Multi-modality imaging and therapeutics used in a case of canine spinal nephroblastoma.

A 4-year-old castrated male golden retriever dog was brought to a veterinary teaching hospital for evaluation of acute progressive paraparesis. Neurological examination indicated a spinal cord lesion between the third thoracic vertebra and third lumbar vertebrae. Magnetic resonance imaging (MRI) revealed an intradural, extra medullary, and/or intramedullary mass centered over the eleventh and twelfth thoracic disc space. The dog underwent cytoreductive surgery and histopathologic analysis diagnosed a nephroblastoma. Following this, the dog underwent multimodal therapy, including multiple surgeries, 2 courses of radiation, and combination chemotherapy. The dog had serial restaging using MRI, computed tomography (CT), and fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography throughout the course of therapy. The dog survived 350 d from date of first presentation until humane euthanasia was elected due to worsening of neurologic status. During postmortem examination, extensive infiltration of the spinal cord by nephroblastoma cells was discovered as well as pulmonary metastatic disease. Key clinical message: Based on the literature search, this is the first case in which surgery, radiation therapy, and chemotherapy were all used for the treatment of canine spinal nephroblastoma. This case report details the aggressive nature of a case of canine spinal nephroblastoma despite multi-modal therapy.

Méthode d'imagerie et de thérapies multimodales utilisées dans un cas de néphroblastome spinal canin. Un chien golden retriever mâle castré âgé de 4 ans a été présenté dans un hôpital d'enseignement vétérinaire pour l'évaluation d'une paraparésie progressive aiguë. L'examen neurologique a révélé une lésion de la moelle épinière entre la troisième vertèbre thoracique et la troisième vertèbre lombaire. L'imagerie par résonance magnétique (MRI) a révélé une masse intradurale, extra-médullaire et/ou intramédullaire centrée sur les onzième et douzième espace de disque thoracique. Le chien a subi une chirurgie de cytoréduction et une analyse histopathologique a diagnostiqué un néphroblastome. Par la suite, le chien a subi une thérapie multimodale, comprenant plusieurs interventions chirurgicales, deux cycles de radiothérapie et une chimiothérapie combinée. Le chien a subi une reclassification en série par MRI, tomodensitométrie (CT) et tomographie par émission de positrons au fluor-18 fluorodésoxyglucose/tomodensitométrie tout au long du traitement. Le chien a survécu 350 jours à partir de la date de la première présentation jusqu'à ce que l'euthanasie soit choisie en raison de l'aggravation de l'état neurologique. Au cours de l'examen post-mortem, une infiltration étendue de la moelle épinière par des cellules de néphroblastome a été découverte ainsi qu'une maladie métastatique pulmonaire.Message clinique clé :D'après la recherche documentaire, il s'agit du premier cas dans lequel la chirurgie, la radiothérapie et la chimiothérapie ont toutes été utilisées pour le traitement du néphroblastome spinal canin. Ce rapport de cas détaille la nature agressive d'un cas de néphroblastome spinal canin malgré une thérapie multimodale.(Traduit par Dr Serge Messier).

Nephroblastoma in a Common Mudpuppy Necturus maculosus simultaneously Present with a Mollicute Bacterium of the Genus Acholeplasma.

In March 2017, a wild-caught female common mudpuppy Necturus maculosus from Iowa, USA, with an enlarged posterior abdomen was submitted for diagnostic assessment. The cause of the abdominal distension was a large fluid-filled abdominal mass, diagnosed as a nephroblastoma. Parasites and numerous bacteria were isolated and identified from the mudpuppy but were determined to be incidental. Samples of the neoplasm inoculated onto an American toad Anaxyrus americanus cell line (BufoTad) yielded cytopathic effect during several passages. However, standard molecular testing of the cell culture supernatant failed to identify any viruses. Next-generation sequencing identified the replicating agent as a bacterium of the genus Acholeplasma. Immunohistochemistry confirmed the presence of Acholeplasma within the nephroblastoma, including within tumor cells. This is the first report of nephroblastoma and the second report of neoplasia in this species. The results also suggest that certain bacteria of the genus Acholeplasma might be oncogenic.

Renal Nephroblastoma in a 17-Month-Old Jack Russell Terrier.

