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.

Diagnosis of transmissible venereal tumors in bitches - platelet indices are a remarkable marker?

Background: Hematological analyses are seen as more preferred laboratory analyses in canine transmissible venereal tumor studies. There is no information about the availability of platelets and their indices in routine practice in canine transmissible venereal tumor cases. Taking this as a starting point, this study analyzed the usefulness of platelet indices in dogs with transmissible venereal tumor in clinical laboratory diagnosis as well as examined the relationship between white blood cells, red blood cells, platelets (PLT), main platelet volume (MPV), platelet distribution width (PDW), plateletcrit (PCT), and the ratio of main platelet volume to platelets (MPV/PLT). Materials, Methods & Results: In the study, a total of 42 bitches of various breeds were used. Nineteen healthy bitches were used as a control group, and the others 23 with cTVT as a study group. Metastasis was not observed in any of the bitches involved in the study. History, clinical findings, and cytological examinations were evaluated for the diagnosis of cTVT. In animals with hemorrhagic discharge and neoplastic lesions, a vaginal cytological examination was performed. Typical TVT cells with large nuclei and intracytoplasmic vacuoles were observed in the vaginal cytological examinations, and the diagnosis of TVT was made. Healthy bitches (19) and those with TVT (23) were 39.16 5.37 months and 47.61 5.14 months old, respectively. From all animals, 2 mL blood samples were collected from V. cephalica to evaluate PIs in the complete blood count (CBC). Collected blood samples were analyzed using an automated hematology analyzer. As a result of the analysis, WBC, RBC, HGB, HCT, MCV, MCHC, RDW, PLT, MPV, PDW, PCT, and MPV/PLT data were obtained. Mild leukocytosis, an increase in PLT, and a decrease in MCV and MPV/PLT were determined in the study group compared to the control group. Cut-off values in CBC of bitches with TVT were determined as WBC: 13.35 (sensitivity: 78%; specificity: 90%); MCV: 67 (sensitivity: 57%; specificity: 95%); PLT: 315.50 (sensitivity: 65%; specificity: 74%); and MPV/PLT: 0.028 (sensitivity: 78%; specificity: 58%). In CBC analyses, a strong negative correlation between PLT and MPV/PLT was detected in both groups. Discussion: Canine transmissible venereal tumors are common in both stray and pet dogs. It is naturally transferred from animal to animal during mating by live tumor cells. This tumor can commonly affect the external genitalia and internal organs in some cases. It generally has the look of cauliflower, and its surface is ulcerated, inflammatory, hemorrhagic, and infectious. More preferred laboratory analyses are complete blood count and blood chemistry analysis in cTVT for to evaluate the success of treatments. Platelet indices have been investigated in many diseases such as endotoxemia, chronic enteropathy, mammary tumor, parvoviral enteritis, septic peritonitis, lymphoma, pyometra, visceral leishmaniasis, and babesiosis in dogs. There is no information available for either diagnostic or prognostic use of the PIs in canine TVT cases. Ultimately, in light of the presented study's results, platelet indices, especially PLT and the MPV/PLT ratio, seem to be notable laboratory markers in terms of easy accessibility and low-cost assessment techniques in canine transmissible venereal tumor cases. New data, however, should be established by a thorough follow-up study using a larger sample size and addressing its usefulness as a diagnostic or prognostic marker in canine transmissible venereal tumors.

Tumor neuroendócrino em coração de cão / Neuroendocrine tumor involving the heart of a dog

Background: Neuroendocrine tumors are epithelial tumors with predominant neuroendocrine differentiation. Ectopic thyroid carcinoma develops in the ectopic thyroid parenchyma, in the anterior mediastinum, being an important differential diagnosis of paraganglioma, although occurring less frequently than the same. The cells invade the mediastinal fat reaching the adventitia of the aorta. There is a possibility of metastatic formations in the lung, kidneys, and pancreas. A supporting treatment was provided. The present study proposes the exposition and description of a case of neuroendocrine tumor in the heart, considering the rarity of the involvement of this tumor in the canine species. Case: A 9-year-old American Bulldog male canine was treated at home in the city of Rio de Janeiro. On clinical examination, dyspnea, edema of the hind limbs and an increase in abdominal volume were observed. With the suspicion of congestive heart failure, mainly on the right, cardiac exams were requested. Because it was an aggressive animal, sedation was performed with a combination of tiletamine and zolazepam. During cardiac auscultation, the presence of S4 was noticed, characterizing a gallop rhythm. No alterations were observed on the electrocardiographic examination. The echocardiogram showed a tumor mass in the atrium and dilation of the venous return vessels. The tumor enveloped 80% of the atrium of a 9-year-old male American Bulldog. The abdominocentesis procedure was performed to drain abdominal free fluid. Furosemide, enalapril and digoxin were prescribed as a treatment. Three months after the start of treatment, the animal presented intense dyspnea that culminated in the death of the patient, who later had the body sent for necropsy and subsequent tissue collection for histopathological analysis. Based on the immunohistochemical markers chromogranin and synaptophysin, the work here presented describes a case of a neuroendocrine tumor suggestive of paraganglioma involving a dog's heart. Discussion: Brachycephalic dogs, such as Boxers, Bulldogs and Boston Terriers, are predisposed to the development of paragangliomas. The genetic predisposition is related to hyperplasia of the carotid bodies generated by chronic hypoxia, resulting from obstructive processes in the airways. As the reported dog is an American Bulldog, the possibility of the tumor in question was reinforced. Paragangliomas are more frequent in males from nine to thirteen years of age, commonly associated with other endocrine neoplasms. It is also an important marker present in paragangliomas. In contrast to the literature, the report points to a neuroendocrine tumor suggestive of paraganglioma, without eliminating the possibility of an ectopic thyroid tumor, because although TTF-1 appears in most thyroid tumors, not all of them are present, although it is very suggestive. Treatment in question, attributed to the control of right congestive heart failure, although with little effect, denotes that the obstructive process of the return pathway, even with the use of drugs that prevent congestion, did not delay the evolution of the disease. However, it is observed that the treatment resources for these tumors, whether by surgical or chemotherapy option, also have few answers. The lack of literature on ectopic thyroid tumors influences the diagnosis of paraganglioma. Thus, clinical and complementary findings, mainly along with immunohistochemistry, were essential in the diagnosis of neuroendocrine tumor. After 3 months of the start of the treatment, the animal died.

