RETROSPECTIVE STUDIES

Thymomas in Rabbits: Clinical Evaluation,

Diagnosis, and Treatment
Frank Künzel, Dr.med.vet., DECZM (Small Mammal), Katharina M. Hittmair, Dr.med.vet., Jasmin Hassan, Dr.med.vet.,
Gilles Dupré, Dr.med.vet., DECVS, Elena Russold, Dr.med.vet., MRCVS, CVA, Abigail Guija de Arespachochaga, Dr.med.vet.,
DECVCP, Andrea Fuchs-Baumgartinger, Dr.med.vet., Andrea Bilek, Dr.med.vet.

ABSTRACT
Thymomas are rarely recorded in rabbits, and the literature includes comparatively few cases. Medical records were reviewed
to identify all pet rabbits in which a mediastinal mass was diagnosed between Feb 2007 and Jan 2010. Signalment, history,
clinical signs, diagnostic work-up (including laboratory data, diagnostic imaging, and ultrasound-guided fine-needle aspiration
of the mediastinal mass), treatment modalities, survival time, and histologic findings were evaluated. Cytologic and/or histo-
pathologic examinations revealed thymomas in all rabbits with mediastinal masses (n¼13). Rabbits with thymomas showed
clinical signs of dyspnea (76.9%), exercise intolerance (53.9%), and bilateral exophthalmos (46.2%). In seven rabbits the
thymoma was removed surgically. Two rabbits were treated conservatively, and four rabbits were euthanized because of their
poor clinical condition. The two rabbits that underwent surgery were euthanized 6 mo and 34 mo later. Mediastinal masses in
rabbits appear to be more common than previously believed and consist primarily of thymomas rather than thymic lympho-
mas. Cytology of samples collected by ultrasound-guided fine-needle aspiration is an accurate diagnostic tool for the
identification of thymomas in rabbits. Due to a high rate of perioperative mortality, intensive perioperative care and the pro-
vision of a low-stress environment are recommended for a successful thoracotomy. (J Am Anim Hosp Assoc 2012; 48:97–104.
DOI 10.5326/JAAHA-MS-5683)

Introduction indications associated with an intrathoracic mass include

A thymoma is a neoplasm in the cranial mediastinum. Thymomas
are composed of thymic epithelium and normally include various
degrees of benign lymphocytic infiltrations. In domestic animals,
the masses are largely restricted to the cranial mediastinum but they
may extend from the neck to the caudal mediastinum. Thymomas
are usually nodular and encapsulated, causing compression of ad-
jacent tissues.1 Although the disease is rarely documented, it has
been reported in dogs and cats, as well as in cattle, goats, sheep, pigs,
1–3
horses, ferrets, rats, and humans.
To date, information about rabbits with thymomas mainly
stems from clinical reports. 4–11
Apart from thymomas, thymic
lymphomas and mediastinal abscesses should also be considered
12–14
as possible causes of mediastinal masses in rabbits. Main
dyspnea, exercise intolerance, and bilateral exophthalmos.4,6,9
Various treatment options for rabbits diagnosed with thymomas
have been proposed, including surgery, chemotherapy, and ra-
diation therapy.9
The rationale underlying this study is that, according to the
authors’ experiences, mediastinal masses, especially thymomas,
often remain unrecognized in rabbits with respiratory distress
and/or exercise intolerance. Furthermore, the authors hypothesize
that mediastinal masses in this species are predominantly repre-
sented by thymomas rather than by thymic lymphomas. The
purpose of the study was to evaluate clinical findings, diagnostic
work-up, treatment options, and the outcome of rabbits with
thymomas.

From the Clinical Department for Small Animals and Horses (F.K., K.H., CT computed tomography; FNA fine-needle aspiration; IM intramuscular(ly)
J.H., G.D., E.R., A.B) and Department for Pathobiology (A.GdA., A.F-B.),
University of Veterinary Medicine, Vienna, Austria.

Correspondence: Frank.kuenzel@vetmeduni.ac.at (F.K.)