A 17 mo old female Jack Russell terrier was diagnosed with unilateral primary malignant nephroblastoma. The dog presented with polyuria and polydipsia. Laboratory tests revealed polycythemia and elevated serum erythropoietin levels. Diagnostic imaging (i.e., MRI) revealed a unilateral renal mass without spinal cord involvement. Nephrectomy was performed, and the histopathologic diagnosis was nephroblastoma. The dog did not receive any chemotherapy, and there was no evidence of recurrent disease or metastasis over 30 mo after nephrectomy. This is the first case report of a dog presenting with polyuria and polydipsia found to be a result of nephroblastoma. Furthermore, this is the longest survival reported for canine nephroblastoma treated with nephrectomy alone.

Nephroblastoma in bester sturgeon, a cultured hybrid of Huso huso × Acipenser ruthenus: Diagnostic imaging, clinical and histopathological study.

Abdominal distention occurred at an incidence of 1% (15 from 1500 fish) in the population of 1-year-old bester (Huso huso × Acipenser ruthenus). Computed tomography (CT) images and radiographs showed a soft tissue mass compressed the posterior part of the swim bladder. Ultrasonography showed that the masses had different patterns. Internal examination revealed the abdominal cavities to be filled with large masses which appeared to encompass most of the visceral organs, including the swim bladder. The masses originated from the posterior kidney. Histologically, the masses were composed of mixtures of embryonal epithelial (tubules and glomeruli), blastema and mesenchymal tissues. The tubules showed cystic, papillary and tubular patterns. Tubules and glomeruloid structures were surrounded by proliferating blastema cells. The primitive mesenchyme was composed of loose streams and whorls of spindle to stellate cells with elongate nuclei. Histological findings in the skeletal muscles, hypoderm and spleen confirmed the metastatic tumour from the kidney in two cases. Immunohistochemically, neoplastic cells of the tubules and glomeruloid structures were positive for cytokeratin AE1/AE3. Sections stained with Masson's trichrome showed blue staining of the stroma. The histopathologic findings were consistent with nephroblastoma.

Neoplasms of the urinary tract in fish.

The veterinary literature contains scattered reports of primary tumors of the urinary tract of fish, dating back to 1906. Many of the more recent reports have been described in association with the Registry of Tumors in Lower Animals, and most of the spontaneous neoplasms of the kidney and urinary bladder are single case reports. In rare instances, such as described in nephroblastomas of Japanese eels and tubular adenomas/adenocarcinomas of Oscars, there is suggestion of a genetic predisposition of certain populations to specific renal neoplasms, environmental carcinogenesis, or potentially an unknown infectious etiology acting as a promoter. Hematopoeitic neoplasms have been infrequently described as primary to the kidney of a variety of fish species, and therefore those case reports of renal lymphoma and plasmacytic leukemia are addressed within the context of this review.

Renal nephroblastoma in a 3-month-old golden retriever.

Nephrectomy was performed in a 3-month-old intact female golden retriever dog for a renal nephroblastoma. The dog has remained disease-free for 19 months with nephrectomy alone. The adoption of human Wilms' tumor grading criteria may be useful in determining clinical stage, adjuvant treatment options, and prognosis in this rare disease.

Néphroblastome rénal chez un Golden Retriever âgé de 3 mois. Une néphrectomie a été réalisée sur une chienne Golden Retriever intacte âgée de 3 mois pour un néphroblastome rénal. La chienne est demeurée exempte de maladie pendant 19 mois, seulement à l'aide de la néphrectomie. L'adoption du critère humain de Wilms pour la classification des tumeurs peut être utile pour déterminer le stade clinique, les options de traitement auxiliaire et le pronostic de cette maladie rare.(Traduit par Isabelle Vallières).

A long survival case of spinal nephroblastoma in a dog.