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.

Clinical presentation, histological findings, and prognosis in female dogs with mixed mammary neoplasms / Apresentação clínica, achados histológicos e prognóstico em cadelas com neoplasias mamárias mistas

The aim of this study was to describe the clinical and morphological characteristics of mixed mammary neoplasms and verify what characteristics affect the prognosis of female dogs with carcinomas in mixed tumors and carcinosarcomas. This was a retrospective study of 67 female dogs that underwent mastectomies and were diagnosed with benign mixed tumors (n=13), carcinomas in mixed tumors (n=44) and carcinosarcomas (n=10). Data regarding the clinical and histological aspects of the neoplasms were collected and the relation with specific survival times, and hazard ratios (HR) in 24 months was calculated. In univariate analysis, the diagnosis of carcinosarcoma (HR 8.26, p=0.006), carcinomatous areas with micropapillary or solid patterns (HR 17.49; p=0. 001) and lymph node metastasis (HR 7.07;p=0.020) were associated with specific survival. In multivariable analysis, only micropapillary or solid pattern (HR=16.34; p=0.007) remained independent factor associated with lower specific survival. Micropapillary or solid carcinomatous patterns were associated with shorter specific survival time (p=0.002) among animals with carcinomas in mixed tumors. Among the carcinosarcomas, lymph node metastasis (p=0.010) was associated with a shorter specific survival time. In conclusion, carcinomas in mixed tumors and carcinosarcomas vary in prognosis depending on the carcinomatous proliferation patterns and spread of the disease.

O objetivo deste estudo foi descrever as características clínicas e morfológicas das neoplasias mamárias mistas e verificar quais características interferem no prognóstico de cadelas com carcinomas em tumores mistos e carcinossarcomas. Este foi um estudo retrospectivo de 67 cadelas, que foram submetidas a mastectomias e diagnosticadas com tumores mistos benignos (n = 13), carcinomas em tumores mistos (n = 44) e carcinossarcomas (n = 10). Foram coletados dados sobre os aspectos clínicos e histológicos das neoplasias e a relação com o tempo de sobrevida específica e a razão de risco (OR) em 24 meses foram calculadas. Na análise univariada, o diagnóstico de carcinossarcoma (HR 8,26; p=0,006), as áreas carcinomatosas com padrão micropapilar e sólido (HR 17,49; p= 0,001) e metástase linfonodal (HR 7,07; p=0,020) foram associadas à menor sobrevida específica. Na análise multivariável, apenas o padrão micropapilar ou sólido (HR=16,34; p=0,007) permaneceu como fator independente associado à sobrevida. Proliferações carcinomatosas micropapilares ou sólidas (p = 0,002) foram associadas a tempos de sobrevida específica mais curtos entre os animais com carcinomas em tumor misto. Entre os pacientes com carcinossarcoma, metástases em linfonodos (p = 0,010) foram associadas a um menor tempo de sobrevida específica. Em conclusão, os resultados mostraram que os carcinomas em tumores mistos e os carcinossarcomas podem ter prognóstico variável, dependendo do padrão de proliferação carcinomatosa e da disseminação linfática da doença.

Cytological grading of canine mast cell tumors: correlation with histologic grading and survival time / Graduação citológica de mastocitomas caninos: correlação com graduação histológica e sobrevida

ABSTRACT: Mast cell tumors are one of the most common neoplasia in dogs and cytopathology and/or histopathology examinations are used for diagnosis. Histologic grading is considered the gold standard test to predict the prognosis of this neoplasia. However, studies have been conducted using the cytological grading system to provide similar information in a faster, less invasive, and more accessible way. This study aimed to investigate cytological graduation and correlate it with histological grading and the survival time of dogs diagnosed with cutaneous mast cell tumors at the Veterinary Hospital of "Universidade Federal de Uberlândia" over five years. For that, cytological and histological slides from 72 animals were reviewed. The statistical methods used were the kappa test for agreement between grading systems, the Kaplan-Meier for survival time, Cox regression for comparison of cytological and histological grades and survival time. The cytological grading when compared to the two-tier histologic grading, high and low grades, had a moderate agreement (kappa 0.566). When the correlation between survival time and the cytological grade was evaluated, there was a higher death rate in the group with high-grade mast cell tumors compared to low grade, pointing to a correlation between survival time and cytological grade (p=0.009). In conclusion, the cytological grade is useful to treatment planning and providing prognostic information that precedes tumor removal, showing a good correlation with the two-tier histologic grading and with the survival time of the animals.

