prognosis for cases with intra-abdominal
STO [Table 3]. Intra-abdominal tumors appeared to
be unnoticeable by owners and were able to grow to a
large size before detection. As a consequence, the
tumor involvement was extensive, which made exci-
sion difficult or impossible and resulted in a poor
prognosis. Cases with dermal, subcutaneous, or intra-
muscular EOS had much better prognoses because of
accessibility of these lesions, allowing an excision en
bloc with a margin of normal tissue.
Regarding tumor size, cases with tumors greater
than 15 cm had the shortest survival times [Table 4].
These larger tumors appeared to involve the intra-
abdominal location. However, it is not clear why cases
in the STO group with tumors less than 5 cm had
shorter survival times than cases with tumors measur-
ing five to 15 cm. A larger sample size may clarify
this finding.
Pulmonary metastatic disease was not common in
the STO group even though lung metastasis is re-
ported to be the most common cause of treatment
failure in a study of cases with appendicular osteosar-
coma. 2 Local recurrence of tumor was the most com-
mon cause of death in cases with STOs. This compares
well to the high local recurrence rate (80%) in axial
skeletal osteosarcomas.3 A reason for the high local
recurrence rate of EOS may be the inaccessibility of
March/April 1998, Vol. 34
MGO† Subcategory
No. of Median Survival Time
Cases (days)
16 90
25 120
2 240
11 90
105
the lesion, and there was no assessment of margins in
this study since many biopsies were older and mar-
gins were not examined routinely at the time of sub-
mission. A relatively high local recurrence rate would
be expected if inadequate tumor-free margins were
obtained. In addition, the majority of cases did not
have thoracic radiography performed at the time of
presentation for recurrence; therefore, subclinical
metastatic disease may have been present.
Osteosarcoma commonly does not metastasize via
regional lymph nodes.2 In this study, no obvious lymph-
node involvement (e.g., enlargement) was seen, and
biopsies typically were not performed. As palpation
for enlargement was used as the sole criterion for
biopsy, regional lymph-node metastasis could have
been missed. Therefore, due to the lack of lymph-
node biopsies, no statement about spread of STO via
lymphatics can be made. Pulmonary metastases were
present in three cases for which thoracic radiography
was part of the staging procedure. These findings
coincided with previous studies of appendicular and
axial osteosarcomas where thoracic radiographs were
positive in 5% to 11% of the cases on initial presenta-
tion.2,3,24
Mammary Gland Osteosarcomas
Mammary gland tumors are the most common neo-
plasms in the female dog. They account for half of all
neoplasms in the bitch. The incidence in dogs is higher
than in other species and three times higher than in
humans.25,26 Mammary gland osteosarcoma neither
had been described previously as a separate entity nor
in conjunction with EOS. It was grouped previously
with canine mammary sarcomas, which comprise
about 7% to 17% of all canine mammary neoplasias. 27
In the authors’ study, MGO was rare, accounting for
only 108 (1%) of 10,345 mammary gland tumors.
Mammary gland osteosarcoma was found most fre-
March/April 1998, Vol. 34
quently in the caudal two sets of mammary glands.
There is no information available about gland in-
volvement in the reference population, but previously
published reports about mammary gland tumors docu-
mented 64% of all MGO to be located in the caudal
mammary glands.28 A reason for this location could
be the larger size of these glands versus the more
cranial glands. The similarities of mammary gland
tumors and MGO in terms of gland involvement,
breeds at risk, and neuter status may mean that these
tumors have similar underlying pathogeneses.
The prognosis for dogs with mammary gland sar-
coma is considered poor. 29 The average survival time
(five to 10 months) is short, and this tumor has the
lowest two-year survival rate of all mammary gland
tumors.27,29 This study supports the finding that MGO,
like other mammary gland sarcomas, is a very aggres-
sive tumor with a short survival time (median, 90
days).
Dogs with caudal MGOs tended to live longer than
dogs with MGOs in the cranial mammary glands
[Table 3]. A previous study of 253 dogs with malig-
nant mammary gland tumors (80% had mammary car-
cinomas) showed a reversed distribution.30 This may
mean that mammary gland sarcomas and mammary
gland carcinomas show a different clinical behavior.