ª 2012 by American Animal Hospital Association JAAHA.ORG 97

Materials and Methods Results
Case Selection Signalment, History, and Clinical Signs
Medical records from the Small Animal Clinic at the Animal Thirteen pet rabbits met the study’s inclusion criteria. In all rabbits
Hospital of the University of Veterinary Medicine Vienna (Austria) the mediastinal mass was identified as a thymoma. Nine rabbits
were reviewed from Feb 2007 to Jan 2010 to identify all rabbits in were males and four were females. Nine rabbits were mixed-breed
which mediastinal masses had been diagnosed. All pet rabbits with rabbits and four were purebreed rabbits of various breeds, including
a clinically recognized cranial mediastinal mass and subsequent Thüringer (n¼1), tan (n¼1), and Lionhead (n¼2). The ages ranged
cytology and/or histology results were included in the study. from 3 yr to 10 yr (median, 6.1 yr).
The histories of 10 of the pet rabbits were available, relating to
Diagnostic Work-up the duration between the onset of the disease and the time the
Diagnostic work-up of the rabbits with a suspected mediastinal rabbits were first examined by a veterinarian. An acute onset was
mass included case history, clinical examination, and diagnostic observed in three rabbits. Seven owners reported clinical signs
imaging with thoracic radiographs (n¼12) and/or ultrasonogra- lasting for a period of up to 6 mo. The median period of noticeable
phy (n¼12). Thoracic radiographs were taken in left lateral and clinical signs in the rabbits before their presentation was 45 days
dorsoventral views. Ultrasound examinations were performed (Table 1).
with an ultrasound unita, employing a 5–8 MHz small parts Typical clinical signs in pet rabbits with a thymoma were
curved-array transducer in a bilateral intercostal approach with dyspnea (n¼10), exercise intolerance (n¼7), and bilateral transient
the rabbits in either sternal or lateral recumbency. Ultrasound- exophthalmos (n¼6). In only two cases was an exophthalmos
guided fine-needle aspiration (FNA) of the mediastinal mass noticed by the owner before the animal presented to a veterinarian.
(n¼11) or thoracocentesis of pleural effusion (n¼1) was per- Symptoms such as lack of appetite, coughing, and bilateral prolapse
formed and evaluated by cytology. FNA of the mass was per- of the third eyelid were also detected in affected animals. Auscul-
formed under sedation with intramuscular (IM) midazolamb tation of the thorax revealed muffled heart sounds or a heart
c
(1 mg/kg) and medetomidine (0.2 mg/kg). In eight rabbits, a murmur in four rabbits (Table 2).
complete blood cell count was performed and serum biochem-
istry was analyzed using standard laboratory methodsd,e. Diagnostic Work-up
Hematology and serum biochemistry profiles were performed in
Treatment eight rabbits. Red blood cell counts showed a mildly decreased
Depending on the clinical condition of the rabbit and the owners’
wishes, the following treatment modalities were implemented:
surgical removal of the thoracic mass, conservative treatment, TABLE 1
and euthanasia.
Duration of Clinical Signs, Treatment Modalities, and Outcome
(Survival Time) of 13 Rabbits Diagnosed with Thymomas
Histopathology Age Duration of clinical Survival time
A histopathologic examination of the surgical removed mediastinal Case (years) signs (days)* Treatment (days)
mass was performed in seven rabbits. Furthermore, a necropsy 1 6.1 60 Thoracotomy 3
2 5.8 1 Aspiration of cyst 150
including histopathology was carried out in nine rabbits (five of the
3 8.3 — Aspiration of cyst and 270
seven rabbits that underwent surgery and four rabbits that were prednisolone
immediately euthanized). Thymoma with .50% lymphocytes 4 6.6 120 Thoracotomy 955
were classified as lymphocyte predominant and cases with .50% 5 3 60 Thoracotomy 1
epithelial cells were subcategorized as being epithelial predom- 6 8.7 10 Euthanasia
7 5.5 180 Thoracotomy 180
inant. Cases with approximately 50:50 cells were diagnosed as
8 4.5 — Euthanasia
mixed lymphoepithelial. In cases of lymphocyte predominant
9 7.1 45 Thoracotomy 0
thymomas (n¼6) where a differentiation between thymoma and 10 6.5 — Euthanasia
thymic lymphoma was difficult, immunohistochemical analysis 11 10 1 Euthanasia
of cytokeratin expression in paraffin-embedded tissues was 12 4.5 20 Thoracotomy 2.5
f
performed. Mouse anticytokeratin was used as the primary 13 4.9 45 Thoracotomy 1.5