RESUMO: O mastocitoma é uma das neoplasias cutâneas mais comum nos cães e os exames citopatológicos e/ou histopatológicos são utilizados para diagnóstico. A graduação histológica é considerada padrão ouro para prever o prognóstico dessa neoplasia. Contudo, estudos têm sido realizados visando utilizar graduação citológica para fornecer informações semelhantes de maneira rápida, menos invasiva e mais acessível. Esse trabalho objetivou realizar graduação citológica e correlacionar com as graduações histológicas e com a sobrevida de cães diagnosticados com mastocitoma cutâneo no Hospital Veterinário da Universidade Federal de Uberlândia durante 5 anos. Para isso, lâminas de citologia e histologia de mastocitomas de 72 animais foram revisadas. Os métodos estatísticos utilizados foram teste kappa para concordância entre os sistemas de graduação, método Kaplan-Meier para tempo de sobrevida dos animais, e análise pela regressão de Cox para comparação do grau citológico e grau histológico e o tempo de sobrevida global. A graduação citológica quando comparada com a histológica de dois níveis, alto grau e baixo grau, obteve uma concordância moderada (kappa 0,566). Na avaliação da correlação entre sobrevida e grau citológico, houve maior taxa de óbito no grupo de cães com mastocitoma de alto grau, comparado aos de baixo grau, sendo observada correlação entre a sobrevida e o grau citológico (p=0,009). Esse estudo concluiu que o grau citológico é útil para o planejamento do tratamento e para fornecer informações prognósticas que antecedem a exérese do tumor, tendo boa correlação com a graduação histológica de dois níveis e com a sobrevida dos animais.

Canine mixed tumors as one of the mammary neoplasia varieties

The most significant interest in veterinary oncology is occupied by tumors of a mixed nature, which are represented by the direct interaction of epithelial and mesenchymal components. According to some data, the formation of cell lineage of mesenchymal cells occurs due to the transformation of epidermal basket cells surrounding the glandular epithelium. In this case, the formation of a cartilage anlage with its further transformation into differentiated bone tissue occurs. The article contains information about the structure and features of the location and interaction of mixed tumors' glandular and stromal components in female dogs (n=29). It was revealed that in addition to simple mixed neoplasms, tumors with proplasia of the mesenchymal component into highly differentiated cartilage or bone tissue were also often registered. To confirm subcellular changes in the expression of certain types of proteins, such as a-SMA and vimentin, an IHC study was used. The expression of the studied biomarkers was established in mesenchymal fibroblastic differon cells and myoepithelial cells. The intensity of immunoreactive material expression ranged from moderate (2+) to strong (3+), indicating changes in myoepithelial cells' genotype during the formation of mixed mammary neoplasms.(AU)

Cholangiocarcinoma in a bitch - multimodal diagnosis

Background: Hepatic tumors of primary origin account for 0.6% to 2.9% of cases in canine species, less common than hepatic metastases. The hepatic tumors are divided into hepatocellular tumors, neuroendocrine tumors, bile duct tumors or cholangiocarcinomas, and mesenchymal tumors. Cholangiocarcinomas, are classified according to their origin, being intrahepatic, extrahepatic, or gallbladder type. Cholangiocarcinomas are considered rare in dogs and cats with a ratio of 29% to 71% compared to hepatocellular carcinomas, accounting for 9% of the hepatic tumors. The present study aims to describe a case of cholangiocarcinoma in a bitch, focusing on the diagnostic approach. Case: A 10-year-old castrated bitch Poodle was attended presenting hypoglycemia and seizure crisis. The patient had previous exams of hemogram and serum biochemical profile, showing a discrete increase of the hepatic enzymes alanine aminotransferase (ALT) and aspartate aminotransferase (AST), besides hypoglycemia. Previous ultrasound exam revealed the presence of a hepatic mass located between the right and square lobes, immeasurable, and significant splenomegaly. Abdominal palpation revealed the presence of immeasurable abdominal formation of undetermined origin. Abdominal computerized tomography (CT), glycemic curve, and insulin dosage were requested. Tomography exam showed an increase in hepatic volume with the presence of a heterogeneous formation in the right lateral lobe topography; increase in spleen dimensions and the presence of multiple nodules; and the presence of a nodule in the right lung, at the caudal thoracic region. The glycemic curve showed acute variations, and insulin dosage was between normal values. The animal was referred for surgery, as in abdominocentesis, it was observed the presence of hemorrhagic fluid, confirming active bleeding by ultrasonography. The owners chose for euthanasia. In the post-mortem evaluation the main lesion was confirmed of hepatic origin, with a massive, irregular, cavitary presentation, involving multiple hepatic lobes, and a single nodule was observed in the right caudal lobe of the right lung. Histopathological evaluation was considered inconclusive. Immunohistochemistry was performed and the association of the immunohistochemical profile with the morphological characteristics indicated diagnosis of cholangiocarcinoma. Discussion: The related symptomatology, in hepatic neoplasms, is generally considered non-specific, with reports of lethargy, vomiting, dyspnea, anorexia and weight loss, however, the dog in this study presented a unique manifestation of hypoglycemia and one episode of convulsive crisis resulting from it. The clinical manifestation observed was extremely unspecific making initial diagnosis difficult. The ultrasonographic examination was effective in evidencing the abdominal mass. In addition, abdominal CT was also performed, which confirmed the hepatic origin, detailing the macroscopic aspect. Biochemical analyses of ALT and AST showed a discrete increase. Biochemical changes may occur in dogs with hepatic neoplasms, although they are not specific. Functional pancreatic beta-cell tumors producing insulin are the most common cause of paraneoplastic hypoglycemia, although in the case the insulin dosage was within normal limits. In cases of nonislet cell tumor the mechanism is frequently associated with the production of insulin-like growth factor (IGF). In most cases the definitive diagnosis of cholangiocarcinoma can be obtained by histopathological examination, although in the present report the result obtained was inconclusive, requiring an immunohistochemical examination. Due to the aggressive and metastatic character of this neoplastic type, early detection becomes extremely important in order to maximize therapeutic chances, however, diagnosis may be difficult.

