Carcinoma uretral primário em uma cadela - tratamento multimodal / Primary urethral carcinoma in a bitch - multimodal treatment

Background: Urethral tumors are uncommon in canines, represented predominantly by transitional cell carcinoma, marked by aggressive behavior associated with short life expectancy. Definitive diagnosis is achieved by histopathological analysis. Surgery associated with chemotherapy is the main therapeutic alternative. The aim of this paper is to report a case of primary transitional cell carcinoma of the urethra in a bitch, submitted to surgical treatment associated with conventional adjuvant chemotherapy and metronomic chemotherapy, achieving survival of 21 months, to date. Case: A 12-year-old bitch mixed breed was admitted at the Veterinary Hospital of Federal Rural University of Rio de Janeiro (UFRRJ), manifesting hematuria and urinary incontinence for one month. Physical examination indicated that vital parameters were within normal limits. Laboratory tests of blood count and serum biochemistry, urinalysis, culture, urinary antibiogram, and abdominal ultrasound were performed. The ultrasound image suggested a neoplastic urethral process. Because of the suspicion of neoplasm, a thoracic X-ray was performed, showing no evidence of metastasis. Computed tomography (CT) of the abdominal region was performed, revealing an expansive lesion in the urethra with loss of definition of the walls and urethral lumen extending to the level of the pelvic floor, measuring about 2.9 x 1.4 x 1.2 cm. After preanesthetic exams, the animal underwent resection and surgical anastomosis of the affected urethral region. The sectioned tissue was sent for histopathological analysis, with diagnosis of transitional cell carcinoma. Adjuvant chemotherapy was performed using carboplatin at a dose of 250 mg/m², intravenously, every 21 days for 6 sessions. After completing the protocol, abdominal ultrasonography was performed again, which showed a cicatricial process in the urethral region of the surgical excision, with no sign of tumor recurrence. A metronomic chemotherapy protocol was then started with cyclophosphamide at a dose of 15 mg/m², daily for 6 months, with periodic oncological follow-up. At the end of the period, the animal remained under periodic follow-up with ultrasound exams performed at 2-month intervals, and has been free from recurrence for 21 months until now. Discussion: Urethral neoplasms account for 0.5 - 2% of all canine tumors, and are represented mostly by transitional cell carcinomas. Clinical signs of urinary obstruction and hematuria are the most common, as reported in the patient in question. The definitive diagnosis is by histopathological examination. However, imaging tests such as computed tomography are important in the initial investigation and surgical planning. The indicated treatment is surgical resection of the mass with subsequent adjuvant chemotherapy or radiotherapy. The chemotherapy protocol associating cisplatin and piroxicam can achieve remission rates of 70%, but this association has a high nephrotoxic effect. In the present case, cisplatin was replaced by carboplatin in order to reduce the nephrotoxic effects of chemotherapy. The metronomic protocol using cyclophosphamide was used as maintenance therapy, at the end of the conventional chemotherapy protocol. Survival achieved was longer than that described in the literature in cases of transitional cell carcinomas in the urethral region. Therefore, multimodal therapy using surgery associated with conventional and metronomic chemotherapy, is an option in canines with urethral carcinoma.

Clinical, anatomopathological, and immunohistochemical findings of a transitional cell carcinoma from nasal cavity, frontal and ethmoidal sinus with meningoencephalic invasion in a dog.

Background: Primary neoplasms of the nasal cavity and sinuses are uncommon in domestic animals, most of which are of epithelial origin, being adenocarcinoma the most common tumor diagnosed in this region. Some malignant nasal cavity neoplasms may invade the brain causing clinical neurological signs, as well as purulent nasal secretion and epistaxis. Case Description: A case of neoplasm is reported in a 14-year-old pincher presenting dyspnea, epistaxis, and neurological alterations. Necropsy revealed the presence of a mass in the oral cavity vestibule, and another in the whole nasal cavity with invasion of the cribiform plate, meninges and brain. Squamous cells carcinoma was diagnosed in the oral cavity and transitional carcinoma in the nasal cavity. The immunohistochemistry confirmed that the brain infiltration was of the same origin as the nasal cavity neoplasm. Conclusion: The present report describes a rare case of transitional carcinoma of the nasal cavity as well as the frontal and ethmoidal sinuses with brain invasion, confirmed by immunohistochemistry. It is extremely important for veterinarians to include neoplasms in their differential diagnoses, when these animals show chronic respiratory signs and neurological alterations that do not improve with appropriate treatment, always associating with complementary exams, for correct diagnosis establishment and prognosis formulation.