antibody. * Between onset of the disease and time of diagnosis

98 JAAHA | 48:2 Mar/Apr 2012

 Characterization of Lapine Thymomas

round, measuring up to 4 cm in diameter (Figure 2), or smaller

TABLE 2
and crescent-shaped (Figure 3).
Clinical Signs Associated with Thymomas in Rabbits
An ultrasound-guided FNA of the mass (n¼11) or a thora-
Clinical signs/ Number cocentesis of pleural effusion (n¼1) was performed. One rabbit was
clinical examination of rabbits Percent
euthanized due to its deteriorating condition before a FNA was
Dyspnea 10 76.9
Exercise intolerance 7 53.9 taken. Cytology of 10 aspirated samples identified the mass as a
Exophthalmos 6 46.2 thymoma (one sample was nondiagnostic). Cytologically, thymomas
Inappetence 4 30.8 were characterized by a mixed population of small and occasional
Coughing 3 23.1 large lymphocytes and various amounts of epithelial cells (Figure 4).
Prolapse of the third eyelid 3 23.1
In one case it was not possible to differentiate between thymoma
Muffled heart sounds 2 15.4
and thymic lymphoma by pleural fluid cytology (Table 4).
Heart murmur 2 15.4
In 11 rabbits in which a histopathologic examination of the
mediastinal mass was performed, the mass was identified as
hematocrit in five cases. Erythrocytes remained within the ref- a thymoma. The thymomas were graded as a lymphocyte pre-
erence range. Total protein was moderately elevated in one rabbit. dominant type (n¼6), a mixed lymphoepithelial type (n¼4), and
A lymphocytosis was observed in four rabbits. In six of the blood an epithelial predominant type (n¼1). Cytokeratin expression was
samples, a hyperglycemia was noted. Ca levels were determined in immunohistochemically detected in all specimens tested (n¼6).
four rabbits and were mildly decreased in one case. Creatinine and In eight cases, cytology and histology were available and histologic
alanine aminotransferase were within the reference range (Table 3). results confirmed the diagnosis of thymoma by cytologic meth-
Diagnostic imaging in 12 rabbits included thoracic radio- ods. Additional postmortem findings in nine rabbits included
graphs and ultrasonography. Thoracic radiographs were almost pleural effusion (n¼6) and pericardial effusion (n¼3) (Table 4).
identical in all cases. The cranial contour of the heart was not visible
and the trachea was elevated (Figure 1A). In the dorsoventral view, Therapy and Outcome
the entire cranial thorax was opacified, and a soft-tissue mass was In seven rabbits the thymomas were removed surgically. Two
suspected (Figure 1B). Ultrasonography of the cranial medias- patients were treated conservatively, and the remaining four were
tinum showed a nonuniform, hypoechoic mass cranial to the euthanized at the owner’s request due to their poor clinical
heart with small to large cystic lesions. The masses were either condition (Table 1).

TABLE 3
Hematology and Serum Biochemistry Results of Eight Rabbits with Thymomas

Case numbers

Parameter 2 3 5 8 10 11 12 13 Reference ranges

Glucose 130 283 221 271 186 217 122 245 75–150 mg/dL
Creatinine 1.1 1.3 1.1 1.4 0.9 1.5 1 1.5 0.8–1.8 mg/dL
Urea — 47 — 26 — — 39.6 48.5 18–37 mg/dL
Total protein 9.4 5.7 5.7 7 6.6 6.8 6.3 5.1 5.3–7.5 g/dL
Alanine aminotransferase 50 39 25 — 23 36 — — 0–61 U/L
Potassium 4.7 — — — — 4.4 4.3 — 3.6–7.5 mmol/L
Ca — 3.5 — 3.1 — 3.8 3.5 — 3.3–3.8 mmol/L
Erythrocytes 5.8 4.6 4.6 5.3 — — 5.5 4.9 4–7.23106/mL
Hematocrit 37.8 28 27.7 31.2 35 30 37 32.8 36–48%
WBCs 36.1 8.9 10.2 17.4 — 20.7 19.1 8.9 3–11.93103/mL
Lymphocytes 28.1 5.2 7 10.7 — 15 13.8 5.5 1.6–7.93103/mL
Monocytes 2.2 0.4 0.2 0.6 — 0.7 0.5 0.3 0–0.83103/mL
Neutrophils 4 3 2.4 5 — 4.1 4.5 2.6 0.8–53103/mL
Eosinophils 0.4 0.1 0.3 0.2 — 0.2 0.1 0.2 0–0.083103/mL
Basophils 0.7 0.3 0.3 0.8 — 0.7 0.2 0.3 0–0.53103/mL