Tumors varied greatly in size from 2.5 to 32 cm in
diameter. A trend was identified for dogs with smaller
tumors to live longer than dogs with larger tumors
[Table 4]. A previous study shows significant differ-
ence in terms of survival with increasing tumor size. 31
The lack of statistical significance in the authors’
study may be due to the relative small sample size in
each category. On the other hand, this can be ex-
plained when considering that tumors with less bio-
logically aggressive behavior may have been present
for a long time, growing to a large size before they
were removed. This is underscored by the finding that
dogs with longer clinical histories had longer sur-
vival times.
As noted in the case of mammary gland sarcomas,
pulmonary metastatic disease was the most common
cause of death for dogs with MGOs. 27,29 This under-
lines another similarity between MGO and mammary
gland sarcomas. The incidence of regional lymph-
node involvement was reported to be lower in dogs
with mammary gland sarcomas (24%) than in dogs
with mammary carcinomas (52% to 68%).30 Only two
dogs in the authors’ study were diagnosed with re-
gional lymph-node involvement from MGO. There-
fore, MGO may behave similarly to other sarcomas in
its tendency for hematogenous metastasis. However,
seven lymph nodes were biopsied, and lymph nodes
were not biopsied routinely as part of the staging
procedure. Therefore, some metastasis to local lymph
nodes could have been missed. It is known from hu-
Extraskeletal Osteosarcomas 119
man breast cancer studies that palpation alone has
only a 30% sensitivity in detecting tumor metastasis.32
Soft-Tissue and Mammary Gland Osteosarcomas
The finding of differing breeds at risk for STO and
MGO and the similarities to the breeds at risk for
osteosarcoma and mammary gland tumors, respec-
tively, suggests that the underlying pathogenesis of
tumor development for the two subcategories of EOS
may be different. Mixed mammary gland tumors pro-
duce osteoid or cartilage. Although rare, malignant
mixed mammary tumors also have been reported in
which there is a malignant epithelial component (i.e.,
carcinoma of ductal elements) and a malignant mes-
enchymal component (i.e., osteosarcoma or chondro-
sarcoma). The myoepithelial cell generally is accepted
as the cell of origin for the mesenchymal component
of mixed mammary tumors in the dog. 33 It is possible
that MGO may arise from malignant transformation
of the myoepithelial cell population. This malignant
transformation may occur de novo or possibly may
arise in a benign mixed mammary tumor. However,
histological evidence for the latter was not noted in
any of the 108 cases of MGO in this report. In a
previous examination of mammary gland sarcomas,
there was no proof that such tumors arose from preex-
isting mammary gland tumors. 27 Serial sectioning and
examination of several sections of large tumors would
be necessary to determine the possibility of malig-
nant transformation of the benign mixed mammary
tumor. The clinical behavior of several MGOs
changed in this study where static tumors began to
enlarge rapidly. The possibility that this enlargement
may represent malignant transformation of benign
mammary gland tumors to MGOs is purely specula-
tive, and it would be quite difficult to evaluate this
idea clinically. Thirteen dogs had other mammary
gland tumors present at the time of diagnosis; none
were in the same gland as the MGO. This and the lack
of histological evidence of concurrent benign tumors
support the contention that MGOs develop de novo.
Conclusion
Extraskeletal osteosarcoma is a rare mesenchymal tu-
mor with two distinctive subcategories (STO and
MGO). Soft-tissue osteosarcoma occurs in older dogs
with no apparent sex predilection. Breeds at risk for
STO are beagles and rottweilers. Mammary gland
osteosarcoma occurs in older, intact females. Breeds
at risk for MGO are mixed-breed dogs, German shep-
herd dogs, and miniature poodles. The tumor carries
the worst prognosis in dogs with an intra-abdominal
location (median survival time, zero days), with cra-
nial mammary gland involvement, with large tumors,
with a short clinical history, or with pulmonary metasta-
120 JOURNAL of the American Animal Hospital Association March/April 1998, Vol. 34

sis at presentation. Due to the many similarities, MGO 26. Dorn CR, Taylor DON, Frye FL, et al. Survey of animal neoplasms in
Almeda and Contra Costa Counties, California. I. Methodology and
might be grouped better with other mammary gland description of cases. J Natl Cancer Inst 1968;40:295–305.
tumors (especially mammary gland sarcomas) than with 27. Misdorp W, Cotchin E, Hampe JF, et al. Canine malignant mammary
EOS. tumours I. Sarcomas. Vet Path 1971;8:99–117.
28. Fidler IJ, Brodey RS. A necropsy study of canine malignant mammary
neoplasms. J Am Vet Med Assoc 1967;151:710–5.
Acknowledgments
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