Collision tumor of myeloma and infiltrative lipoma in the canine spine

Abstract

Collision tumor is a rare phenomenon in dogs, defined by the coexistence of two distinct neoplasms at the same anatomic site, with no previous reports of multiple myeloma (MM) and infiltrative lipoma collision in dogs. MM is a malignant plasma cell neoplasm, accounting for less than 1 % of canine malignant tumors, primarily affecting the axial skeleton with osteolytic lesions. Infiltrative lipomas can invade adjacent tissues, including the spinal canal, leading to neurological deficits. This study describes a case of tumor collision between MM and infiltrative lipoma in the spine of a 14-year-old mixed-breed dog with a three-month history of lumbosacral swelling and progressive neurological deficits, emphasizing the importance of a thorough diagnostic approach for effective treatment. Myelography revealed extensive osteolysis of the fourth, fifth and sixth lumbar vertebrae, along with a sudden contrast interruption and a filling defect at L6, prompting surgical intervention for tumor excision and cauda equina decompression. During surgery, meticulous tissue sampling from the subcutaneous layer to the epidural fat enabled histopathological identification of MM infiltrating beyond L6 and coexisting with an infiltrative lipoma. MM was confirmed by monoclonal gammopathy detected via serum protein electrophoresis. Following diagnosis, treatment with melphalan and prednisone resulted in pain resolution and reduced serum gamma globulin levels. After 925 days of follow-up, the dog remains clinically stable with no recurrence of clinical signs. This case underscores the critical role of accurate diagnosis in identifying tumor collisions, guiding targeted treatment, and improving survival outcomes.