JAAHA.ORG 99

FIGURE 1 Thoracic radiographs of a rabbit in a lateral (A) and
a dorsoventral (B) plane. There is a soft-tissue mass in the cranial
mediastinum causing elevation of the trachea.
Anesthesia and Thoracotomy
All rabbits undergoing surgery were premedicated with 0.2 mg/kg
medetomidine and 5–6 mg/kg ketamineg IM. Anesthesia was in-
h
duced with IV propofol . The trachea was intubated with a cuffed
endotracheal tube (internal diameter was 2–2.5 mm), and anesthesia
100 JAAHA | 48:2 Mar/Apr 2012
FIGURE 2 Ultrasonographic image of the mediastinal mass in
a sagittal view. A large, hypoechoic, irregularly contoured mass (Th)
is seen displacing the heart (H) caudally.
was maintained with a combination of IV propofol (11 mg/kg/hr)
and remifentanili (10–20 mg/kg/hr). Once the thoracic cavity was
opened, the lungs were manually ventilated with a tidal volume of
10–15 mL and a peak pressure of 10 cm H2O. Additionally, the
rabbits received 5 mg/kg carprofenj IV and 0.03 mg/kg bupre-
norphinek IV during anesthesia and the postoperative period. A
combination of lactated Ringer’s solution, hydroxylethyl starchl, and
5% glucose (i.e., 60% lactated Ringer`s solution, 30% hydroxylethyl
FIGURE 3 Ultrasonographic image of the cranial mediastinum
in a sagittal view. A crescent-shaped, hypoechoic mass (Th) is seen
cranial to the heart (H).
 Characterization of Lapine Thymomas

Thymoma excision was performed by subtotal to total median

sternotomy. In cases where the mass adhered to the pericardium,
a partial pericardectomy was performed. The thymoma was re-
moved either in its entirety or in fragments when the tissue was
friable. An 8 French chest drain was placed and connected to
a three-way tap. The chest drain was removed once air or fluid
production was minimal. All rabbits received 10 mg/kg enro-
floxacinm either subcutaneously or orally q 24 hr for 7–14 days.
Five rabbits died within 3 days of surgery. One rabbit im-
proved after surgery but had a recurrence of thymoma 6 mo later
and was euthanized. One rabbit recovered completely after surgery
but was euthanized 955 days following surgery because of a re-
currence of the mediastinal mass (Table 1).

FIGURE 4 Cytology of a thymoma. Note the cluster of thymic

epithelium (large white arrow) surrounded by a mixed population
of large (thin white arrow) and small (black arrow) lymphocytes.
The presence of a heterogeneous lymphocytic population differ-
entiates thymomas from thymic lymphomas. Diff-Quick staining,
original magnification 3400.
starch, and 10% glucose) was administered IV at 10 mL/kg/hr.
Anesthetic depth and physiologic parameters, such as heart rate
and rhythm (via an electrocardiogram), blood pressure (noninva-
sive oscillometric cuff), partial oxygen saturation, end-tidal carbon
dioxide, and anesthetic gas concentrations (mainstream spirometry)
were monitored closely throughout the procedure.
Conservative Treatment
Larger cystic lesions within the thymoma were aspirated in two
rabbits under sedation with 1 mg/kg midazolam and 0.2 mg/kg
medetomidine administered IM. One rabbit was also treated with
oral prednisolonen at a dose of 0.5 mg/kg q 48 hr for 90 days.
Rabbits that received conservative treatment survived for 5 mo
and 9 mo (Table 1).
Discussion
According to the literature, mediastinal masses in rabbits are
composed of thymic lymphomas and thymomas.15 Some authors
have reported that thymomas are uncommon in rabbits; however,

TABLE 4
Cytologic and Histologic Results of 13 Rabbits with a Cranial Mediastinal Mass and Findings of the Postmortem Examination Associated
with a Thymoma

