Epidemiological, clinical, and therapeutic aspects of canine transmissible venereal tumor in Rio de Janeiro, Brazil (2015-2020) / Aspectos epidemiológicos, clínicos e terapêuticos do tumor venéreo transmissível canino no Rio de Janeiro, Brasil (2015-2020)

Canine transmissible venereal tumors (TVT) have a high incidence in Brazil. This is partly due to the large population of stray dogs and the ineffectiveness of epidemiological control programs. This study aimed to describe the epidemiological data, clinical manifestations, and treatments used in dogs affected by TVT. Data were retrospectively collected from the 2015-2020 records of the Veterinary Hospital of the Federal Rural University of Rio de Janeiro. A total of 252 dogs were diagnosed with TVT during the study period. Of these, 81.3% were mixed-breed, 50.4% were males, and 88.9% were young or adult animals. The genital region only was affected in 77.3% of cases. Exclusively extragenital lesions were observed in 22.6% of cases. Among the animals seen, 40.1% received no treatment. Of those treated, 99.3% underwent a vincristine sulfate protocol, and in 77.2%, the treatment resulted in total remission of the neoplasm after 4 to 6 chemotherapy sessions. It was concluded that TVT is a neoplasm most often seen in mixed-breed dogs and located in the genital region, with hemorrhagic secretion being the main clinical sign reported by owners. Vincristine sulfate is currently the most used therapy, with high efficacy. However, despite the good prognosis, there was a high rate of non-adherence or abandonment of treatment, and this is an important factor to be considered and addressed by veterinarians.

O tumor venéreo transmissível (TVT) apresenta elevada incidência no Brasil, relacionada a elevada população de caninos errantes e a ineficácia dos programas de controle epidemiológicos. O objetivo do estudo foi descrever dados epidemiológicos, manifestação clínica e o tratamento empregado em cães acometidos pelo TVT no Hospital Veterinário da Universidade Federal Rural do Rio de Janeiro entre os anos de 2015 e 2020. Foram diagnosticados 252 cães com TVT durante o período do estudo, sendo 81,3% cães sem raça definida, 50,4% machos e 49,6% fêmeas, e com 88,9% animais jovens ou adultos. A região genital foi acometida em 77,3% dos casos. Lesões exclusivamente extragenitais foram observadas em 22,6% dos casos. Quanto ao tratamento, 40,1% dos cães não receberam tratamento. Entre os animais tratados, 99,3% utilizaram protocolo com sulfato de vincristina e em 77,2% o tratamento resultou em remissão total da neoplasia, com a realização de 4 a 6 sessões do quimioterápico. Conclui-se que o TVT é uma neoplasia frequentemente relacionada a cães sem raça definida, localizados na região genital, com secreção hemorrágica sendo o principal sinal clínico reportado pelos proprietários. O sulfato de vincristina é a terapia mais empregada, com alta eficácia. Entretanto, apesar de ser uma neoplasia com bom prognóstico, o alto índice de não adesão ou abandono ao tratamento representa um importante fator a ser considerado e trabalhado pelos médicos veterinários.

Cutaneous epitheliotropic lymphoma in a Lhasa Apso

Background: Lymphoma neoplasms originate from the lymphocytes. Anatomically, these tumors can be classified into multicentric, digestive, mediastinal, and cutaneous forms. The etiology of cutaneous lymphoma remains unclear; however, it has been associated with chronic skin inflammation. The definitive diagnosis is based on histological analysis and immunohistochemistry, although fine-needle aspiration cytology has shown good results. The aim of this paper is to describe the clinicopathological aspects of a case of cutaneous epitheliotropic T cell lymphoma, classified as mycosis fungoides, in a Lhasa Apso dog. Case: A 8-year-old bitch Lhasa Apso with multiple non-pruritic skin nodules and history of 10-day evolution was referred to the Veterinary Hospital of the Centro Universitário do Espírito Santo (UNESC), Colatina, ES, Brazil. The nodules were erythematous, exophytic, firm, circumscribed, and measured 0.2-4 cm in diameter in locations throughout the animal's body. An incisional biopsy was performed with an 8-mm punch and sent for histopathological examination. An infiltrative, poorly demarcated, non-encapsulated, densely cellular neoplasm, which was replacing the dermal collagen and displacing the adnexa, was observed in the dermis. The tumor was composed of a population of round cells, with generally distinct cell borders and a small-to-moderate amount of eosinophilic cytoplasm. The nuclei were irregularly rounded and occasionally edentulous, with vesicular chromatin, a visible nucleus, and 11 mitotic figures in an area of 2.37 mm2 . The immunohistochemical test, which was positive for the CD3 marker, confirmed the diagnosis of T cell lymphoma. On an ultrasound to identify metastasis, the liver showed heterogeneous parenchyma, heterogeneous expansive formation, areas of cavitary appearance, and cytology compatible with lymphoma. Antineoplastic chemotherapy was administered using the CHOP regimen (cyclophosphamide, doxorubicin, vincristine, and prednisone). However, the animal died after 45 days. Discussion: A diagnosis of the mycosis fungoides type of cutaneous epitheliotropic T cell lymphoma was established based on clinical, laboratory, anatomopathological, and immunohistochemical findings. Pruritus is a common clinical condition in animals with mycosis fungoides, particularly in those with the erythrodermic form of the disease. Epitheliotropic lymphomas have no sexual or racial predilections and usually affect dogs over 9 years of age. The Cocker Spaniel, English Bulldog, Boxer, Golden Retriever, Scottish Terrier, Briard, English Springer Spaniel, Beagle, German Shepherd, and English Cocker Spaniel breeds are frequently affected by these lymphomas. These neoplasms can have a primary skin origin, or they can be secondary and associated with lymphoma found elsewhere in the body. Chemotherapy is the treatment of choice, especially in cases with multifocal distribution. Protocol preference varies with disease stage, patient clinical and laboratory conditions, and the degree of toxicity. Commonly used chemotherapy regimens include L-CHOP (vincristine, cyclophosphamide, doxorubicin, L-asparaginase, and prednisolone), CHOP, COP (cyclophosphamide, vincristine, and prednisone), LAP (lomustine, L-asparaginase, and prednisolone), LOPP (lomustine, vincristine, procarbazine, prednisolone), chlorambucil, and prednisolone. The prognosis of canine epitheliotropic cutaneous lymphoma is unfavorable, with a survival time ranging from a few months to 2 years. The animal in this study survived for 105 days. In addition, epitheliotropic cutaneous T cell lymphoma is aggressive, which may result in a shorter survival time in animals affected by this type of tumor.

