A 10-year-old female Shar Pei referred for radiation therapy of a non resectable left subscapular hemangiosarcoma

Patient History

The forelimb lameness of 5 months duration. Recent, significant progression of pain associated with severe swelling over the left shoulder region in January 2018. CT scan at a local referral hospital showed a large heterogeneously contrast enhancing subscapular mass displacing the scapula laterally. Nodular lesions also noted in spleen and lung concerning for possible splenic and pulmonary metastasis. Biopsy confirmed a diagnosis of haemangiosarcoma deemed to be non resectable. Patient was referred to the oncology team for palliative radiation therapy


CT simulation from stereotactic radiation therapy was done on 23/1/2018 and treatment commenced the following day.


The patient tolerated the treatment very well with significant mass reduction and improvement in ambulation and comfort noted by end of treatment. At first recheck in 2 weeks the mass was barely notable. 5 doses of doxorubicin were administered over the following 4 months and the mass completely resolved outwardly. Follow up CT scans were done at 2 months and 8 months post treatment and at each point the mass had decreased in size. The patient passed away in June 2019 18 months after diagnosis of metasatic disease.

Stereotactic radiation therapy (SRT) 3 day course of treatment to the left subscapular region

SRT was prescribed to the right subscapular region as a non-surgical alternative.

30Gy in 3 fractions to the Target volume

VMAT fields are used to provide excellent treatment, preserving healthy tissue and critical surrounding structures.

Daily Cone Beam CT was used to verify the accuracy and precision of treatment.

15 minute treatment time including daily image guided radiation therapy (IGRT).