Case Cytologic diagnosis Histologic diagnosis Histologic subtype Associated findings on postmortem
1 Thymoma* Thymomay Lymphocyte predominantx Pleural effusion, chronic epi- and pericarditis
2 Thymoma* — — —
3 Thymoma* — — —
4 Thymoma* Thymomay Lymphocyte predominantx —
5 Thymoma* Thymomay Mixed lymphoepithelial Vasculitis, peribronchitis
6 Thymoma* Thymoma** Mixed lymphoepithelial Hydropericard
7 Thymoma* Thymoma/lymphomay Lymphocyte predominantx Recurrent thymoma
8 Thymoma* Thymoma** Mixed lymphoepithelial Pleural effusion, hydropericard
9 Nondiagnostic Thymomay Mixed lymphoepithelial —
10 Thymoma/lymphomayy Thymoma** Lymphocyte predominantx Pleural effusion
11 — Thymoma** Epithelial predominant Pleural effusion
12 Thymoma* Thymomay Lymphocyte predominantx Pleural effusion
y
13 Thymoma* Thymoma Lymphocyte predominantx Pleural effusion, hemopericard

* Cytology from ultrasound-guided fine-needle aspiration of the mass

y
Histology from surgically removed mass
x
Immunohistochemical analysis of cytokeratin expression was performed.
** Histology from postmortem examination
yy
Cytology from pleural effusion

JAAHA.ORG 101
the current study revealed a thymoma in 13 rabbits over a period of
3 yr, indicating that mediastinal masses in rabbits consist primarily
8,9
of thymomas rather than thymic lymphomas. This study indi-
cates that thymomas appear to be more common than previously
reported.
The rabbits in the current study were of comparable age
(median age was 6.1 yr; range, 3–10 yr) to those reported in several
other investigations, in which thymomas were found in rabbits
5–10 yr old. 8,10,11
Only one rabbit in the current study was ,4.5 yr.
The current study did not show any breed predilection for
thymomas. To the authors’ knowledge there have been no in-
vestigations of breed predisposition for thymomas in rabbits.
In the current study, dyspnea was observed in approximately
75% of the rabbits with thymomas. There are numerous causes of
dyspnea in rabbits, including upper respiratory disease (e.g.,
pasteurellosis, oronasal fistula following periapical abscess, foreign
bodies, myxomatosis), lower respiratory disease (e.g., broncho-
pneumonia, pulmonary hemorrhage, pulmonary metastases from
uterine or mammary carcinomas, pulmonary edema) as well as cases
that relate to nonrespiratory reasons (e.g., pleural effusion, pneu-
mothorax, diaphragmatic hernia, abdominal distension, metabolic
disease).15,16However thymomas are often neglected.
Bilateral exophthalmos and bilateral prolapse of the third eyelid
were observed in almost 50% and 25% of the rabbits, respectively.
These results are consistent with other reports in which bilateral
4,6,10,11,15
exophthalmos is commonly mentioned. Occasionally, bi-
lateral exophthalmos in rabbits was transient and stress-induced and
the condition was therefore either often undetected or misinter-
preted by the referring veterinarians. According to previous pub-
lications, exophthalmos in rabbits is consistent with cranial vena
cava syndrome due to a space-occupying mass that compresses the
vessels of the thorax and restricts vascular return to the heart.7
Therefore, measurements of intraocular pressures to rule out
buphthalmia were not performed in the six rabbits with bilateral
exophthalmos as the condition was solely attributed to a cranial vena
cava syndrome. Differential diagnoses for unilateral exophthalmos
in rabbits mainly include retrobulbar abscesses due to dental disease
and retrobulbar lymphoma of the Harderian gland.17,18