Fibroblastic osteosarcoma in a guinea pig (Cavia porcellus)

The article describes the case of a 3 year 6 months old Guinea Pig (Cavia porcellus) that was assisted at the Wildlife and Exotic Animal Practice of the Faculty of Veterinary Sciences, National University of Asunción. The patient presented a hard mass in the right hind limb extending from the proximal portion of the femur, projecting caudally to the proximal tuberosity of the calcaneus, with an increase in temperature, and a marked increase in sensitivity. Radiographic diagnosis refers to a mass with amorphous areas of mineral density. Fine needle aspiration puncture revealed an undifferentiated malignant proliferative process, requiring histopathological analysis to characterize the process. Disarticulation was performed and subsequent histopathologic diagnosis under hematoxylin-eosin and Masson's trichrome stain revealed fibroblastic osteosarcoma.(AU)

Malignant tumor of peripheral nerve sheath in the thoracolumbar region in a cat

Background: In veterinary medicine, peripheral nerve tumors (PNST) are classified from the cellular pattern and as benign and malignant (MPNST). The majorities of cases are benign and usually involve the skin and subcutaneous tissue of the head, neck, and limbs. Animals with MPTNS usually have spinal cord and spinal canal involvement and are also described in the small and large intestine, oral cavity, perirenal region, and urinary bladder. Treatment is performed according to the location of the neoplasm and metastasis is rarely described. The present article aims to report a case of a malignant tumor in the peripheral nerve sheath of a cat. Case: A 8-year-old domestic cat was presented with a history of progressive paresis in the pelvic limbs. On neurological evaluation, proprioceptive ataxia and proprioception deficit in the pelvic limbs were observed, suggestive of thoracolumbar injury. Blood work and serum biochemistry showed results within the reference for the species and the bi-directional immunochromatography test for FIV and FeLV were negative. The radiographs of the thoracolumbar segment did not show significant changes. Myelography with iodinated contrast and collection of cerebrospinal fluid (CSF) were performed. On myelography examination, iodinated contrast loss was found between the 6th and 7th thoracic vertebrae, while the CSF analysis was normal. The patient underwent laminectomy and durotomy for excision of a mass found dorsally to the spinal cord, with intradural location. The tumor was sent for histopathological examination. Microscopic analysis showed neoplastic proliferation of spindle-shaped cells with predominance of the Antoni A pattern. Immunohistochemical analysis demonstrated intense cytoplasmic staining of the neoplastic cells for vimentin and S100 protein. Based on these findings, the diagnosis of malignant peripheral nerve sheath tumor was made. Radiotherapy was suggested as adjuvant treatment after surgical procedure. However, the owner refuse to follow this recommendation due to cost restriction. The patient had a satisfactory clinical recovery, he has no longer presented proprioceptive ataxia or proprioception deficits in three months after the surgical procedure. Discussion: In the case described, the feline patient presented a history, clinical signs, and findings in the myelography exam related to MPNST in the region of the vertebral canal. This neoplasm usually involves the spinal canal or spinal cord, but has been described in other locations, such in the small and large intestine, oral cavity, perirenal region, and urinary bladder. Based on the findings of the physical examination and complementary exams, a surgical procedure was recommended. Then, laminectomy and dutoromy were performed to remove the mass. The treatment described in the literature in cases of MPTNS is surgery, which can be curative, but in some cases, the use of radiotherapy may be necessary. The histological patterns observed in this neoplasm are the Antoni A and B, in the case described the Antoni A pattern was observed. The definitive diagnosis was made by immunohistochemistry with vimentin and S100 protein. MPNST are few described in the thoracolumbar region in cats. The surgical treatment was curative, where improvement of the clinical signs could be observed three months after surgery. In addition, monitoring of patients is recommended to ascertain relapses and metastases.

Thecoma in an elderly crioulo mare

Background: Ovarian enlargement in mares can either be a physiological or pathological condition associated with neoplastic or non-neoplastic causes. Neoplasia is more prominent in elderly than young horses. Granulosa cell tumors are the most common neoplastic cause of ovarian enlargement, and thecoma is the rarest. Thecoma is a benign ovarian stromal neoplasia originating from the sexual cords of the embryonic gonad and can affect the production of steroid hormones, leading to changes in behavior and the estrous cycle. If only one ovary is affected, after unilateral ovariectomy, usually the mare can still be used for reproductive purposes. Herein, we report a case of ovarian thecoma in an elderly Crioulo mare. Case: A 15-year-old Crioulo mare was evaluated due to progressive weight loss. The mare presented a low body score, and on physical examination, all parameters were within reference limits. Hematological examination revealed anemia, hyperfibrinogenemia, and neutrophilia. Serum biochemistry examination were within the physiological limits. Rectal palpation revealed an increase in volume in the left ovary (4.3 × 2.9 × 3 cm), smooth consistency and no associated pain in either of the ovaries. Rectal ultrasonography revealed a heterogeneous pattern, suggesting a neoplasm. As a treatment modality and for definitive diagnosis, the mare underwent a unilateral flank ovariectomy laparoscopically in the quadrupedal position. On histopathological evaluation of the left ovary, the sample showed cysts associated with proliferating spindle cells arranged in a solid arrangement, occasionally forming eddies, in addition to hemosiderosis, with clear cytoplasm and lipid vacuoles. Macroscopically, the ovary presented with a regular surface, smooth to firm consistency, a homogeneous brownish appearance with blackened foci, and brownish fluid-filled cysts. These findings confirmed thecoma of the left ovary in the mare. Discussion: Ovarian enlargement in mares can be associated to the presence of neoplasia. Clinical signs of ovarian neoplasms can be nonspecific; therefore, to achieve a definitive diagnosis, it is imperative to evaluate and compare the patient's history, physical examination, and results of complementary examinations. Excessive production of hormones lead to behavioral changes in mares with ovarian tumors, such as masculinized or aggressive behavior, and anestrus persistence. Thecomas may or may not interfere with steroid production and levels. On ultrasound examination, ovarian neoplasms may present similar echogenicity patterns. Histopathological evaluation is the best diagnostic approach after an ovariectomy. The prognosis of ovariectomy is considerably successful with the mare regaining reproductive health, although some mares may become infertile, with a small, inactive contralateral ovary. Thecoma is a rare neoplasm in horses; however, owing to its potential to cause altered reproductive functions, it should be considered as a differential diagnosis in mares with increased ovarian volume.

