Hemangiossarcoma pouco diferenciado grau II em seio nasal esquerdo de cão: relato de caso / Grade II poorly differentiated hemangiosarcoma in the left nasal sinus of dog: case report

Hemangiossarcoma é um câncer com alto poder de malignidade e metástase, tendo origem em células endoteliais de vasos sanguíneos, é frequentemente encontrado em baço, pele e raramente em cavidade nasal de cães. Foi atendido um cão, SRD, de 13 anos, com secreção nasal hemorrágica em narina esquerda e aumento de volume dorsal ao nariz que se estendia até seio frontal, com exoftalmia de globo ocular esquerdo, tendo se instalado de forma aguda. Pela radiografia de crânio nas projeções latero-lateral obliqua e dorso ventral, observou-se lise óssea dos seios nasal, frontal e orbital. Colhido material para Citopatologia, o diagnóstico presuntivo foi osteossarcoma. A fim de se planejar o ato cirúrgico, realizou se a tomografia computadorizada de crânio, que evidenciou formação na cavidade nasal esquerda, com expansão até o osso orbital, sem acometimento de linfonodos regionais. A fim de se avaliar a hemostasia e possibilidades de tromboembolismo no pós-cirúrgico, realizou-se o tromboelastograma e o paciente tinha possibilidades de realizar trombo. Ele foi operado com sucesso, removida a maior parte da massa tumoral e utilizada a eletroquimioterapia no leito cirúrgico. O diagnóstico histopatológico foi hemangiossarcoma pouco diferenciado grau 2. O paciente recebeu tratamento com anti-coagulante nos dias seguintes, teve uma recuperação satisfatória e iniciou-se a quimioterapia adjuvante com doxorubicina após 1 mês da cirurgia, entretanto, ele apresentou quadro de sangramento difuso compatível com CID e veio a óbito. Os hemangiossarcomas são raros na cavidade nasal de cães e parece adotar um pior comportamento nesta região, quando comparado ao baço e pele, inclusive com possibilidade de síndrome para-neoplásica. O trombolestograma tem se mostrado um exame importante para avaliação do equilíbrio hemostático no controle as doenças neoplásicas.

Hemangiosarcoma is a cancer with high power of malignancy and metastasis, originating in endothelial cells of blood vessels, it is often found in the spleen, skin and rarely in the nasal cavity of dogs. A dog, SRD, 13 years old, was treated with hemorrhagic nasal discharge in the left nostril and increase in volume dorsal to the nose that extended to the frontal sinus, with exophthalmos of the left eyeball, which had been installed acutely. On the skull X-ray in the lateral oblique and dorsal-ventral projections, bone lysis of the nasal, frontal and orbital sinuses was observed. After collecting material for cytopathology, the presumptive diagnosis was osteosarcoma. In order to plan the surgical act, a computed tomography scan of the skull was performed, which showed formation in the left nasal cavity, with expansion up to the orbital bone, without involvement of regional lymph nodes. In order to assess hemostasis and possibilities of thromboembolism in the postoperative period, a thromboelastogram was performed and the patient had possibilities of having a thrombus. He was successfully operated on, removing most of the tumor mass and using electrochemotherapy in the surgical bed. The histopathological diagnosis was grade 2 poorly differentiated hemangiosarcoma. The patient received treatment with anticoagulants in the following days, had a satisfactory recovery and adjuvant chemotherapy with doxorubicin was started 1 month after surgery, however, he presented compatible diffuse bleeding. with ICD and died. Hemangiosarcomas are rare in the nasal cavity of dogs and seem to have a worse behavior in this region when compared to the spleen and skin, including the possibility of paraneoplastic syndrome. The thrombolestogram has been shown to be an important test for evaluating the hemostatic balance in the control of neoplastic diseases.