Similarly to other reports, the authors of this study did not
notice anything remarkable or specific in the blood (hematology,
serum biochemistry) of affected rabbits.10,11 Hypercalcemia, found
as a paraneoplastic syndrome in dogs, was not detected in any of
the four rabbits in which Ca levels were measured. Some authors
discuss a connection between hypercalcemia and thymoma in
rabbits; however, they fail to consider a possible influence of diet
and Ca metabolism on the serum concentration of calcium in
rabbits.5,6,15 In this study, the authors observed hyperglycemia in
102 JAAHA | 48:2 Mar/Apr 2012
six rabbits, but assumed this to be stress-induced. Lymphocytosis
associated with a thymoma that was detected in four rabbits and
was previously reported in one dog.19
Methods for the diagnostic imaging of mediastinal masses in
rabbits include radiographs, ultrasonography, and computed to-
mography (CT). Thoracic radiographs were helpful for visualizing
a soft-tissue mass in the cranial mediastinum in conjunction with
the characteristic elevation of the trachea. The dorsoventral plane
was chosen instead of a ventrodorsal view as most rabbits were
suffering from respiratory problems as a result of the thymoma.
Ultrasonography of the cranial mediastinal mass determined
its echogenicity and extent. A small, high-frequency transducer
should be used when attempting the intercostal approach. Because
the masses occupied most of the cranial mediastinum, lung
artifacts did not pose a problem and it was possible to place the
rabbit in lateral recumbency. In accordance with one previous
report, larger cystic lesions in the thymoma were detected in two
rabbits, which were subsequently aspirated under ultrasound-
guidance.10 Aspiration of these cysts is useful when the animal will
not undergo surgery, as it alleviates the dyspnea.
CTs were not performed on any of the patients in this study as
the diagnosis was confirmed by ultrasound-guided FNA. One
author recommends CT of the thorax and the head to evaluate the
extent of the mass and to eliminate the possibility of retrobulbar
masses.10 Thoracic CT (including the application of IV contrast
medium) may provide more information regarding the invasive-
ness of a cranial mediastinal mass and the presence of pulmonary
metastasis. Although the application of a preoperative CT scan is
useful, it can sometimes be difficult to determine the true extent
of pleural and pericardial invasion.9 A greater number of patients
will be required to evaluate whether a CT of the thorax is of di-
agnostic benefit in rabbits with thymomas.
Ultrasound-guided FNA of the cranial mediastinal mass led to
the diagnosis in all cases but one, in which there were too few cells for
an evaluation. In eight cases, cytology and histology were available
and histologic results confirmed the diagnosis of thymoma by cy-
tologic methods, giving a positive predictive value of 100%. Nev-
ertheless, thymomas may be difficult to diagnose by cytology when
a large number of lymphocytes are on the slide. In such cases,
histology with staining for cytokeratin to detect epithelial cells is
indicated to obtain a definitive diagnosis.1
Depending on the lymphocyte component, the thymomas
could be classified as lymphocyte predominant (n¼6), mixed
lymphoepithelial (n¼4) or epithelial predominant (n¼1). In the
six rabbits with a lymphocyte predominant type, immunohisto-
chemical analysis of cytokeratin expression was used to confirm the
diagnosis of thymoma because histologic differentiation between