Lomustine for treatment of canine transmissible venereal tumor / Eficácia da lomustina no tratamento do tumor venéreo transmissível canino

Canine transmissible venereal tumor (TVTC) is a highly casuistic transmissible neoplasm in Brazil. Chemotherapy with vincristine sulfate is considered the treatment of choice, but the need for weekly applications and hematological monitoring, in addition to costs, are obstacles to owners' adhesion to the treatment. Lomustine is an alkylating class antineoplastic agent, and because it is administered orally, it is a more practical and less costly treatment option for the owners of animals with neoplasms sensitive to the drug. This study evaluated the therapeutic efficacy of lomustine in dogs affected by TVTC. Twelve dogs with cytopathological diagnosis of natural genital TVTC were selected. The dogs were submitted to the experimental protocol with lomustine administration at doses of 70 to 85 mg/m2 orally every 21 days, totaling a maximum of two administration cycles. The animals were reevaluated every 7 days until a maximum of +49 days after the first dose of lomustine, to monitor the regression of neoplastic lesions through measurements. Among the 12 dogs submitted to the lomustine protocol, 8/12 achieved complete remission of the neoplasm and were considered cured (66.6%), 1/12 had partial response to treatment (8.33%) and 3/12 had stable disease (25%). Important adverse effects such as severe neutrophilic leukopenia were detected in 3/12 dogs (25%). The clinical study indicated that lomustine may be a treatment option for TVTC.

O tumor venéreo transmissível canino (TVTC) é uma neoplasia transmissível de elevada casuística no Brasil. A quimioterapia com sulfato de vincristina é considerada o tratamento de escolha, mas a necessidade de aplicações semanais e acompanhamento hematológico, além dos custos, são obstáculos à adesão dos proprietários ao tratamento. A lomustina é um antineoplásico da classe dos agentes alquilantes e, por ser administrado por via oral, representa um opção de tratamento mais prática e menos onerosa para os proprietários de animais com neoplasias. O objetivo deste estudo foi avaliar a eficácia terapêutica da lomustina em cães acometidos por TVTC. Foram selecionados 12 cães com diagnóstico citopatológico de TVTC genital de ocorrência natural. Os cães foram submetidos ao protocolo experimental com administração de lomustina nas doses de 70 a 85 mg/m2 por via oral a cada 21 dias, totalizando no máximo dois ciclos de administração. Os animais foram reavaliados a cada sete dias até um máximo de +49 dias após a primeira dose de lomustina, para monitorar a regressão das lesões neoplásicas por meio de mensuração das lesões. Entre os 12 cães submetidos ao protocolo, 8/12 obtiveram remissão completa da neoplasia e foram considerados curados (66,6%), 1/12 tiveram resposta parcial ao tratamento (8,33%) e 3/12 tiveram doença estável (25%). Efeitos adversos importantes, como leucopenia neutrofílica grave, foram detectados em 3/12 cães (25%). O estudo clínico indicou que a lomustina pode ser uma opção de tratamento para TVTC.

Tumor venéreo transmissível (TVT) nasal em cães / Nasal transmissible venereal tumor (TVT) in dogs

Background: Transmissible venereal tumors (TVT) are naturally occurring neoplasms that can be transmitted throughcopulation or cell transplantation. It is a disease that affects canines, has no preference for sex or breed, and generallynoticed in the external genital apparatus. Extragenital occurrence may eventually be seen; however, nasal involvementhas been described in only a few reports of studies conducted in Brazil. Therefore, the objective of this study is to report3 cases of nasal TVT in dogs who were treated in 2 municipalities in the mountainous region of Santa Catarina, Brazil.Cases: This case report includes 3 male mixed-breed canines of age 3-13. Only 1 of the animals was castrated. As per themedical history, some points, such as an enlarged nasal region, sneezing, nasal discharge, and hoarseness, reported by thedogs’ respective owners were similar among all the dogs. Likewise, nosebleed was observed on physical examination inall the cases. The result of cytological examination was inconclusive only in 1 case. Rhinoscopy, incisional biopsy, andhistopathological examination were then performed for achieving a definitive diagnosis. In the 2 cases wherein cytologygave conclusive results, the cytological smears showed changes suggestive of TVT, such as cells with eccentric nuclei andlittle cytoplasm, which had vacuoles inside them. In 2 cases, radiographic examinations of the skull were also performed.The images showed changes in bone radiopacity, conformation of trabeculae with areas of bone lysis and cell proliferation,and irregularity in the contour of the nasal bone. After TVT diagnosis was confirmed, chemotherapy was initiated usingvincristine at a dose of 0.75 mg/m2 for 2 cases and 0.025 mg/kg for the remaining case...

Tumor venéreo transmissível (TVT) nasal em cães / Nasal transmissible venereal tumor (TVT) in dogs

Background: Transmissible venereal tumors (TVT) are naturally occurring neoplasms that can be transmitted throughcopulation or cell transplantation. It is a disease that affects canines, has no preference for sex or breed, and generallynoticed in the external genital apparatus. Extragenital occurrence may eventually be seen; however, nasal involvementhas been described in only a few reports of studies conducted in Brazil. Therefore, the objective of this study is to report3 cases of nasal TVT in dogs who were treated in 2 municipalities in the mountainous region of Santa Catarina, Brazil.Cases: This case report includes 3 male mixed-breed canines of age 3-13. Only 1 of the animals was castrated. As per themedical history, some points, such as an enlarged nasal region, sneezing, nasal discharge, and hoarseness, reported by thedogs respective owners were similar among all the dogs. Likewise, nosebleed was observed on physical examination inall the cases. The result of cytological examination was inconclusive only in 1 case. Rhinoscopy, incisional biopsy, andhistopathological examination were then performed for achieving a definitive diagnosis. In the 2 cases wherein cytologygave conclusive results, the cytological smears showed changes suggestive of TVT, such as cells with eccentric nuclei andlittle cytoplasm, which had vacuoles inside them. In 2 cases, radiographic examinations of the skull were also performed.The images showed changes in bone radiopacity, conformation of trabeculae with areas of bone lysis and cell proliferation,and irregularity in the contour of the nasal bone. After TVT diagnosis was confirmed, chemotherapy was initiated usingvincristine at a dose of 0.75 mg/m2 for 2 cases and 0.025 mg/kg for the remaining case...(AU)