Lymphatic invasion is a significant indicator of poor patient outcome in canine bladder urothelial carcinoma.

BACKGROUND: Urothelial carcinoma (UC), also known as transitional cell carcinoma, is the most common malignant tumor of the canine urinary bladder and represents a model for studying human bladder cancer. However, the existing literature has limited data on the clinicopathological characteristics of these tumors and their prognostic value. AIM: The aim of this study was to evaluate such factors, correlating them with follow-up, in a group of 32 dogs with bladder UC. METHODS: Clinical data of these cases, submitted to São Paulo State University and VetPat Private Laboratory (São Paulo/Brazil), were recorded between January 2000 and November 2019. For each case, formalin-fixed and paraffin-embedded sections were stained with hematoxylin and eosin and histologically evaluated. Survival analysis was carried out, and the prognostic value of the presence of lymphatic invasion and the treatment used was determined. RESULTS: Dogs with neoplastic lymphatic vessel invasion had a lower overall survival compared to those without lymphatic invasion, and dogs that received vinblastine in addition to surgery had higher global survival when compared to animals that received carboplatin in addition to surgery. CONCLUSION: The results obtained show the importance of further studies regarding the prognostic value of the two factors demonstrated as potential survival predictors, especially the lymphatic vessel invasion.

Bilateral double-pigtail ureteral stent placement for management of ureteral obstruction secondary to transitional cell carcinoma in a dog

Background: Transitional cell carcinoma (TCC) usually affects the trigone region of the bladder and proximal portionof the urethra. TCC in dogs is often complicated by local tumor invasion and obstruction of the urethra, ureters, or both.Urinary obstruction is the cause of death in approximately 60% of dogs with TCC. Radical surgeries are associated withmorbidity and mortality rates. Stents have recently been evaluated for use in dogs with ureteral obstruction resulting froma variety of urinary tract tumors. This report aims to describe bilateral ureteral stent placement for treatment of malignantureteral obstruction and long-term follow-up in a dog.Case: An 11-year-old female spayed Maltese dog with ureteral obstruction secondary to transitional cell carcinoma (TCC)in the bladder trigone. After palliative debulking procedure and diagnostic of TCC in bladder and NSAIDs treatment,recurrence has occurred causing ureteral obstruction and TCC had invaded the abdominal wall. Abdominal wall localtumor resection, trigone mass debulking and bilateral ureteral stent placement was made. A double-pigtail ureteral stentof appropriate length was advanced to bypass the ureteral obstruction. Stent sizes were 3.5 Fr in diameter and from 8 to32 cm in length. The patient underwent surgical resection of the transitional cell carcinoma in the abdominal wall. Thecorrect location of the bilateral ureteral pigtail stent was certified by abdominal radiography. Recovery was uneventfuland the dog was discharged 2 days after surgery. Eleven months after stent placement, the dog developed lumbar vertebrae metastasis, without evidence of recurrent ureteral obstruction. The owners elected euthanasia 517 days after originalpresentation and 337 days after ureteral stent placement. Euthanasia was unrelated to the local tumor obstruction but was...(AU)

Bilateral double-pigtail ureteral stent placement for management of ureteral obstruction secondary to transitional cell carcinoma in a dog