thymoma and thymic lymphoma is difficult. To the authors’
knowledge, this is the first time that thymomas in rabbits have been
classified into subtypes, as described in dogs and cats. Whereas
the lymphocyte predominant type of thymoma seems to occur
more often in rabbits, the epithelial predominant type predominates
in dogs and cats.2,20 Based on the results of the current study it is not
possible to conclude whether the percentage of lymphocytes within
thymomas has an influence on the survival time in rabbits, as has
been documented in cats and dogs. Pathologic periocular findings
2
(such as orbital abscesses, cysts, or neoplasms) were not found in
the rabbits that underwent a postmortem examination, and no
thoracic or abdominal metastases were detected on necropsy. There
is only one report of renal metastases in a rabbit with thymoma.10
The authors of this work emphasize the risk of classifying a thy-
moma as benign following histology without considering thymic
carcinoma and possible metastases. Several authors report that
thymomas rarely give rise to metastases in any species.1,9,10,20 Fur-
thermore, findings of the postmortem examination included pleural
and pericardial effusion, which may have contributed to the dys-
pnea or cardiovascular problems in some rabbits.
To date there are only a few published reports on the treat-
ment of thymomas in rabbits. The most common treatment
options in rabbits are surgery and, with increasing frequency,
radiation therapy.6,7,9,11,15 Recommendations for surgery or radi-
ation therapy in rabbits depend on several factors such as con-
current diseases (e.g., cardiopulmonary disorders), the condition
of the animal, the availability of a radiation treatment facility, and
9
the owners’ wishes. Only 2/7 rabbits that underwent surgery were
still alive 6 mo postsurgically. One rabbit had a recurrence of the
thymoma 180 days after surgery and was euthanized. The other
rabbit was euthanized .2.5 yr following surgery. In this case,
thoracic radiographs revealed a mass in the cranial mediastinum.
Therefore, a recurrence of thymoma was suspected, but could not
be confirmed as cytology or histopathology was not available.
According to one report, perioperative death is the most
common surgical complication.9 In the current study, five rabbits
died within 3 days of surgery, largely as a result of acute respi-
ratory distress. Some authors assume that perioperative death may
be related to pain, stress, anesthesia complications, or the inability
to remove the tumor.9 Thus, they strongly recommend intensive
perioperative care (including placement of a chest tube and ap-
propriate analgesia) and monitoring, as well as providing a low-
stress environment for the rabbits. It has not been assessed
whether placement of a chest tube in rabbits causes discomfort
and consequently affects their clinical condition. Nevertheless,
pleural and pericardial effusion and chronic inflammation of the
epi- and pericardium were detected in the postmortem examination
Characterization of Lapine Thymomas
of five rabbits, which may have contributed to the animals’ post-
operative death. In general, the survival time of rabbits that undergo
sternotomy is strongly biased by the fact that patients with a poor
clinical condition are excluded from invasive surgery because of
a poor prognosis.
Radiation therapy is recommended after incomplete surgical
resection of a thymoma or if a patient is not considered a good
candidate for surgery. It is important to take possible side ef-
fects into account, such as pneumonitis, pulmonary fibrosis, and
thrombosis of the thoracic vessels.9 The survival time in the cases
reported ranged from 7 wk to 98 wk after the start of treatment,
and one rabbit died during treatment.9,11,15 However, complica-
tions associated with irradiation of the lungs in rabbits have not
yet been well documented.
One rabbit treated with aspiration of large cysts in the thy-
moma improved clinically, but died suddenly for unknown reasons
5 mo later. To date, the survival time after aspiration of thymic cysts
has not been reported in rabbits, and there has been only one
report of survival time of a rabbit with a thymoma that did not
receive any treatment. That rabbit was euthanized 4 mo following
diagnosis because of severe respiratory distress.4 In the current
study, prednisolone was administered to one rabbit for a period of
90 days. The clinical signs disappeared for 270 days, after which
time the animal was euthanized due to acute dyspnea. A necropsy
was not performed. In one report, prednisolone (0.5–2 mg/kg
orally q 12 hr) was successfully used as an adjuvant treatment
in rabbits undergoing radiation therapy.9 However, radiation
or steroid therapy (i.e., prednisolone) in rabbits may cause
immunosuppression followed by the clinical manifestation of
encephalitozoonosis.15
There is limited information regarding the efficacy of che-
motherapy in rabbits as a treatment for metastatic or invasive
thymomas or as supportive therapy in conjunction with surgery.9
One rabbit in the documented study collapsed after receiving
chemotherapy.
Conclusion
Mediastinal masses often remain unrecognized in rabbits for a long
period and should be considered as an important differential
diagnosis in rabbits with respiratory distress and/or bilateral ex-
ophthalmos. This study found that mediastinal masses in rabbits
consist primarily of thymomas rather than thymic lymphomas,
and that they appear to be more common than previously reported.
Cytology of samples collected by ultrasound-guided FNA give
a good indication of the mass origin. Therefore, cytology is an
accurate diagnostic tool to identify thymomas in rabbits. As
surgical excision carries significant perioperative risk, intensive
JAAHA.ORG 103
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thoracotomy. a geriatric rabbit with hypercalcemia and periodic exophthalmos.
J Am Vet Med Assoc 1995;206(6):820–2.
7. Clippinger TL, Bennett RA, Alleman AR, et al. Removal of
The authors would like to thank Mag. Med. Vet. Andrea Frischengruber a thymoma via median sternotomy in a rabbit with recurrent
for the submission of case materials included in this report. appendicular neurofibrosarcoma. J Am Vet Med Assoc 1998;213(8):
1140–3, 1131.
8. Florizoone K. Thymoma-associated exfoliative dermatitis in
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Hitachi 911 Chemistry Analyzer; Roche Diagnostics, Mannheim, 11. Sanchez-Migallon Guzman D, Mayer J, Gould J, et al. Radiation
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