Vincristine sulfate treatment influence on kidney function of female dogs with transmissible venereal tumor / Influência do tratamento com sulfato de vincristina na função renal de cadela com tumor transmissível venéreo

Chemotherapy agents have some undesirable and non-selective cytostatic effects. Considering that kidneys are vulnerable to drug-induced toxicity, this study evaluated renal injury caused by vincristine sulfate (VS) in 12 female dogs diagnosed with transmissible venereal tumor (TVT). The animals were treated with VS (0.025 mg/kg IV) every 7 days for 4 weeks. During treatment, the animals were subjected to clinical examination, blood count, serum measurement of symmetric dimethylarginine (SDMA), blood urea nitrogen (BUN), creatinine, alanine aminotransferase, and alkaline phosphatase. In addition, urinalysis and urinary gamma-glutamyl transferase (GGT) measurements were performed. All parameters were determined three times: before beginning the treatment (T0), after 14 days (T1), and after 28 days (T2). During the study period, there were no changes in serum urea or creatinine levels, urine specific gravity, or persistent proteinuria. Furthermore, urinary GGT measurement did not indicate tubular lesions, and consistent elevation of SDMA was found in only one patient above the reference range. The results showed that weekly therapy with VS as a single agent for 28 days does not induce renal injury in most cases.(AU)

Os agentes quimioterápicos possuem efeitos citostáticos indesejáveis e não seletivos. Considerando a vulnerabilidade renal à toxicidade induzida por drogas, este estudo avaliou a lesão renal causada pelo sulfato de vincristina (VS) em 12 cadelas com diagnóstico de tumor venéreo transmissível (TVT). Os animais foram tratados com VS (0,025 mg / kg IV) a cada sete dias, durante quatro semanas. No transcurso do tratamento, os animais foram submetidos a exame clínico, hemograma, dosagem sérica de dimetilarginina simétrica (SDMA), nitrogênio ureico sanguíneo (BUN), creatinina, alanina aminotransferase e fosfatase alcalina. Além disso, foram realizadas análises de urina e medições de gama-glutamil transferase (GGT) urinária. Todos os parâmetros foram mensurados em três tempos, antes do início do tratamento (T0), aos 14 dias (T1) e aos 28 dias (T2). Durante o período do estudo, não houve alterações nas concentrações de ureia ou creatinina séricas, na gravidade específica da urina ou proteinúria persistente. Além disso, a medição de GGT urinária não indicou lesões tubulares, e elevação consistente de SDMA foi encontrada em apenas um paciente acima do intervalo de referência. Os resultados mostraram que a terapia semanal com VS como agente único por 28 dias não induz lesão renal na maioria dos casos.(AU)

Tumor venéreo transmissível canino em laringe com metástase pulmonar / Canine transmissible venereal tumor in the larynx with pulmonary metastasis

Background: Canine transmissible venereal tumor (TVT) is one of the most common canine neoplasms in Brazil. Lesions develop mainly in the genital tissue and less frequently in other areas, in the extragenital form. Metastasis is rare, and the disease progression depends on the patient’s immune status. The treatment of choice is chemotherapy with vincristine sulfate, considered an effective and safe modality. The present work describes the first case of extragenital TVT in the larynx with pulmonary metastasis at the time of diagnosis. Case: An approximately 4-month-old mixed-breed bitch was attended manifesting acute clinical respiratory signs. The patient had been rescued from the street 2 months beforehand. Physical examination revealed pale mucous membranes and crackling pulmonary auscultation. Thoracic radiography was performed in 3 projections, showing multiple nodules in the lung parenchyma, followed by cytopathological examination using fine needle puncture guided by thoracic ultrasound, confirming the diagnosis of TVT. Considering the cytological finding and the absence of primary tumor lesions in the genital, oral, cutaneous or nasal regions, endoscopy was performed in order to locate a possible primary focus. The exam revealed a small erythematous tumor with smooth and regular surface, measuring approximately 2.5 cm, located in the larynx, between the arytenoid cartilages. Chemotherapy was performed with vincristine sulfate with radiographic follow-up throughout the treatment. Full remission of the pulmonary and laryngeal nodules was achieved at the end of the protocol. The animal remained in complete remission for a period of 2 years. Discussion: TVT is more frequently observed in animals of active reproductive age, and rarely in animals under 1 year of age, as in the case...

Adenocarcinoma em glândula lacrimal de equino / Equine lacrimal gland adenocarcinoma

Background: Lacrimal gland adenocarcinoma is an extremely rare malignant neoplasm, with few descriptions in the literature. Therefore, its etiology and treatment are not well understood. The present study aims to report the case of an equine histologically diagnosed with lacrimal gland adenocarcinoma in the lower eyelid region and third eyelid treated by surgical excision and intralesional chemotherapy. Case: A 17-year-old male mixed-breed equine weighing 300 kg was treated in the large animal clinic and surgery sector of the Federal University of Santa Catarina in the city of Curitibanos, Santa Catarina, Brazil. The equine revealed an alert and docile temperament without considerable physiological changes in the physical examination. In the evaluation of the right eye, a tumor mass was observed in the region of the lacrimal gland adhered to the third eyelid and lower eyelid, with a light red ulcerated appearance approximately 7 cm in diameter. Therefore, the surgical excision of the adhered tumor mass was performed, with the subsequent intralesional application of 2 mL of Vincristine Sulfate. In the histopathological evaluation following the surgical excision of the tumor mass, yellowish-white fragments of irregular nodules were observed measuring from 3.5×2.0×1.7 cm to 2.0×0.5×0.3 cm, in addition to microscopy focus clusters of weakly basophilic neoplastic glandular cells, some with a randomly arranged lacy aspect, forming disorganized acinar structures and others showed marking islands of the cells organized in a palisade shape by vascular delicate stroma. The neoplastic cells presented anisocytosis, anisokaryosis, prominent nucleoli sometimes binucleated and with basophilic intracytoplasmic secretory material, delimited by scarce connective tissue. In some areas, there were small foci of infiltrated lymphocytes and plasmocytes and areas of necrosis. The mass was surrounded by connective tissue, where red blood vessels were found outside the vessels (hemorrhage), and mitoses were observed 2 per field at high magnification (40x). After the surgical procedure, it was not possible to follow up and reassess of the patient, so there is no clarification on the possibility of tumor recurrence. Discussion: The case reported is uncommon, being only the second report of adenocarcinoma in the equine lacrimal gland. Therefore, there are few descriptions in the literature about its defined etiology and the best treatment method, although, surgical excision is the method of choice because it is a tumor of high recurrence and invasiveness. In this case, we opted for the exeresis of the tumor mass and later application of chemotherapy, a treatment that was relatively effective, to avoid recurrence and the failure of the technique. In these cases, monitoring the animal after the procedure is recommended, evaluating whether there was tumor recurrence, although this was not possible in the present possible. The third eyelid, lacrimal, and zygomatic salivary glands may be sources of intraorbital neoplasms. These neoplastic processes may have similar histological and behavioral characteristics, and their differentiation is, therefore, problematic. These structures may be differentiated based on the anatomical location, however, clinical appearance and symptoms are identical in most cases. Adenocarcinoma in the equine lacrimal gland is a neoplasm considered rare, so it is important to emphasize an accurate diagnosis through histopathological analyses to differentiate it from other frequent orbital neoplasms in horses, allowing more information about this tumor and establishing different treatment methods.