Clinical and complementary diagnosis of sinus neoplasia in horses

Background: Sinus neoplasms are reported as low frequency in horses. Its clinical characteristics are often nonspecific, depend on complementary methods for diagnosis, and when diagnosed, generally they are already advanced, limiting therapeutic possibilities. The objective of this case series was to detail clinical aspects and complementary exams for sinus neoplasms for early diagnosis, comparing them with the literature. Cases: Four horses were treated at the College of Veterinary Medicine and Animal Science of the University of São Paulo, with different clinical signs and previous diagnoses, which when evaluated by respiratory endoscopy, radiography, oral cavity evaluation and histopathological exams, revealed the diagnosis of anaplastic carcinoma, poorly differentiated carcinoma, ossifying fibroma and lymphoma. Previous diagnosis, based mainly on clinical signs, were sinusitis secondary to apical infection, ethmoidal hematoma, sinus cyst and sinusitis secondary to periapical disease. The cases of anaplastic carcinoma (case 1) and lymphoma (case 4) presented with an advanced degree of the disease with involvement and destruction of paranasal structures and adjacent tissues, in addition to a poor general condition, which made surgical treatment impossible and led to euthanasia. In these cases, previous treatment was made to apical infection and periodontal disease with secondary sinusitis, but negative evolution led to suspicion of neoplasia, confirmed by histopathological exam of incisional biopsy of the mass in oral cavity. Benign ossifying fibroma (case 3) presented with progressive respiratory difficulty due to occlusion of the lumen of some nasal meatus and radiographic signs of invasion and deformation of the adjacent bones, it was submitted for surgical excision and there was no recurrence until hospital discharge. The poorly differentiated carcinoma (case 2) was a multilobulate neoformation in the ethmoidal region, similar to ethmoid hematoma in endoscopic and radiographic evaluation, it was submitted for excision and two sessions of electrochemotherapy with bleomycin, associated with administration of piroxicam, which obtained a good result until the period of 1 year after discharge. Discussion: It was found that many characteristics are common with these types of neoplasms, and the clinical signs, such as nasal secretions, airway obstruction, increased facial volume, severe alterations in oral cavity, although unspecific, suggest the differential diagnosis for neoplasms. It is important to differentiate from other diseases noting the evolution and growth of these tumors, like in cases 1 and 4, especially the growth to internal tissues, using complementary methods described here, like endoscopic and radiographic examination. Late identification or even manipulation of neoplasms, without proper diagnosis, leads to a few prognoses regarding life. When it is possible to perform surgical excision, complementary methods are important to guide the procedure, and definitive diagnosis is made through histopathologic exam and some need immunohistochemistry analysis. Cases 2 and 3 had surgical access, were submitted to excision and treatment with good results, both with close monitoring in first months and prolonged quality of life. These results highlight the importance of complementary methods for early diagnosis, correct intervention and monitoring of evolution.

Sinonasal neoplasms in 49 dogs: clinical, macroscopic, and histopathological aspects / Neoplasmas nasossinusais em 49 cães: aspectos clínicos, macroscópicos e histopatológicos

This study aimed to quantify nasosinusal neoplasms diagnosed in dogs in 20 years (2000-2019) and characterize the main clinical, macroscopic, and histological aspects of these neoplasms. The sex, breed, age, skull conformation, the main clinical signs, and the anatomopathological characteristics (distribution, macroscopy, and histology) were computed. During this period, 49 dogs were affected by neoplasms in these regions, totaling 50 neoplasms (one dog had two neoplasms of different locations and histogenetic origins). Similar amounts of mixed-breed dogs (25/49) and purebred dogs (24/49) were affected, these distributed in 16 breeds. Among purebreds, it was noted that dogs with mesocephalic cranial conformation (12/24) were the most affected, followed by dolichocephalic (10/24) and brachycephalic (2/24). There were 22 cases in males and 27 in females, making a proportion of 1:1.23. There was an age variation from 11 months to 16 years old. The epithelial neoplasms have occurred in older dogs compared to those of other histogenic origins (mesenchymal and other origins/round cells). The main clinical signs were similar between the histogenetic categories, related to the involvement of the upper respiratory tract, sometimes accompanied by nervous signs (when there was brain invasion of nasal neoplasms or vice versa). The possible origin site was mostly in the nasal cavity concerning the paranasal sinuses (and other locations). Invasions occurred in different tissues adjacent to the nasal cavity and paranasal sinuses, resulting in cranial and facial deformities (21/49). The frequency was 48% of epithelial neoplasms, 32% of mesenchymal neoplasms, and 10% of neoplasms with other origins and round cells. The neoplasms most frequently observed, in decreasing order of frequency, were: adenocarcinoma (9/50), squamous cell carcinoma (9/50), transmissible venereal tumor (5/50), osteosarcoma (5/50), chondrosarcoma (4/50), and undifferentiated sarcoma (4/50). Through this study, it was possible to establish the frequency of these neoplasms in 20 years and their clinical, macroscopic, and histological characteristics.(AU)