Ovarian papillary carcinoma in a Mongolian gerbil (Meriones unguiculatus)

Neoplasms are among the most impacting disease diagnoses in veterinary medicine and have become increasingly common due to the greater longevity of animals as living conditions improved. The Mongolian gerbil is a small rodent species that has become popular recently. In these animals, the occurrence of neoplastic processes is relatively common, mainly tumors of the ventral gland in males and ovarian tumors in females. This work aims to report an ovarian tumor in a Mongolian gerbil Meriones unguiculatus Milne-Edwards 1867 (Rodentia, Muridae). At the initial presentation, the animal had dyspnea, prostration, and increased abdominal volume in the topography of the right ovary of approximately 2 cm. The animal was submitted to exploratory laparotomy because of the emergency nature of the case and the owners' refusal of additional exams due to financial restrictions. Thus, an ovariohysterectomy was performed, followed by a histopathological examination. The histopathology revealed an ovarian papillary carcinoma affecting both ovaries and cystic endometrial hyperplasia. With surgical removal and drainage of the thoracic fluid, the animal showed good recovery, with general improvement and return to regular activity, with a life expectancy of two years. Currently, the demand for specialized veterinarians for unconventional pets is increasing. This condition allows owners to raise their animals more properly, favoring greater longevity. Knowledge about the prevalence and incidence of diseases in different species is of enormous relevance in establishing the appropriate therapy, improving life quality, and increasing life expectancy in animals' lives.(AU)

Acinar adenocarcinoma of the lung in a cat: case report / Adenocarcinoma acinar pulmonar primário em gato: relato de caso

Among the diseases that cause dyspnea in felines, primary pulmonary neoplasia is rare and tends to affect senile cats. This study reports the case of a seven teen year old FeLV infected cat who was diagnosed acinar adenocarcinoma of the lung and kidney metastasis. It presented prostration and anorexia and was hospitalized with dyspnea and pleural effusion. Chest radiography indicated increased radiopacity in the cranial portion of the right hemithorax, compatible with presence of intrathoracic mass and the cytologic analysis of pleural effusion suggested feline infectious peritonitis. The animal died two days after, and the definitive diagnosis was concluded after necropsy and histopathological examination. Pulmonary adenocarcinoma should be included with differential diagnosis of respiratory diseases in cats, especially the elderly.

Entre as doenças que causam dispneia em felinos, a neoplasia pulmonar primária é rara e costuma acometer gatos senis. Este trabalho tem por objetivo relatar o caso de um felino, de 17 anos, portador do vírus da leucemia felina, diagnosticado com adenocarcinoma acinar pulmonar primário com metástase no rim e na pleura parietal. O paciente apresentava histórico inespecífico, sendo as principais queixas prostração e anorexia, e foi internado apresentando dispneia e efusão pleural. A radiografia torácica indicou aumento da radiopacidade na porção cranial do hemitórax direito, compatível com presença de neoformação intratorácica. A citologia da efusão foi sugestiva de peritonite infecciosa felina. O animal veio a óbito dois dias após o atendimento inicial e o diagnóstico definitivo foi determinado por meio da necropsia e da avaliação histológica. O adenocarcinoma pulmonar deve ser incluído como diagnóstico diferencial de doenças respiratórias em gatos, principalmente idosos.

Síndrome da feminização em cão com sertolioma / Feminization syndrome in a dog with Sertoli cell tumor

Background: The uncontrolled multiplication of Sertoli cells causes Sertoli cell tumor or Sertolioma. Because of this, the level of estrogen in the bloodstream increases rapidly and approximately 25% of dogs with this tumor develop feminization syndrome. Testicular neoplasms are more common in dogs than cats, and are often found in elderly patients. This work aims to describe the clinical signs of the feminization syndrome and the treatment instituted in a canine diagnosed with sertolioma. Case: A 18-year-old male canine, 19.5 kg of body mass, with an increase in testicular volume for about 2 years, was treated at the University Veterinary Hospital. On clinical examination, a matte and brittle coat, alopecia on the hind limbs and gynecomastia were observed. Also noted, non-harmonious aspect of the scrotum, pendular foreskin, atrophied right testicle and hyperplastic left, scrotal hyperthermia and absence of pain. In addition, as a result of the hyperestrogenism resulting from the neoplasm, the paraneoplastic syndrome of feminization, the patient also presented galactorrhea, pendular foreskin, atrophy of the penis and the contralateral testicle, dermatopathies, such as bilateral symmetrical alopecia of the flanks, easily removable hair and variable hyperpigmentation. Rectal body temperature of 38.6°C, clear lung auscultation and muffled cardiac auscultation. The results of laboratory tests showed changes such as thrombocytopenia, platelet counts below the reference levels, platelet count of 163,000/uL. There were no alterations that represented metastases in the imaging exams, such as in the chest X-ray in three incidences and in the abdominal ultrasonography. Then, we opted for the surgical procedure of orchiectomy, with the traditional technique of three clamps, associated with total ablation of the scrotum. Samples were sent to the histopathology laboratory and the diagnosis of sertolioma was confirmed. At 10, 30 and 90 days after the operation, the patient was reassessed for possible recurrences or alterations, but there were no complications or recurrence after the procedure. Discussion: Neoplasms of the male reproductive system are common in dogs. Sertolioma is considered one of the most frequent neoplasms in elderly dogs and that results in systemic clinical signs. This is in line with the 18-year-old dog described in the present report. In addition, it may result in clinical signs resulting from hyperestrogenism resulting from the neoplasm that is called paraneoplastic feminization syndrome. The characteristics of this syndrome are: gynecomastia, galactorrhea, pendular foreskin, atrophy of the penis and contralateral testicle, associated with dermatopathies, such as symmetrical bilateral alopecia. All these clinical signs were present. The diagnosis is made through complete anamnesis, complete clinical examination and complementary examination such as ultrasound help in the presumptive diagnosis, but only with histopathology can it be confirmed. In the clinical approach, histopathology was performed to close the diagnosis. Treatment is behind orchiectomy and total ablation of the scrotum, which was performed in the reported case. The treatment of choice was easy to apply, in addition to improving the patient's quality of life, promoting rapid post-surgical healing and an early return to normal life. However, for the effectiveness of the technique, the early diagnosis and collaboration of tutors is fundamental.