Linfoma mediastinal em gato com vírus da leucemia felina / Mediastinal lymphoma in a cat with feline leukemia virus

Background: Mediastinal lymphoma occurs at a high incidence in cats positive for feline leukemia virus (FeLV). It is a malignant lymphocytic neoplasm that may trigger clinical signs such as dyspnea, apathy, regurgitation, and weight loss. The objective of this work is to report a case of mediastinal lymphoma associated with FeLV in a cat, and describe the clinical, pathological, diagnostic, and therapeutic aspects that can help the diagnosis and treatment of this disease. Case: A 3-year-old male neutered cat weighing 4.6 kg, positive for FeLV, and with a history of dyspnea and hyporexia was referred to a private veterinary clinic in the city of Caxias do Sul, RS, Brazil. The only alteration found at the clinical examination was a muffled sound during lung auscultation. Radiographs of the thorax revealed the presence of pleural effusion; after drainage of the fluid, a mass located in the mediastinal area became radiographically observable. An analysis of the effusion fluid showed high cellularity characterized by a markedly pleomorphic population of individual round cells consistent with lymphocytes. Small lymphocytes with a high nucleus:cytoplasm ratio, round nucleus, condensed chromatin, and inconspicuous nucleoli were observed, along with medium and large lymphocytes. The medium and large lymphocytes were characterized by a variably increased nucleus:cytoplasm ratio and a scant to moderate cytoplasm exhibiting moderate to intense basophilia and, occasionally, vacuoles. The nuclei were round, idented, or irregular; most of them were located eccentrically and contained coarse to finely granular chromatin. Nucleoli varied from single to multiple, round to angular, and central to peripheral and prominent. Macronucleoli and marked anisonucleosis were also observed, as well as binucleated cells and rare multinucleated cells. The conclusion was that it was a case of neoplastic effusion caused by a lymphoma. After an appointment with an oncologist, a chemotherapy protocol was established. The treatment of choice was CHOP, a combination of cyclophosphamide (20 mg/kg orally), doxorubicin (1 mg/kg intravenously), vincristine (0.5 mg/m2 intravenously), and prednisolone with a regressive dose starting at 2 mg/kg. The patient underwent 4 rounds of chemotherapy, and received a maintenance treatment thereafter. The patient's condition remained stable for 390 days without relevant clinical or hematological alterations. Discussion: The diagnosis of mediastinal lymphoma was established by associating clinical finings, laboratory exams, and radiographic findings. Exams of utmost importance to reach this diagnosis were the thoracic radiography, which revealed the presence of a mass in the thorax, and the cytopathological analysis of the effusion fluid, as round cell neoplasms are easily dissociated. Young cats are the group most affected by FeLV, and mediastinal lymphoma is considered the most prevalent type of lymphoma in this species. The most common clinical sign is dyspnea; however, other signs such as apathy, weight loss, regurgitation (due to pressure on the esophagus), and Horner's syndrome (owing to pressure on the thoracic sympathetic innervation) may also occur. This disease is treated with chemotherapy, with CHOP frequently used as the chemotherapeutic protocol. The good therapeutic response for a longer time than the average estimated by studies on the prognostic of this disease indicates that a correct diagnosis along with an assertive approach and the cooperation of the tutor are essential in cases of mediastinal lymphoma.

Acute phase protein and vitamin D concentration in dogs with multicentric lymphoma / Concentração de proteínas de fase aguda e vitamina D em cães com linfoma multicêntrico

This study aimed to evaluate the serum concentration of vitamin D (25-Hydroxyvitamin D) and acute phase proteins (APPs; alpha-1 acid glycoprotein, haptoglobin, transferrin, ceruloplasmin, albumin, IgA, IgG and alpha-1 - antitrypsin) as potential biomarkers for prognostic and therapy response in dogs with multicentric lymphoma submitted to the CHOP (Cyclophosphamide, Doxorubicin, Vincristine and Prednisone) chemotherapy protocol. Thirteen dogs with multicentric lymphoma classified as high grade by cytology were included in the treatment group (GL), while ten healthy dogs were included in the control group (GC). Serum was collected in the weeks T0, T5 and T10 of CHOP chemotherapy protocol, for the GL group, and in a single collection, for the GC group. All the collected samples were evaluated for the APPs and vitamin D concentrations through electrophoresis and chemiluminescence methods, respectively. Diagnostic and staging tests were performed for all the dogs in the GL group, and included cytopathology, histopathology and immunohistochemistry of the affected lymph node. Of these dogs, 9 achieved a complete response and 4 a partial response to the treatment. Data analysis was performed with the R software. The results demonstrated that serum concentrations of IgA, haptoglobin and α1-acid glycoprotein were significantly different between the groups and also between the different chemotherapy times analyzed (p<0.05), indicating that these proteins can be considered as sensitive biomarkers for lymphoma in dogs. Furthermore, the α1-acid glycoprotein showed prognostic value for the disease, with 63% specificity. However, vitamin D concentration was not correlated with prognosis of the dogs with lymphoma.