Background: Dogs' nephroblastoma of the spinal cord is a rare neoplastic disease, with few reports of long-term survival after surgery. We experienced that surgical treatment with postoperative radiation therapy for spinal nephroblastoma in a dog resulted in the long-term survival of 11 years. Case Description: The patient presented to our veterinary hospital because of progressive hindlimb paralysis. Based on diagnostic imaging, she was diagnosed with a thoracolumbar spinal cord tumor and was treated with surgery. The gross tumor tissue was removed after laminectomy, followed by postoperative radiation therapy using orthovoltage equipment. The histopathological features of the surgical specimen were consistent with those of previously reported spinal nephroblastoma, although infrequent mitotic figures were observed. The dog recovered well after treatment and resumed her normal walking condition. No tumor recurrence was observed on periodic follow-up magnetic resonance imaging performed 10 and 21 months after surgery. Imaging evaluation for the gradual development of hindlimb weakness was performed 9 years after surgery; however, no recurrence of tumor tissue was observed, and spondylosis deformans, probably induced after laminectomy, were identified as a possible cause. The dog died of aspiration pneumonia 11 years after surgery, independent of spinal nephroblastoma. Conclusion: To date, no clinical cases of canine spinal cord primary nephroblastoma that survived for 11 years after surgery have been reported. This case strongly suggests that providing intensive treatment for canine spinal nephroblastoma is very important.

Spinal cord nephroblastoma in dogs: 11 cases (1985-2007).

OBJECTIVE: To evaluate clinical features and outcome of dogs with a confirmed spinal cord nephroblastoma and to describe the use of Wilms tumor-1 (WT-1) immunohistochemical staining to confirm a diagnosis of nephroblastoma in dogs. DESIGN: Retrospective case series. Animals-11 dogs with a spinal cord nephroblastoma. PROCEDURES: Medical records of dogs with a spinal cord nephroblastoma were reviewed. Information extracted included signalment, history, clinical signs, results of diagnostic testing, tumor location, treatment, and outcome. The diagnosis was confirmed through histologic review and WT-1 immunohistochemical staining of a tumor sample. In dogs with negative results for staining with WT-1, staining for cytokeratin, vimentin, and glial fibrillar acidic protein was performed. RESULTS: 11 dogs had a spinal cord tumor with a histologic appearance and immunohistochemical staining consistent with a nephroblastoma. Positive results for staining with WT-1 were detected in 9 of 11 dogs. Age at admission ranged from 5 to 48 months (median, 14 months). Nine dogs were female. All had progressive paraparesis, paraplegia, or ataxia. Duration of clinical signs ranged from 2 to 60 days (median, 14 days). Median survival time was 30 days from the time of diagnosis. Median survival time in dogs treated via surgical resection was 70.5 days. CONCLUSIONS AND CLINICAL RELEVANCE: The prognosis for dogs with a spinal cord nephroblastoma appeared to be poor, although combined surgical resection and radiation therapy may provide a good functional outcome. Results for staining with WT-1 can be used to support a diagnosis of nephroblastoma.

Canine spinal nephroblastoma: long-term outcomes associated with treatment of 10 cases (1996-2009).

OBJECTIVE: To report clinical outcome associated with treatment of canine spinal cord nephroblastoma (CSN). STUDY DESIGN: Case series. ANIMALS: Dogs (n=10) with histopathologically confirmed CSN. METHODS: Records of dogs with CSN were reviewed and clinicopathologic, diagnostic imaging, treatment, outcome, and survival data were collected. RESULTS: CSN resulted in clinical signs of chronic, progressive T3-L3 myelopathy in young, large breed dogs, with an overrepresentation of German Shepherd Dogs (n=4). All CSN were located between T9 and L2. Dogs treated with cytoreductive surgery (n=6) or radiotherapy (1) survived longer (median, 374 days; range, 226-560 days) than dogs treated palliatively (3; median, 55 days; range, 38-176 days). Tumors confined to an intradural-extramedullary (ID-EM) location were associated with superior survival (n=6; median, 380 days; range, 176-560 days) than tumors with intramedullary (IM) involvement (n=4; median, 140 days; range, 38-269 days). Treatment resulted in temporary improvement in neurologic function in 9 dogs, including all dogs treated surgically, but local disease progression resulted in death of 8 dogs. CONCLUSIONS: Results of this observational study suggest that surgical cytoreduction and radiotherapy are effective at improving survival in dogs with CSN, and that ID-EM tumors may be associated with a more favorable prognosis than IM neoplasms.

Nasopharyngeal nephroblastoma in a 3-month-old Boer goat.