Alterations in APC, BECN1, and TP53 gene expression levels in colon cancer cells caused by monosodium glutamate / Alterações nos níveis de expressão gênica APC, BECN1 e TP53 em células de câncer de cólon causadas por glutamato monossódico

Colorectal cancer (CRC) is a disease with high incidence worldwide. As of 2018, it is the second leading cause of cancer deaths in the world. In Saudi Arabia, the incidence of this disease has been increasing in the younger population. Both genetic and lifestyle factors may have contributed to its increased incidence and pathogenesis. Monosodium glutamate (MSG) is a food flavor enhancer that can be found in many commercial foods, and it can sometimes be used as a substitute to table salt. MSG has been investigated for its possible genotoxicity, yielding controversial results. In the present study, the effect of MSG on cell viability and its effect on expression of APC, BECN1, and TP53 genes in SW620 and SW480 colon cancer cell lines were studied. TP53 is a tumor suppressor gene that functions in modifying DNA errors and/or inducing apoptosis of damaged cells, and both APC and BECN1 genes are involved in CRC and are of importance in cellular growth and metastasis. Cancer cell viability was analyzed using MTT assay, and the results showed a significant increase in the number of viable cells after 24h of treatment with MSG with different concentrations (0.5, 1.0, 10, 50, and 100mM). Moreover, gene expression results showed a significant increase in the expression levels of APC and BECN1 under specified conditions in both cell lines; conversely, TP53 showed a significant decrease in expression in SW620 cells. Thus, it can be concluded that MSG possibly confers a pro-proliferative effect on CRC cells.

O câncer colorretal (CCR) é uma doença com alta incidência mundial. Desde 2018, é a segunda principal causa de mortes por câncer no mundo. Na Arábia Saudita, a incidência dessa doença vem aumentando na população mais jovem. Tanto fatores genéticos quanto de estilo de vida podem ter contribuído para o aumento da sua incidência e patogênese. O glutamato monossódico (MSG) é um intensificador de sabor de alimentos que pode ser encontrado em muitos alimentos comerciais e às vezes pode ser usado como um substituto do sal de cozinha. O MSG tem sido investigado por sua possível genotoxicidade, produzindo resultados controversos. Neste estudo, foram estudados o efeito do MSG na viabilidade celular e seu efeito na expressão dos genes APC, BECN1 e TP53 em linhas de células de câncer de cólon SW620 e SW480. TP53 é um gene supressor de tumor que atua modificando erros de DNA e/ou induzindo apoptose de células danificadas, estando os genes APC e BECN1 envolvidos no CRC e sendo importantes no crescimento celular e metástase. A viabilidade das células cancerosas foi analisada por meio do ensaio MTT, e os resultados mostraram um aumento significativo no número de células viáveis após 24 h de tratamento com MSG em diferentes concentrações (0,5; 1,0; 10; 50 e 100mM). Além disso, os resultados da expressão gênica mostraram um aumento significativo nos níveis de expressão de APC e BECN1 sob condições especificadas em ambas as linhagens celulares. Por outro lado, TP53 mostrou uma diminuição significativa na expressão em células SW620. Assim, pode-se concluir que, possivelmente, o MSG confere um efeito pró-proliferativo às células CRC.