Objetivou-se caracterizar a concentração sérica da vitamina D e das PFAs (Proteínas de Fase Aguda) (alfa-1 glicoproteína ácida, haptoglobina, transferrina, ceruloplasmina, albumina, IgA, IgG e alfa-1 ­ antitripsina) em cães com linfoma multicêntrico, submetidos ao tratamento quimioterápico com protocolo CHOP (Ciclofosfamida, Doxorrubicina, Vincristina e Prednisona), determinando o valor prognóstico desses marcadores para a doença. Foram avaliadas as concentrações séricas das PFAs, através do método da eletroforese e as concentrações da vitamina D, através da quimioluminescência em dois grupos experimentais, um grupo de 13 cães com linfoma multicêntrico classificados como alto grau pela citologia (GL) durante as semanas T0, T5 e T10 do tratamento com protocolo quimioterápico antineoplásico e em um grupo de 10 animais saudáveis para compor o grupo controle (GC), em coleta única. Para isso, foi realizado o diagnóstico, estadiamento e avaliação de resposta terapêutica dos 13 pacientes com linfoma multicêntrico através de técnicas de citopatologia, histopatologia, imuno-histoquímica do linfonodo periférico acometido. Foi observado que 9 pacientes tiveram resposta completa e 4 pacientes tiveram resposta parcial ao tratamento. Os dados foram analisados através do software R. Os resultados indicam que as diferenças entre as variáveis IgA, haptoglobina e α1-glicoproteína ácida foram significativas entre os grupos, e entre os diferentes momentos da quimioterapia (p< 0,05), indicando que podem ser marcadores sensíveis ao linfoma em cães. A α1-glicoproteína ácida apresentou valor prognóstico para o linfoma, com 63% de especificidade. Porém a vitamina D não apresentou valor prognóstico para o linfoma multicêntrico em cães.

Combinação da auto-hemoterapia e sulfato de vincristina no tratamento de tumor venéreo transmissível em cadelas em Moçambique / Combination of autohemotherapy and vincristine sulfate in treatment of canine transmissible venereal tumor in bitches in Mozambique

Background: Canine transmissible venereal tumor (TVT) is a tumor of round cells. Vincristine sulfate is the most effective for TVT. Alternatively, hemotherapy is an alternative therapy that consists of the administration of autologous blood and the positive effects are associated with an immunomodulatory effect. Since chemotherapy has some collateral effects, it is necessary to study another treatment with minimal side effects. In this context, this report case aimed to describe the use of autohemotherapy associated with vincristine sulfate for treating a transmissible venereal tumor in the vulvar mucosa of 7 adult bitches, being the first case report in Mozambique, Africa. Case: Seven adult bitches, median size, were referred to the School Veterinary Hospital, School of Veterinary, Eduardo Mondlane University, Maputo, Mozambique, Africa, with a diagnosis of TVT in the vulvar mucosa. All bitches were treated weekly with autohemotherapy and vincristine sulfate for 21 days. The parameters assessed included clinical and TVT macroscopic examination, complete blood count, serum biochemical examination and urinalysis, and were evaluated 60-min before each treatment. No clinical side effects were identified during the treatments. Color, appearance and tumor size were changed during the treatment period, and all bitches showed complete remission of the tumor 21 days after the beginning of treatment or after the third therapeutic session. The values of the complete blood count, serum biochemical and urinalysis did not demonstrate significant variations throughout the evaluated time-points. The TVT cytopathological classification was lymphocytic (42.9 %), plasmacytic (28.6 %) and lymphoplasmacytic (28.6 %). Discussion: The aims of this report were to describe the combination of autohemotherapy and vincristine sulfate for treating the transmissible venereal tumor located in the vulvar mucosa of adult bitches, through clinical and laboratory evaluation, and was not...

Comparison between hematological and biochemical changes caused by conventional and metronomic chemotherapies in the treatment of canine transmissible venereal tumor / Comparação entre as alterações hematológicas e bioquímicas ocasionadas pela quimioterapia convencional e quimioterapia metronômica no tratamento do tumor venéreo transmissível canino

This study aimed to report the hematological and biochemical changes caused by conventional and metronomic chemotherapies, using vincristine sulfate to treat canine Transmissible Venereal Tumor (TVT). Twelve dogs were selected, six of them for the group receiving conventional chemotherapy (G1), and six dogs for the group receiving metronomic chemotherapy (G2). The G1 group received vincristine sulfate once a week at the dose of 0.75mg/m² until the tumor had disappeared with treatment, and the G2 group was treated with vincristine sulfate three times a week at the dose of 0.25mg/m2 until the tumor had disappeared. Before and after chemotherapy treatment, hematological and biochemical blood tests were performed to evaluate the main alterations caused by both chemotherapeutic models. Dogs undergoing conventional chemotherapy had significant leukocyte changes (p<0.05), causing neutropenia and leukopenia. In dogs undergoing metronomic chemotherapy, leukocytes remained within the reference range. Half of the dogs in group G1 had normochromic, normocytic anemia. The only biochemical alteration observed was the increase of urea in group G2. Thus, metronomic chemotherapy for the treatment of TVT with vincristine sulfate proved to be an excellent method for treatment, with fewer adverse effects, especially in maintaining the leukogram of dogs within normal range and reducing the number of anemia in animals during treatment.(AU)

Esta pesquisa teve como objetivo relatar as alterações hematológicas e bioquímicas causadas pelo tratamento quimioterápico convencional e pela quimioterapia metronômica, utilizando-se sulfato de vincristina para o tratamento do tumor venéreo transmissível canino(TVTC). Foram selecionados 12 cães, sendo seis para o grupo que recebeu quimioterapia convencional (G1) e seis cães para o grupo que recebeu quimioterapia metronômica (G2). O grupo G1 recebeu sulfato de vincristina, uma vez por semana, na dose de 0,75mg/m2, até o desaparecimento do tumor e o grupo G2 foi tratado com sulfato de vincristina, três vezes por semana, na dose de 0,25mg/m2, até o desaparecimento do tumor. Antes e após o tratamento quimioterápico foram realizados exames hematológicos e bioquímicos sanguíneos para avaliação das principais alterações causadas pelos dois modelos quimioterápicos. Os cães submetidos à quimioterapia convencional tiveram alterações leucocitárias significativas (p<0,05), causando uma leucopenia por neutropenia enquanto nos cães, submetidos à quimioterapia metronômica, os leucócitos mantiveram-se dentro do intervalo de referência. A metade dos cães do grupo G1 tiveram uma anemia do tipo normocítica normocrômica. A única alteração bioquímica observada foi o aumento da ureia no grupo G2. Desta forma, a quimioterapia metronômica para o tratamento do TVT com sulfato de vincristina, demonstrou ser um excelente método para a cura do animal, com menores reduções de efeitos adversos, sobretudo, na manutenção do leucograma dos cães e na redução de animais com anemia.(AU)