A 3-mo-old, female Boer goat was presented because of respiratory difficulties. Tachypnea and inspiratory dyspnea were noted during physical examination. Thoracic radiographs were unremarkable; however, upper airway and nasal passage radiographs revealed a soft tissue mass within the nasal passages. The patient underwent cardiorespiratory arrest and did not respond to resuscitation efforts during endoscopy. A large, pedunculated, semi-firm mass originated from the soft palate and obstructed 90% of the nasopharynx on autopsy. Histologically, the mass was composed of primitive cells that multifocally formed tubules and glomeruloid structures intermingled with areas of fusiform and blastemal cells. The neoplastic cells were positive for cytokeratin (tubular and glomeruloid cells), vimentin (fusiform population and blastemal cells), and Wilms tumor 1 protein (glomeruloid structures) on immunohistochemistry, consistent with a triphasic nephroblastoma. To our knowledge, nasopharyngeal nephroblastoma has not been reported previously in any species.

Hand-assisted laparoscopic removal of a nephroblastoma in a horse.

A 3-year-old Thoroughbred was presented for evaluation of hematuria post exercise. On physical examination, an enlarged kidney was identified, as well as serum biochemical abnormalities such as an elevated creatine kinase (CK) and hypoalbuminemia. The kidney was removed laparoscopically and a nephroblastoma was identified.

Intramedullary spinal nephroblastoma in a mixed breed dog.

A 1-year-old male mixed breed dog presented for the evaluation of progressive hindlimb paresis. Neurological examination indicated a spinal cord lesion between the 3rd thoracic and 3rd lumbar vertebrae. Magnetic resonance imaging (MRI) revealed an intramedullary spinal cord lesion located at the level of the 1st and 2nd lumbar vertebrae. Following cytoreductive surgery of the mass, palliative radiation therapy was administered. A diagnosis of nephroblastoma was made based on histological examination. After radiation therapy, the disappearance of the spinal lesion was confirmed by MRI. The dog was improved from gait abnormality and alive at 16 months postoperatively, with slight signs of neurological dysfunction.

Intralobar nephroblastematosis in a nine-week-old Wistar rat.

Intralobar nephroblastematosis (ILNB) is a precursor lesion to the development of nephroblastoma (NB) in rats. Unilateral ILNB was observed in the kidney of a nine-week-old female Wistar rat (Crl:WI) from a short-term toxicity study. Clinical pathology and urinalysis did not reveal altered renal function. This microscopic, unencapsulated lesion consisted of basophilic sheets of blastemal cells that did not include a prominent mesenchymal component. These cells expanded in the interstitium, which trapped and compressed few normal renal tubules. The blastemal cells moderately differentiated to form rosettes, primitive tubules, and a glomeruloid body. Multifocally, the lumen of primitive tubules contained eosinophilic secretions with basophilic material in the center. The diagnostic criteria used were compared and differentiated with renal dysplasia, nephrogenic rest, NB in rats, and with that of the identical lesion in children.

Stromal-type Nephroblastoma with or without Anaplasia in Two Hedgehogs (Atelerix albiventris).

We describe the clinical and histological characteristics of stromal-type nephroblastomas that developed in two hedgehogs (Atelerix albiventris). In case 1, the tumour was composed of a proliferation of anaplastic stromal cells with ductal structures resembling the epithelium of nephroblastoma. In case 2, spindle-shaped cells that were somewhat larger than nephroblasts were frequently seen surrounding the cell cluster, and there was proliferation of stromal cells with collagen fibres at the periphery. Immunohistochemically, the tumour cells labelled weakly to strongly for the nephroblast marker Wilms' tumour-1 and were positive for Ki67 with rates of 5% and 10% for cases 1 and 2, respectively. Based on the above, the diagnosis was of stromal-type nephroblastoma with anaplasia in case 1 and without anaplasia in case 2. Our findings suggest that stromal-type nephroblastomas arise in adult hedgehogs and are clinically benign, and that histological anaplasia does not affect the prognosis.

Urinary Tract Cytology.

Cytologic evaluation of the urinary tract can be diagnostically rewarding in cases of renomegaly or when discrete kidney or bladder masses are identified. Cytology can often help to distinguish between cystic, inflammatory, and neoplastic disorders. Various types of cystic and benign urinary tract lesions, diseases associated with urinary tract inflammation, and the cytologic differences between primary and metastatic neoplasms of the kidney and bladder are described. Basic sampling techniques for urinary tract cytology are also discussed.

