Retrospective evaluation of canine anal sac carcinoma (260 cases) in Brazil: late detection and failures in lymph node evaluation / Avaliação retrospectiva do carcinoma de saco anal canino (260 casos) no Brasil: detecção tardia e falhas na avaliação dos linfonodos

Anal sac neoplasms are common in companion animals, and the epidemiological profile has been extensively described in international studies; however, national data are still lacking. Data on the Brazilian reality of anal sac carcinoma cases' diagnosis and treatment are also scarce. The purpose of this study was to retrospectively evaluate cases of canine anal sac carcinoma and assess the profile of involvement, tumor size, and lymphatic invasion at the time of diagnosis. Information was obtained from Vetpat laboratory database, from 260 cases spanning a 12-year period (2010-2021). In histopathological evaluation at the time of diagnosis, data on sex, age, and race were described, as well as tumor size and lymphatic invasion. The presence of metastasis was also assessed in cases where lymph nodes were sampled. Simple descriptive statistical analysis was used to evaluate the data. Adult and elderly, female, and mixed-breed animals were more involved, indicating differences from international studies that can be attributed to sociocultural factors. In terms of tumor size, it was observed that 93% of the cases had the largest diameter above 2.5cm. Only 7% of the cases had the largest diameter below 2.5cm, demonstrating the often late diagnosis and the importance of rectal palpation examination during the general physical assessment of canine patients, particularly at an advanced age. Regarding lymphatic invasion and affected lymph nodes, 50% of the cases had lymphatic invasion described in the histopathological examination. However, only 5% of the lymph nodes were sent along with the primary tumor, indicating the disease's aggressive behavior but with possible metastases underdiagnosed.

As neoplasias de saco anal possuem incidência importante nos animais de companhia, tendo o seu perfil epidemiológico de acometimento amplamente descrito em estudos internacionais, entretanto dados nacionais ainda são escassos. De modo semelhante, dados acerca da realidade brasileira, associados ao diagnóstico e conduta desses casos, são inexistentes. O objetivo do presente trabalho foi avaliar, de forma retrospectiva, os casos de carcinoma de saco anal canino, avaliando o perfil de acometimento, o tamanho tumoral e a invasão linfática no momento do diagnóstico. Foi obtido informações de 260 casos, respectivo a um período de 12 anos (2010-2021), proveniente do banco de dados do laboratório Vetpat. Foram descritos os dados acerca do sexo, idade e raça, bem como o tamanho tumoral e presença de invasão linfática em avaliação histopatológica no momento do diagnóstico. Os casos que cursavam com envio dos linfonodos também foram avaliados quanto a presença de metástase. Os dados foram avaliados mediante análise estatística descritiva simples. Foi encontrado um maior acometimento em animais adultos a idosos, do sexo feminino e sem raça definida, evidenciando diferenças em relação a estudos internacionais, que podem ser atribuídas a fatores socioculturais. Em relação ao tamanho tumoral, observou-se que 93% dos casos apresentavam o maior diâmetro acima de 2,5cm e apenas 7% dos casos apresentavam o maior diâmetro abaixo de 2,5cm, evidenciando o diagnostico frequentemente tardio, bem como a importância do exame de palpação retal durante a avaliação física geral de pacientes caninos, principalmente em idade avançada. Quanto a avaliação da invasão linfática e linfonodos acometidos, 50% dos casos cursavam com invasão linfática descrita em exame histopatológico, entretanto em apenas 5% dos casos os linfonodos foram enviados junto ao tumor primário, evidenciando o comportamento agressivo da doença, porém com metástases possivelmente subdiagnosticadas.

Adenocarcinoma de saco anal com metástase vertebro-medular em um Cocker Spaniel / Anal sac adenocarcinoma with vertebromedullary metastasis in a Cocker Spaniel

Background: Several neoplasms can affect the perianal region, being the hepatic adenoma and the anal sac adenocarcinoma (ASAC), which is considered the most frequent. The ASAC is a malignant neoplasm originating from the secretory epithelium of the perianal apocrine glands and is rarely seen in veterinary medicine. The ASAC occurs mainly in adult to elderly canines with high metastasis rates. Patients may be asymptomatic or manifest discomfort and behavioral changes. In the presence of metastasis, the most frequent clinical signs are inappetence, coughing, dyspnea, and colorectal obstruction. Given this scenario, this paper aims to describe the clinical presentation, diagnostic examination, and necropsy findings of a Cocker Spaniel with ASAC and metastasis in the vertebral body, spinal cord, and cauda equina. Case: A 8-year-old neutered male Cocker Spaniel (12 kg of body mass) with a clinical history of non-ambulatory paraparesis was evaluated. The patient also presented tenesmus, difficulty to defecate, and the presence of nodules in the anal sac area. On the neurological examination, asymmetrical changes compatible with injury between L4-S3 were found. A complete blood count, serum biochemistry, and imaging exams such as plain radiography, abdominal ultrasonography (US), and magnetic resonance imaging (MRI) were requested. Blood count revealed anemia and neutrophilic leukocytosis and hypercalcemia. The liver showed increased echogenicity and thickened pancreas in the abdominal US scan. A slightly heterogeneous, vascularized mass with irregular borders was identified in the topographic region of the sublumbar lymph nodes; MRI images demonstrated an expansile formation in the ventral region of the lumbosacral spine, corresponding to the sublumbar lymph nodes and interruption of the cerebrospinal fluid at L5, suggestive of compression of the spinal cord and cauda equina. A presumptive diagnosis of perianal neoplasm with metastasis was made based on the complementary exams. The dog was referred to necropsy, which revealed a 4 cm tumor in the perianal region that invaded the pelvic canal. Multifocal nodules were present on the lung surface, liver, and kidneys, suggesting metastasis. On the cross-section of the spine, one could note the presence of the tumor in the vertebral bodies, spinal cord, and cauda equina from L5 to S3. Even with histopathological evaluation of the tumor, only the immunohistochemical analysis allowed us to confirm the anal sac adenocarcinoma. Discussion: Adenomas and carcinomas are perianal gland neoplasms common in adult and elderly male dogs; the Cocker Spaniel breed is among the most affected. The clinical signs presented by the patient, such as tenesmus and difficulty in adopting the posture of defecation, are common, although neurological changes are rare. As for metastasis, carcinomas of the perianal region present high chances of metastasis to organs including the liver, kidneys, and lungs, both lymphatically and hematogenously, but few studies have related these factors to neurological alterations due to metastasis. We concluded that metastases from carcinomas to the spine must be considered a possible differential diagnosis in cases of patients presenting clinical signs that are compatible with spinal cord compression and a history of previous neoplasm.