Comparison between hematological and biochemical changes caused by conventional and metronomic chemotherapies in the treatment of canine transmissible venereal tumor / Comparação entre as alterações hematológicas e bioquímicas ocasionadas pela quimioterapia convencional e quimioterapia metronômica no tratamento do tumor venéreo transmissível canino

This study aimed to report the hematological and biochemical changes caused by conventional and metronomic chemotherapies, using vincristine sulfate to treat canine Transmissible Venereal Tumor (TVT). Twelve dogs were selected, six of them for the group receiving conventional chemotherapy (G1), and six dogs for the group receiving metronomic chemotherapy (G2). The G1 group received vincristine sulfate once a week at the dose of 0.75mg/m² until the tumor had disappeared with treatment, and the G2 group was treated with vincristine sulfate three times a week at the dose of 0.25mg/m2 until the tumor had disappeared. Before and after chemotherapy treatment, hematological and biochemical blood tests were performed to evaluate the main alterations caused by both chemotherapeutic models. Dogs undergoing conventional chemotherapy had significant leukocyte changes (p<0.05), causing neutropenia and leukopenia. In dogs undergoing metronomic chemotherapy, leukocytes remained within the reference range. Half of the dogs in group G1 had normochromic, normocytic anemia. The only biochemical alteration observed was the increase of urea in group G2. Thus, metronomic chemotherapy for the treatment of TVT with vincristine sulfate proved to be an excellent method for treatment, with fewer adverse effects, especially in maintaining the leukogram of dogs within normal range and reducing the number of anemia in animals during treatment.(AU)

Esta pesquisa teve como objetivo relatar as alterações hematológicas e bioquímicas causadas pelo tratamento quimioterápico convencional e pela quimioterapia metronômica, utilizando-se sulfato de vincristina para o tratamento do tumor venéreo transmissível canino(TVTC). Foram selecionados 12 cães, sendo seis para o grupo que recebeu quimioterapia convencional (G1) e seis cães para o grupo que recebeu quimioterapia metronômica (G2). O grupo G1 recebeu sulfato de vincristina, uma vez por semana, na dose de 0,75mg/m2, até o desaparecimento do tumor e o grupo G2 foi tratado com sulfato de vincristina, três vezes por semana, na dose de 0,25mg/m2, até o desaparecimento do tumor. Antes e após o tratamento quimioterápico foram realizados exames hematológicos e bioquímicos sanguíneos para avaliação das principais alterações causadas pelos dois modelos quimioterápicos. Os cães submetidos à quimioterapia convencional tiveram alterações leucocitárias significativas (p<0,05), causando uma leucopenia por neutropenia enquanto nos cães, submetidos à quimioterapia metronômica, os leucócitos mantiveram-se dentro do intervalo de referência. A metade dos cães do grupo G1 tiveram uma anemia do tipo normocítica normocrômica. A única alteração bioquímica observada foi o aumento da ureia no grupo G2. Desta forma, a quimioterapia metronômica para o tratamento do TVT com sulfato de vincristina, demonstrou ser um excelente método para a cura do animal, com menores reduções de efeitos adversos, sobretudo, na manutenção do leucograma dos cães e na redução de animais com anemia.(AU)

Comparison between hematological and biochemical changes caused by conventional and metronomic chemotherapies in the treatment of canine transmissible venereal tumor

ABSTRACT: This study aimed to report the hematological and biochemical changes caused by conventional and metronomic chemotherapies, using vincristine sulfate to treat canine Transmissible Venereal Tumor (TVT). Twelve dogs were selected, six of them for the group receiving conventional chemotherapy (G1), and six dogs for the group receiving metronomic chemotherapy (G2). The G1 group received vincristine sulfate once a week at the dose of 0.75mg/m² until the tumor had disappeared with treatment, and the G2 group was treated with vincristine sulfate three times a week at the dose of 0.25mg/m2 until the tumor had disappeared. Before and after chemotherapy treatment, hematological and biochemical blood tests were performed to evaluate the main alterations caused by both chemotherapeutic models. Dogs undergoing conventional chemotherapy had significant leukocyte changes (p 0.05), causing neutropenia and leukopenia. In dogs undergoing metronomic chemotherapy, leukocytes remained within the reference range. Half of the dogs in group G1 had normochromic, normocytic anemia. The only biochemical alteration observed was the increase of urea in group G2. Thus, metronomic chemotherapy for the treatment of TVT with vincristine sulfate proved to be an excellent method for treatment, with fewer adverse effects, especially in maintaining the leukogram of dogs within normal range and reducing the number of anemia in animals during treatment.

RESUMO: Esta pesquisa teve como objetivo relatar as alterações hematológicas e bioquímicas causadas pelo tratamento quimioterápico convencional e pela quimioterapia metronômica, utilizando-se sulfato de vincristina para o tratamento do tumor venéreo transmissível canino(TVTC). Foram selecionados 12 cães, sendo seis para o grupo que recebeu quimioterapia convencional (G1) e seis cães para o grupo que recebeu quimioterapia metronômica (G2). O grupo G1 recebeu sulfato de vincristina, uma vez por semana, na dose de 0,75mg/m2, até o desaparecimento do tumor e o grupo G2 foi tratado com sulfato de vincristina, três vezes por semana, na dose de 0,25mg/m2, até o desaparecimento do tumor. Antes e após o tratamento quimioterápico foram realizados exames hematológicos e bioquímicos sanguíneos para avaliação das principais alterações causadas pelos dois modelos quimioterápicos. Os cães submetidos à quimioterapia convencional tiveram alterações leucocitárias significativas (p 0,05), causando uma leucopenia por neutropenia enquanto nos cães, submetidos à quimioterapia metronômica, os leucócitos mantiveram-se dentro do intervalo de referência. A metade dos cães do grupo G1 tiveram uma anemia do tipo normocítica normocrômica. A única alteração bioquímica observada foi o aumento da ureia no grupo G2. Desta forma, a quimioterapia metronômica para o tratamento do TVT com sulfato de vincristina, demonstrou ser um excelente método para a cura do animal, com menores reduções de efeitos adversos, sobretudo, na manutenção do leucograma dos cães e na redução de animais com anemia.