The cell tube block technique and an immunohistochemistry panel including Wilms tumor 1 to assist in diagnosing cavitary effusions in dogs and cats.

BACKGROUND: Cell blocks and immunohistochemistry (IHC) are increasingly recognized as being complementary tools for cytologic diagnostics, especially for neoplastic diseases. OBJECTIVES: The study aimed to evaluate the utility of cell tube block (CTB) IHC for refining the diagnosis of effusions in dogs and cats. METHODS: Cavitary effusions (n = 25) from dogs and cats classified by cytology as reactive, neoplastic, borderline (suspicious of neoplasia), and chylous were studied. CTB sections were stained with H&E, and immunostained with PAX-5, CD3, pancytokeratin (CK), vimentin, and Wilms tumor 1 protein (WT1) antibodies, according to the cytologic diagnoses. A histologic case series of confirmed normal, reactive, and neoplastic mesothelium and several different carcinomas were included to test the utility of WT1 as a marker of mesothelial cells. RESULTS: CTBs had a layered appearance with reduced background staining. CD3 and PAX5 immunolabeling allowed immunophenotype assessment in all of the lymphoma cases. In carcinomatous effusions, neoplastic cells were CK-positive, WT1-negative, and vimentin-negative (except for two cases). Wilms tumor 1 protein was positive in the nuclei of normal, reactive, and neoplastic mesothelial cells, and ovarian carcinomatous cells. Other carcinomas and lymphomas were negative. CONCLUSIONS: CTBs are valuable tools to assist in making a diagnosis of cavitary effusions in dogs and cats, and WT1 is a promising marker to differentiate mesothelial from carcinomatous cells.

Multifocal Spinal Cord Nephroblastoma in a Dog.

A 1-year-old male American pit bull terrier was presented with a history of proprioceptive deficits and mild lameness of the right hindlimb, which progressed after 5 months to paraparesis, culminating in tetraparesis after 2 weeks. Necropsy findings were limited to the spinal cord and consisted of multiple, intradural, extramedullary, slightly red masses which produced segmental areas of medullary swelling located in the cervical intumescence, thoracolumbar column, sacral segment and cauda equina. Histological evaluation revealed a tumour, composed of epithelial, stromal and blastemal cells, with structures resembling tubules, acini and embryonic glomeruli. Immunohistochemical labelling for vimentin, cytokeratin and S100 was positive for the stromal, epithelial and blastemal cells, respectively. A final diagnosis of multifocal spinal cord nephroblastoma was established. This is the first report of such a tumour showing concomitant involvement of the cervicothoracic, thoracolumbar, sacral and cauda equina areas of the spinal cord.

A blastema-predominant canine renal nephroblastoma with gingival metastasis: case report and literature review.

Nephroblastomas are uncommon embryonal tumors in dogs. We report herein a blastema-predominant nephroblastoma with gingival metastasis in an 8-y-old Miniature Pinscher dog. Histologically, the mass was composed mainly of blastemal elements with minor epithelial and mesenchymal differentiation. Metastatic masses in the gingiva had histologic and immunohistochemical features similar to those of the primary renal nephroblastoma. Neoplastic cells were extensively positive for both vimentin and PAX8, and scattered positive for cytokeratin. Using the clinical staging of human Wilms tumor, we staged our case as stage IV with <4 mo of survival time. We summarized previous studies of canine renal and spinal nephroblastomas, and analyzed the correlations among clinical staging, histologic classification, and mean survival time of dogs with renal nephroblastomas. Clinical staging was significantly correlated with survival time, as shown in humans. In dogs, however, additional factors can potentially influence the outcome of treatment and disease development.

[Nephroblastoma in a 2-year-old female dog]. / Nephroblastom bei einer 2-jährigen Hündin.

An intact female 2-year-old boxer presented with polydipsia, polyuria, and decreased feed intake. Palpation of the abdomen was painful. Sonography revealed an abdominal mass of the left kidney causing displacement of the organs located in the cranial and mid-abdomen. Dimen sion and invasiveness of the process were evaluated both by contrast enhanced ultrasound (CEUS) and contrast-enhanced computed tomography. Histopathological examination of a biopsy sample revealed a nephroblastoma. The case report describes the clinical, sonographic, and computed tomographic results and the outcome in the untreated dog over a period of 5 months.