Background: Transitional cell carcinoma (TCC) usually affects the trigone region of the bladder and proximal portionof the urethra. TCC in dogs is often complicated by local tumor invasion and obstruction of the urethra, ureters, or both.Urinary obstruction is the cause of death in approximately 60% of dogs with TCC. Radical surgeries are associated withmorbidity and mortality rates. Stents have recently been evaluated for use in dogs with ureteral obstruction resulting froma variety of urinary tract tumors. This report aims to describe bilateral ureteral stent placement for treatment of malignantureteral obstruction and long-term follow-up in a dog.Case: An 11-year-old female spayed Maltese dog with ureteral obstruction secondary to transitional cell carcinoma (TCC)in the bladder trigone. After palliative debulking procedure and diagnostic of TCC in bladder and NSAIDs treatment,recurrence has occurred causing ureteral obstruction and TCC had invaded the abdominal wall. Abdominal wall localtumor resection, trigone mass debulking and bilateral ureteral stent placement was made. A double-pigtail ureteral stentof appropriate length was advanced to bypass the ureteral obstruction. Stent sizes were 3.5 Fr in diameter and from 8 to32 cm in length. The patient underwent surgical resection of the transitional cell carcinoma in the abdominal wall. Thecorrect location of the bilateral ureteral pigtail stent was certified by abdominal radiography. Recovery was uneventfuland the dog was discharged 2 days after surgery. Eleven months after stent placement, the dog developed lumbar vertebrae metastasis, without evidence of recurrent ureteral obstruction. The owners elected euthanasia 517 days after originalpresentation and 337 days after ureteral stent placement. Euthanasia was unrelated to the local tumor obstruction but was...

Radical Cystectomy and Cutaneous Ureterostomy in 4 Dogs with Trigonal Transitional Cell Carcinoma: Description of Technique and Case Series.

OBJECTIVE: To describe radical cystectomy followed by cutaneous ureterostomy as a treatment of invasive bladder neoplasia in dogs. STUDY DESIGN: Retrospective study. ANIMALS: Client-owned dogs with transitional cell carcinoma of the bladder trigone (n=4). METHODS: Perioperative complications and long-term outcomes of dogs that underwent cutaneous ureterostomy following radical cystectomy and lymphadenectomy for transitional cell carcinoma of the urinary bladder trigone were reviewed. Both ureters were transected and anastomosed to the ventral abdominal skin. Polyvinyl chloride catheters were placed in the ureteral stomas and maintained for 5 days. After catheter removal, dogs were managed with an absorbent diaper over the stomas. Long-term outcome and survival were documented by follow-up visits or phone contact. RESULTS: Median age at the time of surgery was 10.3 years (range, 8-12). Average procedural time was ∼4.7 hours (range, 3.8-6.1). Minor complications occurred in all dogs, including bleeding and edema of the ureterostomy site during the first 2-3 days after surgery. One dog developed urine scald that resolved with improved stoma care and hygiene. Median survival time after surgery was 278.6 days (range, 47-498). Distant metastases were documented in 2 dogs at 47 days (bone) and 369 days (lung) after surgery. CONCLUSION: Radical cystectomy with cutaneous ureterostomy is a viable salvage procedure for urinary diversion after cystectomy in dogs with invasive bladder neoplasia. Postoperative management and quality of life were considered acceptable by most owners. Future studies are warranted to evaluate survival time in a larger number of animals.

Ureterocolonic anastomosis in a dog with transitional cell carcinoma in the vesical trigone / Anastomose ureterocolônica em um cão com carcinoma de células de transição no trígono vesical

Background: Primary bladder tumors are rare in dogs, in spite of that, the transitional cell carcinoma (TCC) is the malignant tumor that most affects dogs. The TCC usually begins in the vesical trigone and extends into the bladder, and may cause partial or complete obstruction of the urinary flow. The treatment with cystectomy and urinary diversion in veterinary medicine is not usual probably because the partial cystectomy has low success and ureterocolonic anastomosis can cause pyelonephritis and/ or urinary incontinence. This paper describes the cystectomy surgery and ureterocolonic anastomosis in a dog with TCC in the bladder and bilateral hydronephrosis. Case: A 8-year-old, male, not castrated, Pitbull was referred to the Veterinary Clinic Hospital - UFRGS. The patient had progressive weight loss, low appetite, dysuria, and hematuria. Abdominal ultrasound showed bilaterally hydronephrosis, kidney pelvis and ureter dilatation. The mesogastric region presented a mass measuring about 14 cm. An exploratory laparotomy was request by the responsible veterinarian. A mass, measuring about 20 cm was observed in the spleen and a splenectomy was requested. An increased of the kidneys volume and an expansion of the renal pelvis and ureter were observed. The bladder wall had thickened and presented a firm consistency, an ureterocolonic anastomosis was requested by the responsible [...]