Hepatozoonose canina associada a quimioterapia para linfossarcoma de Sticker em Santa Catarina, Brasil / Canine hepatozoonosis associated with chemotherapy for Sticker's Lymphosarcoma in Santa Catarina, Brazil

A hepatozoonose canina, causada pelo protozoário Hepatozoon spp, é uma enfermidade que acomete carnívoros domésticos. O desenvolvimento da doença por vezes depende do estado imunológico do animal e pode se desenvolver, na maioria dos casos, na forma subclínica e crônica. O Linfossarcoma de Sticker, também conhecido como Tumor Venéreo Transmissível (TVT), é uma neoplasia de células redondas que acomete principalmente a membrana mucosa da genitália externa. Este trabalho teve por objetivo descrever o diagnóstico de Hepatozoonose em cão associado ao tratamento quimioterápico para TVT. Foi atendido na Clínica Veterinária Escola da UFSC um cão macho, idoso, SRD, não castrado. Na anamnese foi relatado aumento do volume na base da região peniana com presença de sangramento pelo orifício prepucial. À exposição da glande do pênis, nada foi observado, mas, durante a palpação interna do prepúcio, foram notadas várias massas de aspecto polipoide que, por meio de citologia, evidenciaram TVT. O paciente iniciou quimioterapia com vincristina e, após a terceira sessão, iniciou com quadro clínico de emagrecimento, conjuntivite e blefarite. Ao hemograma, observou-se gamonte de H. canis em neutrófilo. O paciente foi tratado com doxiciclina e dipropionato de imidocarb associado à atropina e recuperou-se bem. O esfregaço sanguíneo foi uma ferramenta diagnóstica muito importante nesse caso, pois as formas de H. canis foram melhor observadas em decorrência do aumento da parasitemia causada pela imunossupressão do animal.

Canine hepatozoonosis, caused by the Hepatozoon spp, is a disease that affects domestic carnivores. The development of the disease sometimes depends on the animal's immune status and it can develop, in most cases, in the subclinical and chronic form. Sticker's Lymphosarcoma, also known as Transmissible Venereal Tumor(TVT), is a round cell neoplasma that mainly affects the mucous membrane of the external genitalia. This study aimed to describe the diagnosis of Hepatozoonosis in a dog associated with chemotherapy treatment for TVT. A male dog, elderly, SRD, not neutered was seen at the Veterinary Clinic of UFSC. In the anamnesis, an increase in volume at the base of the penile with bleeding through the preputial orifice was reported. Upon exposure of the glans penis, nothing was observed, but during the internal palpation of the foreskin, several polypoid masses were noticed, which, through cytology, showed TVT. The patient started chemotherapy with vincristine and, after the third session, started having weight loss, conjunctivitis and blepharitis. At hemogram, a gamonte of H. canis was observed in neutrophils. The patient was treated with doxycycline and atropine-associated imidocarb dipropionate and recovered well. The blood smear was a very important diagnostic tool in this case, as the forms of H. canis were better observed due to the increase in parasitemia caused by the animal's immunosuppression.

LOPH and D-MHC in the treatment of FeLV associated acute leukemia in a cat

Background: Bone marrow primary malignancies are denominated leukemias, classified as myeloid or lymphoid, according to the cell lineage, and acute or chronic, according to the cell´s state of maturation. In cats, acute lymphoid leukemiais the most common form, especially in regions endemic for feline leukemia virus and / or feline immunodeficiency virus.A new treatment protocol for lymphomas, called LOPH, was described for animals with FeLV persistent viremia. Thisstudy aimed to report a case of a cat presenting with FeLV associated acute leukemia and treated with the LOPH protocol,and, in the rescue phase, a modification of the D-MAC protocol, denominated D-MHC.Case: A 4-year-old mixed breed intact queen was attended due to lethargy and inappetence. The patient did not present anyrelevant abnormalities in the clinical exam and complementary exams were performed including complete blood count,biochemical profile, SNAP Feline Triple Test, chest radiographs and abdominal ultrasound. Imaging tests and biochemicalvalues were unremarkable, but the patient presented a reagent result for FeLV and severe leukocytosis due to lymphocytosis. The morphological evaluation of the blood smear revealed the presence of blasts, in a concentration greater than 20%of the nucleated cells, which allowed the characterization of a leukemic state, probably lymphoid. First-line treatmentwas based on the LOPH protocol, including Lomustine, Vincristine, Prednisolone and Doxorubicin, in four-week cycles.Nevertheless, during the third cycle, 66 days after the institution of this protocol, the patient presented a febrile conditionalong with marked leukocytosis due to lymphocytosis, confirming leukemia recurrence. A rescue attempt was performedwith a modification of the D-MAC protocol, originally consisting of the combination of dexamethasone, melphalan, actinomycin-D and cytarabine, but with replacement of actinomycin-D by doxorubicin, and therefore denominated D-MHC....

Hepatozoonose canina associada a quimioterapia para linfossarcoma de Sticker em Santa Catarina, Brasil / Canine hepatozoonosis associated with chemotherapy for Sticker's Lymphosarcoma in Santa Catarina, Brazil

A hepatozoonose canina, causada pelo protozoário Hepatozoon spp, é uma enfermidade que acomete carnívoros domésticos. O desenvolvimento da doença por vezes depende do estado imunológico do animal e pode se desenvolver, na maioria dos casos, na forma subclínica e crônica. O Linfossarcoma de Sticker, também conhecido como Tumor Venéreo Transmissível (TVT), é uma neoplasia de células redondas que acomete principalmente a membrana mucosa da genitália externa. Este trabalho teve por objetivo descrever o diagnóstico de Hepatozoonose em cão associado ao tratamento quimioterápico para TVT. Foi atendido na Clínica Veterinária Escola da UFSC um cão macho, idoso, SRD, não castrado. Na anamnese foi relatado aumento do volume na base da região peniana com presença de sangramento pelo orifício prepucial. À exposição da glande do pênis, nada foi observado, mas, durante a palpação interna do prepúcio, foram notadas várias massas de aspecto polipoide que, por meio de citologia, evidenciaram TVT. O paciente iniciou quimioterapia com vincristina e, após a terceira sessão, iniciou com quadro clínico de emagrecimento, conjuntivite e blefarite. Ao hemograma, observou-se gamonte de H. canis em neutrófilo. O paciente foi tratado com doxiciclina e dipropionato de imidocarb associado à atropina e recuperou-se bem. O esfregaço sanguíneo foi uma ferramenta diagnóstica muito importante nesse caso, pois as formas de H. canis foram melhor observadas em decorrência do aumento da parasitemia causada pela imunossupressão do animal.(AU)