Este estudo teve como objetivo quantificar os neoplasmas nasossinusais diagnosticados em cães em 20 anos (2000-2019) e caracterizar os principais aspectos clínicos, macroscópicos e histológicos desses neoplasmas. Foram computados sexo, raça, idade, conformação do crânio, principais sinais clínicos e características anatomopatológicas (distribuição, macroscopia e histologia). Nesse período, 49 cães foram acometidos por neoplasmas nessas regiões, totalizando 50 neoplasmas (um cão tinha dois neoplasmas de localização e origens histogenéticas distintas). Foram acometidas quantidades semelhantes de cães sem raça definida (25/49) e de cães com raça definida (24/49), estes distribuídos em 16 raças. Entre os cães com raça definida, notou-se que os cães com conformação craniana mesocefálica (12/24) foram os mais acometidos, seguidos pelos dolicocefálicos (10/24) e braquicefálicos (2/24). Foram observados 22 casos em machos e 27 em fêmeas, perfazendo a relação de 1:1,23. Ocorreu uma variação de idade de 11 meses a 16 anos; tendo os neoplasmas epiteliais ocorrido em cães mais velhos quando comparado aos de outras origens histogênicas (mesenquimais e outras origens/células redondas). Os principais sinais clínicos foram semelhantes entre as categorias histogenéticas, sendo relacionados ao comprometimento do trato respiratório superior, por vezes acompanhados de sinais nervosos (quando houve invasão encefálica de neoplasmas nasais ou vice-versa). O possível local de origem em sua maioria foi na cavidade nasal em relação aos seios nasais (e de outras localizações). Ocorreram invasões para diferentes tecidos adjacentes à cavidade nasal e seios paranasais, tendo como consequência deformidades cranianas e faciais (21/49). A frequência foi de 48% de neoplasmas epiteliais, 32% de neoplasmas mesenquimais e 10% de neoplasmas com outras origens e de células redondas. Os neoplasmas mais frequentemente observados, em ordem decrescente de frequência, foram: adenocarcinoma (9/50), carcinoma de células escamosas (9/50), tumor venéreo transmissível (5/50), osteossarcoma (5/50), condrossarcoma (4/50) e sarcoma indiferenciado (4/50). Com isso, pode-se estabelecer a frequência desses neoplasmas em 20 anos, bem como suas características clínicas, macroscópicas e histológicas.(AU)

Sinonasal neoplasms in 49 dogs: clinical, macroscopic, and histopathological aspects / Neoplasmas nasossinusais em 49 cães: aspectos clínicos, macroscópicos e histopatológicos

This study aimed to quantify nasosinusal neoplasms diagnosed in dogs in 20 years (2000-2019) and characterize the main clinical, macroscopic, and histological aspects of these neoplasms. The sex, breed, age, skull conformation, the main clinical signs, and the anatomopathological characteristics (distribution, macroscopy, and histology) were computed. During this period, 49 dogs were affected by neoplasms in these regions, totaling 50 neoplasms (one dog had two neoplasms of different locations and histogenetic origins). Similar amounts of mixed-breed dogs (25/49) and purebred dogs (24/49) were affected, these distributed in 16 breeds. Among purebreds, it was noted that dogs with mesocephalic cranial conformation (12/24) were the most affected, followed by dolichocephalic (10/24) and brachycephalic (2/24). There were 22 cases in males and 27 in females, making a proportion of 1:1.23. There was an age variation from 11 months to 16 years old. The epithelial neoplasms have occurred in older dogs compared to those of other histogenic origins (mesenchymal and other origins/round cells). The main clinical signs were similar between the histogenetic categories, related to the involvement of the upper respiratory tract, sometimes accompanied by nervous signs (when there was brain invasion of nasal neoplasms or vice versa). The possible origin site was mostly in the nasal cavity concerning the paranasal sinuses (and other locations). Invasions occurred in different tissues adjacent to the nasal cavity and paranasal sinuses, resulting in cranial and facial deformities (21/49). The frequency was 48% of epithelial neoplasms, 32% of mesenchymal neoplasms, and 10% of neoplasms with other origins and round cells. The neoplasms most frequently observed, in decreasing order of frequency, were: adenocarcinoma (9/50), squamous cell carcinoma (9/50), transmissible venereal tumor (5/50), osteosarcoma (5/50), chondrosarcoma (4/50), and undifferentiated sarcoma (4/50). Through this study, it was possible to establish the frequency of these neoplasms in 20 years and their clinical, macroscopic, and histological characteristics.(AU)