Cutaneous myxoma in broiler chicken detected during slaughtering

Background: A cutaneous or superficial myxoma is a benign neoplasm of dermal or subcutaneous fibroblast origin. Although rare, it has been previously described in several species, including poultry. It presents as a single node or soft mass with a gelatinous cut surface. Histopathological analysis is essential for diagnosis and to differentiate it from other mesenchymal neoplasms and inflammatory or degenerative processes. Microscopically, it consists of dermal or subcutaneous lobules of plump, stellate, or spindle-shaped, bland-looking cells embedded in a basophilic myxoid matrix. This report describes the pathological findings in a rare case of cutaneous myxoma in a 42-day-old broiler flock. Cases: During ante mortem inspection of a 42-day-old broiler flock at a slaughterhouse under the authority of the Federal Inspection Service (southern Brazil), nodular lesions or encrusted areas with yellow and black areas were observed in the head skin of less than 1% of animals. These lesions, approximately 0.5 cm in diameter, were observed on the comb, in the periocular skin region, and close to the animals' nostrils. During the breeding period, no health or epidemiological events were observed. Fragments of the lesions in the comb and periocular skin were collected and fixed in buffered 10% formalin. The samples were sent to the laboratory, routinely processed, and stained with hematoxylin and eosin and Alcian blue. Microscopically, the lesions consisted of irregular multifocal proliferation of connective tissue showing spindle cells with poorly demarcated borders and scarce cytoplasm in a slightly basophilic myxoid aspect matrix. The adjacent epidermis is compressed due to neoplastic proliferation. No areas of epithelial hyperplasia or inclusion bodies were observed. According to the pathologic description and considering its descriptive epidemiology, our main clinical suspicion was cutaneous fowl pox, a pathology characterized by the appearance of nodules in regions devoid of feathers. However, the microscopic changes observed were compatible with those described for cutaneous myxomas. In addition, the extracellular matrix was positive for Alcian Blue staining, which is an indicator of myxoma. In the present case, the SIF did not report the same macroscopic lesions in other flocks of the same origin. Discussion: Connective tissue tumors, including myxomas, occur considerably less frequently under field conditions. In addition, these neoplasms are more frequent in mature birds and are not usually described in broilers, as observed in this report. The cutaneous myxoma described in broilers is usually a sporadic neoplasm that does not cause zootechnical losses, as observed in the case report. Its etiology is unknown and has been associated with various factors, such as local trauma and foreign bodies. Some fragments of plant material from the breeding environment were microscopically detected in the encrusted areas, which may indicate previous trauma or a foreign body. Myxoma has been associated with avian leukosis virus (ALV) subgroup A, but SIF did not report the same macroscopic lesions in other flocks of the same breeder hen's origin in the present case. Furthermore, sporadic connective tissue tumors associated with the virus occur in mature chickens but not in broilers. Myxoma lesions should be considered in the differential diagnosis of other connective tissue tumors and infectious agents that cause lesions in the skin and subcutaneous tissue.

Alterations in APC, BECN1, and TP53 gene expression levels in colon cancer cells caused by monosodium glutamate / Alterações nos níveis de expressão gênica APC, BECN1 e TP53 em células de câncer de cólon causadas por glutamato monossódico

Colorectal cancer (CRC) is a disease with high incidence worldwide. As of 2018, it is the second leading cause of cancer deaths in the world. In Saudi Arabia, the incidence of this disease has been increasing in the younger population. Both genetic and lifestyle factors may have contributed to its increased incidence and pathogenesis. Monosodium glutamate (MSG) is a food flavor enhancer that can be found in many commercial foods, and it can sometimes be used as a substitute to table salt. MSG has been investigated for its possible genotoxicity, yielding controversial results. In the present study, the effect of MSG on cell viability and its effect on expression of APC, BECN1, and TP53 genes in SW620 and SW480 colon cancer cell lines were studied. TP53 is a tumor suppressor gene that functions in modifying DNA errors and/or inducing apoptosis of damaged cells, and both APC and BECN1 genes are involved in CRC and are of importance in cellular growth and metastasis. Cancer cell viability was analyzed using MTT assay, and the results showed a significant increase in the number of viable cells after 24h of treatment with MSG with different concentrations (0.5, 1.0, 10, 50, and 100mM). Moreover, gene expression results showed a significant increase in the expression levels of APC and BECN1 under specified conditions in both cell lines; conversely, TP53 showed a significant decrease in expression in SW620 cells. Thus, it can be concluded that MSG possibly confers a pro-proliferative effect on CRC cells.(AU)

O câncer colorretal (CCR) é uma doença com alta incidência mundial. Desde 2018, é a segunda principal causa de mortes por câncer no mundo. Na Arábia Saudita, a incidência dessa doença vem aumentando na população mais jovem. Tanto fatores genéticos quanto de estilo de vida podem ter contribuído para o aumento da sua incidência e patogênese. O glutamato monossódico (MSG) é um intensificador de sabor de alimentos que pode ser encontrado em muitos alimentos comerciais e às vezes pode ser usado como um substituto do sal de cozinha. O MSG tem sido investigado por sua possível genotoxicidade, produzindo resultados controversos. Neste estudo, foram estudados o efeito do MSG na viabilidade celular e seu efeito na expressão dos genes APC, BECN1 e TP53 em linhas de células de câncer de cólon SW620 e SW480. TP53 é um gene supressor de tumor que atua modificando erros de DNA e/ou induzindo apoptose de células danificadas, estando os genes APC e BECN1 envolvidos no CRC e sendo importantes no crescimento celular e metástase. A viabilidade das células cancerosas foi analisada por meio do ensaio MTT, e os resultados mostraram um aumento significativo no número de células viáveis após 24 h de tratamento com MSG em diferentes concentrações (0,5; 1,0; 10; 50 e 100mM). Além disso, os resultados da expressão gênica mostraram um aumento significativo nos níveis de expressão de APC e BECN1 sob condições especificadas em ambas as linhagens celulares. Por outro lado, TP53 mostrou uma diminuição significativa na expressão em células SW620. Assim, pode-se concluir que, possivelmente, o MSG confere um efeito pró-proliferativo às células CRC.(AU)

Pancreatic cancer orthotopic graft in a murine model

Purpose: Pancreatic ductal adenocarcinoma (PDAC) is one of the deadliest cancers with increasing incidence. Even if progress have been made, the five-year overall survival remains lower than 10%. There is a desperate need in therapeutic improvements. In the last two decades, new in-vitro models have been developed and improved, including tridimensional-culture spheroids and organoids. However, animal studies remain mandatory in the upscaling before clinical studies. Orthotopic and syngeneic grafting is a robust model to test a drug efficiency in a tumor and its microenvironment. Methods: We described a method for orthotopic and syngeneic graft of KRAS mutated, p53 wildtype, 8305 cells in a C57BL/6J mouse model. Results: With this microsurgical method, 30 mice were grafted, 24 by a junior and six by a senior, resulting in 95,8 and 100% of (partial and total) successful tumoral implantation, respectively. Twenty mice underwent ultrasound follow-up. It was an efficient method for the tumoral growth evaluation. At day 16 after grafting, 85% of the tumors were detectable by ultrasound, and at day 22 all tumors were detected. Conclusions: The presented method appears to be a robust and reliable method for pre-clinical studies. A junior master student can provide positive results using this technique, which can be improved with training.