Intracranial transitional meningioma in a cat / Meningioma transicional intracraniano em gato

Background: Meningioma is a tumor that is usually attached to the dura mater. It typically arises from the meningothelial cell of the arachnoid or pia mater. Considered an extra-axial tumor of the central nervous system which can occur on any region of the meninges. The biological behavior tends to be benign and usually is not infiltrative allowing surgical indication, conferring to the patient a better prognosis. Geriatric patients are the most affected and there is no breed predisposition. This paper describes the clinical signs, pathological findings, and immunohistochemical features of a case of transitional meningioma in a cat. Case: A 14-year-old, neutered male mongrel cat was referred to the Veterinary Clinic Hospital. The history was that the cat had anorexia and disorientation. On the day of admission, lethargy and blindness were observed. Full complete blood counts showed leukopenia and lymphopenia. The serum biochemistry tests were unspecific. Thoracic and skull radiographs and ultrasound examination revealed no abnormalities. The cat was hospitalized and the main treatment was based on antibiotics and corticosteroids. The cat tested negative for FIV and FeLV. Toxoplasma gondii serum antibodies were not detected using indirect fluorescent antibody test performed with a commercial kit. The clinical signs progressed to walking in circles, stumbling, wandering [...]

Ureterocolonic anastomosis in a dog with transitional cell carcinoma in the vesical trigone / Anastomose ureterocolônica em um cão com carcinoma de células de transição no trígono vesical

Background: Primary bladder tumors are rare in dogs, in spite of that, the transitional cell carcinoma (TCC) is the malignant tumor that most affects dogs. The TCC usually begins in the vesical trigone and extends into the bladder, and may cause partial or complete obstruction of the urinary flow. The treatment with cystectomy and urinary diversion in veterinary medicine is not usual probably because the partial cystectomy has low success and ureterocolonic anastomosis can cause pyelonephritis and/ or urinary incontinence. This paper describes the cystectomy surgery and ureterocolonic anastomosis in a dog with TCC in the bladder and bilateral hydronephrosis. Case: A 8-year-old, male, not castrated, Pitbull was referred to the Veterinary Clinic Hospital - UFRGS. The patient had progressive weight loss, low appetite, dysuria, and hematuria. Abdominal ultrasound showed bilaterally hydronephrosis, kidney pelvis and ureter dilatation. The mesogastric region presented a mass measuring about 14 cm. An exploratory laparotomy was request by the responsible veterinarian. A mass, measuring about 20 cm was observed in the spleen and a splenectomy was requested. An increased of the kidneys volume and an expansion of the renal pelvis and ureter were observed. The bladder wall had thickened and presented a firm consistency, an ureterocolonic anastomosis was requested by the responsible [...](AU)

Intracranial transitional meningioma in a cat / Meningioma transicional intracraniano em gato

Background: Meningioma is a tumor that is usually attached to the dura mater. It typically arises from the meningothelial cell of the arachnoid or pia mater. Considered an extra-axial tumor of the central nervous system which can occur on any region of the meninges. The biological behavior tends to be benign and usually is not infiltrative allowing surgical indication, conferring to the patient a better prognosis. Geriatric patients are the most affected and there is no breed predisposition. This paper describes the clinical signs, pathological findings, and immunohistochemical features of a case of transitional meningioma in a cat. Case: A 14-year-old, neutered male mongrel cat was referred to the Veterinary Clinic Hospital. The history was that the cat had anorexia and disorientation. On the day of admission, lethargy and blindness were observed. Full complete blood counts showed leukopenia and lymphopenia. The serum biochemistry tests were unspecific. Thoracic and skull radiographs and ultrasound examination revealed no abnormalities. The cat was hospitalized and the main treatment was based on antibiotics and corticosteroids. The cat tested negative for FIV and FeLV. Toxoplasma gondii serum antibodies were not detected using indirect fluorescent antibody test performed with a commercial kit. The clinical signs progressed to walking in circles, stumbling, wandering [...](AU)