Este estudo teve como objetivo quantificar os neoplasmas nasossinusais diagnosticados em cães em 20 anos (2000-2019) e caracterizar os principais aspectos clínicos, macroscópicos e histológicos desses neoplasmas. Foram computados sexo, raça, idade, conformação do crânio, principais sinais clínicos e características anatomopatológicas (distribuição, macroscopia e histologia). Nesse período, 49 cães foram acometidos por neoplasmas nessas regiões, totalizando 50 neoplasmas (um cão tinha dois neoplasmas de localização e origens histogenéticas distintas). Foram acometidas quantidades semelhantes de cães sem raça definida (25/49) e de cães com raça definida (24/49), estes distribuídos em 16 raças. Entre os cães com raça definida, notou-se que os cães com conformação craniana mesocefálica (12/24) foram os mais acometidos, seguidos pelos dolicocefálicos (10/24) e braquicefálicos (2/24). Foram observados 22 casos em machos e 27 em fêmeas, perfazendo a relação de 1:1,23. Ocorreu uma variação de idade de 11 meses a 16 anos; tendo os neoplasmas epiteliais ocorrido em cães mais velhos quando comparado aos de outras origens histogênicas (mesenquimais e outras origens/células redondas). Os principais sinais clínicos foram semelhantes entre as categorias histogenéticas, sendo relacionados ao comprometimento do trato respiratório superior, por vezes acompanhados de sinais nervosos (quando houve invasão encefálica de neoplasmas nasais ou vice-versa). O possível local de origem em sua maioria foi na cavidade nasal em relação aos seios nasais (e de outras localizações). Ocorreram invasões para diferentes tecidos adjacentes à cavidade nasal e seios paranasais, tendo como consequência deformidades cranianas e faciais (21/49). A frequência foi de 48% de neoplasmas epiteliais, 32% de neoplasmas mesenquimais e 10% de neoplasmas com outras origens e de células redondas. Os neoplasmas mais frequentemente observados, em ordem decrescente de frequência, foram: adenocarcinoma (9/50), carcinoma de células escamosas (9/50), tumor venéreo transmissível (5/50), osteossarcoma (5/50), condrossarcoma (4/50) e sarcoma indiferenciado (4/50). Com isso, pode-se estabelecer a frequência desses neoplasmas em 20 anos, bem como suas características clínicas, macroscópicas e histológicas.(AU)

Comparison of standard radiography and computed tomography in 21 dogs with maxillary masses.

Imaging of patients with oral cancer is required to determine tumor extension in order to assist in prognosis and surgical planning. Conventional screen-film radiography (SFR) used to be the most common method for oral assessment, but computed tomography (CT) has become more available and is being used for obtaining complementary information. CT examinations eliminate superimposition by acquiring cross-sectional images of the region of interest. The objective of this study was to determine the diagnostic value of SFR compared with CT examinations for evaluation of oral masses in dogs. Twenty-one dogs received head and thorax SFR, and pre- and post-contrast head CT. Bony changes were observed in 80.9% and 95.2% of the cases in SFR and CT studies, respectively. Invasion of adjacent structures (i.e. nasal cavity, frontal and sphenoidal sinuses, orbit, maxillary recess, nasopharynx) was observed in only 30% of cases with SFR while CT showed 90.4% involvement. CT is an important preoperative examination modality and is more effective in identifying bone changes and tumor invasion of adjacent structures compared with SFR.

