Vaccine-associated sarcoma

Source: Wikipedia, the free encyclopedia.

A vaccine-associated sarcoma (VAS) or feline injection-site sarcoma (FISS) is a type of

vaccines. VAS has become a concern for veterinarians and cat owners alike and has resulted in changes in recommended vaccine protocols. These sarcomas have been most commonly associated with rabies and feline leukemia virus vaccines, but other vaccines and injected medications have also been implicated.[1]

History

VAS was first recognized at the

aluminum adjuvant, and a law in 1987 requiring rabies vaccination in cats in Pennsylvania.[3] In 1993, a causal relationship between VAS and administration of aluminium adjuvanted rabies and FeLV vaccines was established through epidemiologic methods, and in 1996 the Vaccine-Associated Feline Sarcoma Task Force was formed to address the problem and promote research.[4]

In 2003, a study of ferret fibrosarcoma indicated that this species also may develop VAS. Several of the tumors were located in common injection sites and had similar histologic features to VAS in cats.[5] Also in 2003, a study in Italy compared fibrosarcoma in dogs from injection sites and non-injection sites to VAS in cats, and found distinct similarities between the injection site tumors in dogs and VAS in cats. This suggests that VAS may occur in dogs.[6]

Pathology

malignant fibrous histiocytoma, and undifferentiated sarcoma.[11]

Similar examples of sarcomas developing secondary to inflammation include tumors associated with metallic implants and foreign body material in humans, and sarcomas of the

acetaminophen toxicity.[10]

Diagnosis

VAS appears as a rapidly growing firm mass in and under the skin. The mass is often quite large when first detected and can become ulcerated or infected. It often contains fluid-filled cavities, probably because of its rapid growth.[12] Diagnosis of VAS is through a biopsy. The biopsy will show the presence of a sarcoma, but information like location and the presence of inflammation or necrosis will increase the suspicion of VAS. It is possible for cats to have a granuloma form after vaccination, so it is important to differentiate between the two before radical surgery is performed. One guideline for biopsy is if a growth is present three months after surgery, if a growth is greater than two centimeters, or if a growth is becoming larger one month after vaccination.[1]

X-rays are taken prior to surgery because about one in five cases of VAS will develop metastasis, usually to the lungs but possibly to the lymph nodes or skin.[8]

Treatment

Treatment of VAS is through aggressive surgery. As soon as the tumor is recognized, it should be removed with very wide margins to ensure complete removal. Treatment may also include chemotherapy or radiation therapy. The most significant prognostic factor is initial surgical treatment. One study showed that cats with radical (extensive) initial surgery had a median time to recurrence of 325 days versus 79 days for cats with marginal initial excision.[3] The expression of a mutated form of p53, a tumor suppressor gene, is found commonly in VAS and indicates a poorer prognosis.[13]

Precautionary measures

New vaccine protocols have been put forth by the American Association of Feline Practitioners that limit the type and frequency of vaccinations given to cats.

panleukopenia/calicivirus vaccines should be given as kittens, a year later and then every three years. Also, vaccines should be given in areas making removal of VAS easier,[15] namely: as close as possible to the tip of the right rear paw for rabies, the tip of the left rear paw for feline leukemia (unless combined with rabies), and on the right shoulder—being careful to avoid the midline or interscapular space—for other vaccines (such as FVRCP).[16] There have been no specific associations between the development of VAS and vaccine brand or manufacturer, concurrent infections, history of trauma, or environment.[17]

See also

  • Vaccine injury

References

  1. ^ a b c "Vaccine-Associated Feline Sarcoma Task Force: Roundtable Discussion". Journal of the American Veterinary Medical Association. 226 (11). 2005. Retrieved 2006-08-27.
  2. PMID 1748617
    .
  3. ^ a b Kitchell, Barbara E. (2005). "Feline Vaccine-Associated Sarcomas". Proceedings of the 30th World Congress of the World Small Animal Veterinary Association. Retrieved 2006-08-27.
  4. PMID 17078805
    .
  5. PMID 12724570
    .
  6. S2CID 3753206
    .
  7. ^ O'Rourke, Kate (2004). "Researchers probe vaccine-associated feline sarcoma". Journal of the American Veterinary Medical Association. 225 (6). Retrieved 2006-08-27.
  8. ^
    PMID 10638320
    .
  9. PMID 20510635
    .
  10. ^
    PMID 13677599
    .
  11. S2CID 23721821
    .
  12. S2CID 24469628
    .
  13. S2CID 29956787
    .
  14. ^ "Canine and Feline Vaccination Guidelines". UC Davis School of Veterinary Medicine. Retrieved 2012-06-23.
  15. ^ Eigner, Diane R. "Feline Vaccine Guidelines". The Winn Feline Foundation. Archived from the original on 2002-07-17. Retrieved 2006-08-27.
  16. ^ "VAFSTF Vaccine Site Recommendations". Vaccine-Associated Feline Sarcoma Task Force of the American Association of Feline Practitioners (AAFP), American Animal Hospital Association (AAHA), American Veterinary Medical Association (AVMA), and Veterinary Cancer Society (VCS). Retrieved 2012-12-04.
  17. PMID 14621215
    .

External links
Retrieved from "https://en.wikipedia.org/w/index.php?title=Vaccine-associated_sarcoma&oldid=1205975185"