Transitional cell carcinoma in the distal urethra of a female Golden retriever

Background: Urinary tract tumours represent only 0.5-1% of neoplasms in dogs, and transitional cell carcinoma (TCC) is the most common. It is most common to find TCCs in the trigone region. Diagnosis can be made with image analysis, cytology or histology. With non-infiltrative lesions in the early stages, it is possible to obtain a biopsy by endoscopy. Surgical resection is the treatment option of choice for this tumour. Dogs with poor response to chemotherapy or at an advanced stage of the disease are candidates for palliative treatment. This paper reports an special case of TCC located in the distal urethra of a female dog, obtaining the diagnosis through endoscopy, cytology and immunohistochemistry.Case: A nine-year old, female, neutered Golden Retriever was referred for examination after suffering vaginal bleeding. Vaginal palpation revealed an apparent mass on the vaginal floor. Cytology by imprinting the mass revealed a carcinoma. A vaginoscopy was performed on the patient. An endoscopic examination showed normal vaginal mucosa, but, through the urethra, a mass was observed in the urethral lumen, with thickening and dilatation of the urinary meatus. A tissue biopsy was obtained. Episiotomy was performed to remove the tumour. Histopathological studies diagnosed the mass as transitional cell carcinoma with incomplete surgical margins. An immunohistochemistry analysis of the...

Transitional cell carcinoma in the distal urethra of a female Golden retriever

Background: Urinary tract tumours represent only 0.5-1% of neoplasms in dogs, and transitional cell carcinoma (TCC) is the most common. It is most common to find TCCs in the trigone region. Diagnosis can be made with image analysis, cytology or histology. With non-infiltrative lesions in the early stages, it is possible to obtain a biopsy by endoscopy. Surgical resection is the treatment option of choice for this tumour. Dogs with poor response to chemotherapy or at an advanced stage of the disease are candidates for palliative treatment. This paper reports an special case of TCC located in the distal urethra of a female dog, obtaining the diagnosis through endoscopy, cytology and immunohistochemistry.Case: A nine-year old, female, neutered Golden Retriever was referred for examination after suffering vaginal bleeding. Vaginal palpation revealed an apparent mass on the vaginal floor. Cytology by imprinting the mass revealed a carcinoma. A vaginoscopy was performed on the patient. An endoscopic examination showed normal vaginal mucosa, but, through the urethra, a mass was observed in the urethral lumen, with thickening and dilatation of the urinary meatus. A tissue biopsy was obtained. Episiotomy was performed to remove the tumour. Histopathological studies diagnosed the mass as transitional cell carcinoma with incomplete surgical margins. An immunohistochemistry analysis of the...(AU)

Carcinoma de células de transição da pelve renal em uma cadela - relato de caso / Transitional cell carcinoma of renal pelvis in a bitch - case report / Carcinoma de células de transición en pelvis renal de una perra-relato del caso

Em cães, os tumores renais primários são raros, sendo mais frequentes os carcinomas renais. Os tumores renais podem ser classificados segundo sua origem como tubular renal, nefroblásticos, não epiteliais e de células de transição. Este último tipo pode se originar tanto no ureter quanto na pelve renal. O objetivo deste trabalho é relatar um caso de uma fêmea da espécie canina, SRD, de nove anos de idade, não castrada, atendida no setor de cirurgia de um Hospital Veterinário Escola. Ao exame ultrassonográfico de abdômen, visibilizou-se uma massa em região mesogástrica direita. O ovário e o rim direitos não foram visualizados. A paciente foi submetida a laparotomia exploratória, seguida de nefrectomia e ovariossalpingo-histerectomia. O exame histopatológico da formação confirmou o diagnóstico de carcinoma de células de transição de pelve renal.(AU)

Primary renal tumors in dogs are rare; among these, renal carcinomas are the most frequent. Renal tumors may be classified according to their origin as renal tubular, nephroblastic, non-epithelial and transitional cell carcinomas. The latter can originate either in the ureter or in the renal pelvis. This work reports the case of a non-neutered nine-year-old female mongrel assisted by the Surgery Sector of a Veterinary Hospital. Ultrasound examination of the abdomen disclosed a mass in the right mesogastric region. The ovary and right kidney could not be visualized. The patient underwent exploratory laparotomy, followed by nephrectomy and hysterectomy with salpingo-oophorectomy. Histopathology confirmed the diagnosis of transitional cell carcinoma of renal pelvis.(AU)