Canine hepatozoonosis, caused by the Hepatozoon spp, is a disease that affects domestic carnivores. The development of the disease sometimes depends on the animal's immune status and it can develop, in most cases, in the subclinical and chronic form. Sticker's Lymphosarcoma, also known as Transmissible Venereal Tumor(TVT), is a round cell neoplasma that mainly affects the mucous membrane of the external genitalia. This study aimed to describe the diagnosis of Hepatozoonosis in a dog associated with chemotherapy treatment for TVT. A male dog, elderly, SRD, not neutered was seen at the Veterinary Clinic of UFSC. In the anamnesis, an increase in volume at the base of the penile with bleeding through the preputial orifice was reported. Upon exposure of the glans penis, nothing was observed, but during the internal palpation of the foreskin, several polypoid masses were noticed, which, through cytology, showed TVT. The patient started chemotherapy with vincristine and, after the third session, started having weight loss, conjunctivitis and blepharitis. At hemogram, a gamonte of H. canis was observed in neutrophils. The patient was treated with doxycycline and atropine-associated imidocarb dipropionate and recovered well. The blood smear was a very important diagnostic tool in this case, as the forms of H. canis were better observed due to the increase in parasitemia caused by the animal's immunosuppression.(AU)

LOPH and D-MHC in the treatment of FeLV associated acute leukemia in a cat

Background: Bone marrow primary malignancies are denominated leukemias, classified as myeloid or lymphoid, according to the cell lineage, and acute or chronic, according to the cell´s state of maturation. In cats, acute lymphoid leukemiais the most common form, especially in regions endemic for feline leukemia virus and / or feline immunodeficiency virus.A new treatment protocol for lymphomas, called LOPH, was described for animals with FeLV persistent viremia. Thisstudy aimed to report a case of a cat presenting with FeLV associated acute leukemia and treated with the LOPH protocol,and, in the rescue phase, a modification of the D-MAC protocol, denominated D-MHC.Case: A 4-year-old mixed breed intact queen was attended due to lethargy and inappetence. The patient did not present anyrelevant abnormalities in the clinical exam and complementary exams were performed including complete blood count,biochemical profile, SNAP Feline Triple Test, chest radiographs and abdominal ultrasound. Imaging tests and biochemicalvalues were unremarkable, but the patient presented a reagent result for FeLV and severe leukocytosis due to lymphocytosis. The morphological evaluation of the blood smear revealed the presence of blasts, in a concentration greater than 20%of the nucleated cells, which allowed the characterization of a leukemic state, probably lymphoid. First-line treatmentwas based on the LOPH protocol, including Lomustine, Vincristine, Prednisolone and Doxorubicin, in four-week cycles.Nevertheless, during the third cycle, 66 days after the institution of this protocol, the patient presented a febrile conditionalong with marked leukocytosis due to lymphocytosis, confirming leukemia recurrence. A rescue attempt was performedwith a modification of the D-MAC protocol, originally consisting of the combination of dexamethasone, melphalan, actinomycin-D and cytarabine, but with replacement of actinomycin-D by doxorubicin, and therefore denominated D-MHC....(AU)

Abordagem de tratamento de múltiplos sarcóides em equino da raça Crioulo / Approach to treatment of multiple sarcoids in Crioulo horses

Background: The equine sarcoid corresponds to one third of equine tumors, and may present as single or multiple and insix different shapes. The etiology is still unknown, but it brings with it some predisposing factors. Confirmatory diagnosisis made based on histopathology evaluation. There are several treatments described in the literature, therefore, it variesaccording to the choice of the veterinarian, the conditions and interests of the owner and the characteristics of the sarcoidtumor. The present case report describe of a Crioulo horse that presented of a multiple sarcoids in different shapes of thebody and, testing the efficacy and response to the chosen treatment.Case: The Crioulo gateado coat stallion, aged six years and seven months, weigh 360 kg. In the physical evaluation observed alert behavior, body score (ECC) three (1-5), 36 bpm and 20 mpm. The pelvic right limb (PRL) presented a mobilefibroblastic nodule was found on the proximal dorsal face of the third metatarsal bone (MTIII), pendular and broad-based,ulcerated, with a diameter of approximately 10 cm x 7 cm associated of a dark pink color. Likewise, on the caudal surface ofthe ear observed verrucous sessile flat lesion with a diameter of 5 cm and, in the right corner of the mouth, a non-ulcerated,pendular, mobile dark red color nodule evidenced with a diameter approximately 3 cm. Similarly, there were multipleulcerated pendulous dark pink color mobiles nodules in the region of the left and right groin, as well in the pectoral region.Histopathological evaluation of the 0,5 cm specimen tumor observed a proliferation of connective tissue and thickening ofthe epidermis with pseudocarcinomatous projections suggestive of sarcoid lesion tumor...

Abordagem de tratamento de múltiplos sarcóides em equino da raça Crioulo / Approach to treatment of multiple sarcoids in Crioulo horses

Background: The equine sarcoid corresponds to one third of equine tumors, and may present as single or multiple and insix different shapes. The etiology is still unknown, but it brings with it some predisposing factors. Confirmatory diagnosisis made based on histopathology evaluation. There are several treatments described in the literature, therefore, it variesaccording to the choice of the veterinarian, the conditions and interests of the owner and the characteristics of the sarcoidtumor. The present case report describe of a Crioulo horse that presented of a multiple sarcoids in different shapes of thebody and, testing the efficacy and response to the chosen treatment.Case: The Crioulo gateado coat stallion, aged six years and seven months, weigh 360 kg. In the physical evaluation observed alert behavior, body score (ECC) three (1-5), 36 bpm and 20 mpm. The pelvic right limb (PRL) presented a mobilefibroblastic nodule was found on the proximal dorsal face of the third metatarsal bone (MTIII), pendular and broad-based,ulcerated, with a diameter of approximately 10 cm x 7 cm associated of a dark pink color. Likewise, on the caudal surface ofthe ear observed verrucous sessile flat lesion with a diameter of 5 cm and, in the right corner of the mouth, a non-ulcerated,pendular, mobile dark red color nodule evidenced with a diameter approximately 3 cm. Similarly, there were multipleulcerated pendulous dark pink color mobiles nodules in the region of the left and right groin, as well in the pectoral region.Histopathological evaluation of the 0,5 cm specimen tumor observed a proliferation of connective tissue and thickening ofthe epidermis with pseudocarcinomatous projections suggestive of sarcoid lesion tumor...(AU)