Carcinoma de tireoide associado à metástase pulmonar e efusão pleural em um gato: relato de caso / Thyroid carcinoma associated with pulmonary metastasis and pleural effusion in a cat: case report

O presente trabalho relata um caso de carcinoma de tireoide em um felino doméstico, SRD de 10 anos de idade, fêmea, em que foram realizados exames laboratoriais e de imagem no laboratório veterinário Delort em Jundiaí (SP). A paciente apresentava apenas perda de peso e aumento de volume em região cervical ventral no início do quadro. Durante os exames de ultrassom abdominal e radiografia torácica observou-se presença de efusão pleural e opacificação pulmonar por padrão miliar, o que sugeria um quadro metastático. Após os achados o paciente foi encaminhado para o oncologista, além de ser realizada a colheita de material para exame citológico, onde foi confirmado o diagnóstico de carcinoma.(AU)

This paper reports a case of thyroid carcinoma in a crossbreed domestic feline, 10 years old, female. Laboratory and imaging exams were performed at the veterinary laboratory Delort in Jundiaí (SP). The patient presented weight loss and volume increase in the ventral cervical region at the beginning of the condition. During abdominal ultrasound and thorax radiography, pleural effusion and pulmonary opacification by miliary pattern were observed, which suggested a pulmonary metastasis. After the findings, the patient was referred to the oncologist, in addition to the collection of material for cytological examination, where the diagnosis of carcinoma was confirmed.(AU)

A comparative analysis of anatomopathological features and COX-2 expression of mammary neoplasms with malignant mesenchymal components in female dogs / Análise comparativa das características anatomopatológicas e expressão de COX2 em neoplasias mamárias com componentes mesenquimais malignos em cadelas

ABSTRACT: Canine mammary neoplasms with malignant mesenchymal components, such as carcinosarcomas and sarcomas, belong to an uncommon and histologically heterogeneous group. Little is known about the biological behavior of these histogenic variants. This study aimed to compare the clinicopathological characteristics and the COX-2 immunohistochemical expression of different histologic subtypes of carcinosarcomas and sarcomas. Samples of 23 carcinosarcomas and 15 sarcomas from the mammary glands of female dogs were studied. Medical records were reviewed to obtain clinical data. Subsequently, histology microscope slides were analyzed to assess for mesenchymal subtypes, necrosis, vascular invasion, histologic grades, and lymph node metastasis. Immunohistochemistry was used to assess the COX-2 expression. The malignant mesenchymal proliferation was categorized into osteosarcomas (23/40), fibrosarcomas (5/40), liposarcomas (6/40) and chondrosarcomas (4/40). The osteosarcomatous differentiation was the most predominant type among the sarcomas and carcinosarcomas and was associated with vascular invasion (P=0.010) and lymph node metastases (P=0.014). High COX-2 expression was detected in 14.3% of the carcinosarcomas (carcinoma and/or sarcoma cells) and 27.3% of the sarcomas. The carcinosarcomas and sarcomas had similar clinical and pathological characteristics and developed as large tumors, with intratumoral necrosis and a predominance of high histologic grades, although the frequency of vascular invasion and lymph node metastasis was low. Osteosarcoma subtypes presented more aggressive characteristics than non-osteosarcoma subtypes.

RESUMO: Neoplasias mamárias caninas com componentes mesenquimais malignos, como carcinossarcomas e sarcomas, são um grupo de neoplasias pouco frequentes e histologicamente heterogêneas e pouco se sabe sobre o comportamento biológico das variantes histogênicas. O objetivo desse estudo é comparar as características anatomopatológicas e a expressão imunoistoquímica de COX-2 de diferentes subtipos histológicos de carcinossarcomas e sarcomas. Foram estudados 23 carcinosarcomas e 17 sarcomas da glândula mamária de cadelas. Os prontuários médicos foram revisados para obtenção de dados clínicos. Posteriormente, as lâminas histológicas foram avaliadas para acessar os subtipos mesenquimais, necrose, invasão vascular, grau histológico, metástase linfonodal. A imunoistoquímica foi realizada para avaliar a expressão de COX-2. Os tipos encontrados de proliferação mesenquimal maligna foram osteossarcoma (23/40), fibrossarcoma (7/40), lipossarcoma (6/40) e condrossarcoma (4/40). A diferenciação osteossarcomatosa foi predominante entre os sarcomas e carcinossarcomas e foi associado com invasão vascular (P=0,006) e metástase linfonodal (P=0,014). Uma expressão alta de COX-2 foi detectada em 14,3% dos carcinossarcomas (células carcinomatosas e/ou sarcomatosas) e 27,3% dos sarcomas. Os carcinossarcomas e sarcomas apresentaram características clínicas e patológicas semelhantes e se desenvolveram como tumores grandes, com necrose intratumoral e predomínio de alto grau histológico, mas com baixa frequência de invasão vascular e metástase distante. Os subtipos osteossarcomatosos apresentaram características mais agressivas quando comparados com subtipos não osteossarcomatosos.