Los tumores renales primarios son raros en perros, siendo los carcinomas las neoplasias más frecuentes. Los tumores renales pueden ser clasificados según su origen como tumores del túbulo renal, nefrablásticos, no epiteliales y de células de transición. Este último tipo puede originarse tanto en el uréter como en la pelvis renal. El objetivo de este trabajo es relatar un caso de una hembra canina, mestiza, de nueve años de edad, no castrada, que fue atendida en el sector de cirugía de un Hospital Veterinario Escuela, a la que durante la ecografía abdominal, se le detectó una masa en región mesogástrica derecha. El ovario y el riñón derechos no pudieron ser visualizados. Se le realizó una laparotomía exploratoria y posterior nefrectomía y ovariohisterectomia. El examen histopatológico de la formación confirmó la presencia de un carcinoma de células de transición de pelvis renal.(AU)

Carcinoma de células de transição da pelve renal em uma cadela - relato de caso / Transitional cell carcinoma of renal pelvis in a bitch - case report / Carcinoma de células de transición en pelvis renal de una perra-relato del caso

Em cães, os tumores renais primários são raros, sendo mais frequentes os carcinomas renais. Os tumores renais podem ser classificados segundo sua origem como tubular renal, nefroblásticos, não epiteliais e de células de transição. Este último tipo pode se originar tanto no ureter quanto na pelve renal. O objetivo deste trabalho é relatar um caso de uma fêmea da espécie canina, SRD, de nove anos de idade, não castrada, atendida no setor de cirurgia de um Hospital Veterinário Escola. Ao exame ultrassonográfico de abdômen, visibilizou-se uma massa em região mesogástrica direita. O ovário e o rim direitos não foram visualizados. A paciente foi submetida a laparotomia exploratória, seguida de nefrectomia e ovariossalpingo-histerectomia. O exame histopatológico da formação confirmou o diagnóstico de carcinoma de células de transição de pelve renal.

Primary renal tumors in dogs are rare; among these, renal carcinomas are the most frequent. Renal tumors may be classified according to their origin as renal tubular, nephroblastic, non-epithelial and transitional cell carcinomas. The latter can originate either in the ureter or in the renal pelvis. This work reports the case of a non-neutered nine-year-old female mongrel assisted by the Surgery Sector of a Veterinary Hospital. Ultrasound examination of the abdomen disclosed a mass in the right mesogastric region. The ovary and right kidney could not be visualized. The patient underwent exploratory laparotomy, followed by nephrectomy and hysterectomy with salpingo-oophorectomy. Histopathology confirmed the diagnosis of transitional cell carcinoma of renal pelvis.

Los tumores renales primarios son raros en perros, siendo los carcinomas las neoplasias más frecuentes. Los tumores renales pueden ser clasificados según su origen como tumores del túbulo renal, nefrablásticos, no epiteliales y de células de transición. Este último tipo puede originarse tanto en el uréter como en la pelvis renal. El objetivo de este trabajo es relatar un caso de una hembra canina, mestiza, de nueve años de edad, no castrada, que fue atendida en el sector de cirugía de un Hospital Veterinario Escuela, a la que durante la ecografía abdominal, se le detectó una masa en región mesogástrica derecha. El ovario y el riñón derechos no pudieron ser visualizados. Se le realizó una laparotomía exploratoria y posterior nefrectomía y ovariohisterectomia. El examen histopatológico de la formación confirmó la presencia de un carcinoma de células de transición de pelvis renal.

Transitional cell carcinoma of the renal pelvis in a dog with combined treatment with unilateral nephrectomy and carboplatin

A transitional cell carcinoma of the renal pelvis was diagnosed in a 10-year-old, male German shepherd that presented with a 1-month history of hematuria and weight loss. Unilateral nephrectomy and chemotherapy with carboplatin was applied, but the dog was euthanized five months after the surgery due to metastasis.