Condrosarcoma mesenquimal sinonasal grado tres y carcinosarcoma de glándula Mamaria de un canino: estudios clínico e histopatológico / Sinunasal mesenchymal chondrosarcoma grade 3 and mammary gland carcinosarcoma of canine: clinical and histopathology study

A la Clínica Veterinaria de la Universidad de los Llanos, llegó un canino hembra de 9 años de edad raza Chow Chow, cuyo motivo de consulta fue epistaxis bilateral 4 meses atrás y una masa en la región nasal. Según lo reportado por el propietario, la masa había comenzado a salir 1 mes atrás del día de la consulta. Al examen clínico presentaba una masa subdérmica en la región nasal superior de 2 cm de diámetro. Se realizó una citología de la misma y se encontraron células inflamatorias sin presencia de células neoplásicas. El paciente volvió al mes y la masa con un diámetro de 5cm, estaba ubicada en la región nasal superior y región zigomática. El can presentaba disnea, anorexia, deshidratación del 6 por ciento, secreción mucopurulenta nasal y ocular, midriasis bilateral, reflejo corneal bilateral negativo, aumento de la presión infraocular del ojo derecho. En la glándula mamaria inguinal derecha presentaba una masa de 2cm de diámetro dura y móvil. Se realizó una citología por aspirado con aguja fina, de distintas zonas de las masas, tanto de la nariz, como de la glándula mamaria. Se valoró la citología permitiéndose definir el origen tumoral del proceso. Se realizó biopsia por incisión de la región sinonasal, diagnosticándose tumor mesenquimal maligno grado tres condrosarcoma sinonasal, conformado por células cartilaginosas pleomórficas con anisocariosis. Se realizaron radiografías de la región nasal y del pulmón, encontrándose una zona radiopaca a nivel del seno maxilar con osteolisis del hueso, se evidenciaba la masa de aproximadamente 4 cm de ancho por 2 cm de largo en el lado derecho. En el pulmón no se evidenció metástasis. Después del diagnóstico de histopatología se decide realizar la eutanasia, encontrándose histopatológicamente metástasis en pulmón, confirmación del condrosarcoma mesenquimal y un carcinosarcoma de glándula mamaria.

To the Veterinary Clinic of the Universidad de los Llanos, come a 9 years old Chow Chow female canine, whose consultation reason was a bilateral epistaxis occurred 4 months ago, sudden loss of the vision and a mass in the nasal region of 2cm of diameter approximately, according to the report of the owner, the mass showed up 1 month the day of the consultation. To the clinical exam they were the following abnormal discoveries. Hirsute hair, opaque, presented a subdermic mass approximately in the nasal region superior of 2 cm. diameter that grew to 5 cm. diameter after 1 month of the consultation, located in the nasal region superior and zigomatic region, of hard consistency, the animal had dysnea, bilateral mydriasis, the bilateral corneal reflection was negative, increase of the infraocular pressure of the right eye, the realized test of obstacles in the clinic was negative, that which showed us a blindness. Besides a complete clinical exploration and taking of the advantages of the cytology, she was carried out an aspired with fine needle of different areas of the masses so much neoplastic of the nose and of the region of the mammary gland, being obtained two types of samples. The cytology was evaluated to define origin of the tumors of the process. She was carried out biopsy for incision of the sinunosal region being diagnosed wicked tumor mesenchymal Chondrosarcoma sinunasal that commits bone. After having carried out the autopsy they took samples for histopathology. Being diagnosed mesenchymal chondrosarcoma sinunasal grade 3, with metastasis to lung, and a carcinosarcoma of mammary gland.

Histological and electron microscopic studies of endemic ethmoidal carcinomas in cattle.

In five cases of endemic ethmoidal carcinoma in cattle from the Dominican Republic three tumor types could be classified: undifferentiated carcinoma (3), adenocarcinoma (1), and squamous cell carcinoma (1). Electron microscopy showed that the tumor cells in undifferentiated carcinomas closely resembled the cells of the normal olfactory mucosa. This was especially true for the dark cells of Bowman's gland. Ultrastructurally, the lymphoid cells of the undifferentiated bovine carcinoma resembled the lymphoid cells of human nasopharyngeal carcinoma being closely associated with Epstein-Barr Virus. This and epidemiological observations suggested a viral cause of endemic ethmoidal carcinoma.