Incidentally detected retroperitoneal paraganglioma in a 10-year-old French bulldog.

This article reports a case of a 10-year-old French bulldog initially seen for reluctance to move and episodes of pain. A magnetic resonance imaging study was undertaken in order to rule out a herniated disc. A large, retroperitoneal mass was visualized and cytological analysis suggested a neoplastic proliferation. The mass appeared to compress the caudal vena cava when viewed by abdominal CT scan. The mass was surgically removed. A nephrectomy was also carried out and aortic bleeding identified after dissection of adhesions. Despite these complications, the dog did well after the procedures. Postoperative checkups were normal. Histological and immunohistochemical analyses of the mass were compatible with a retroperitoneal paraganglioma. Key clinical message: This type of tumor is poorly described in the veterinary literature. As the behavior of this tumor type is not yet fully understood, each new description adds to our knowledge and should help in diagnosing and treating it more effectively in the future.

Paragangliome rétropéritonéal de découverte fortuite chez un bouledogue Français de 10 ans. Cet article expose le cas d'un chien mâle entier bouledogue Français de 10 ans présenté initialement pour des difficultés locomotrices et des manifestations algiques. Un examen d'imagerie par résonnance magnétique (IRM) est rapidement réalisé afin d'explorer l'hypothèse d'une hernie discale. Une volumineuse masse rétropéritonéale est alors mise en évidence. L'analyse cytologique de cette dernière est compatible avec un processus néoplasique. Après la réalisation d'un examen par tomodensitométrie de l'abdomen et la mise en évidence d'une compression marquée de la veine cave caudale par la masse, une prise en charge chirurgicale avec exérèse de la masse est décidée. Lors de l'intervention chirurgicale une néphrectomie est réalisée et un saignement aortique est identifié après la dissection des adhérences. Malgré ces complications, le chien se réveille bien et les contrôles post opératoires effectués sont satisfaisants. Les analyses histologiques et immunohistochimiques de la masse seront en faveur d'un paragangliome rétropéritonéal extra surrénalien.Message clinique clé :Ce type tumoral fait l'objet de peu de descriptions dans la littérature vétérinaire. Toute la lumière n'a pas encore été faite sur son comportement et chaque nouvelle description permet d'en enrichir les connaissances et donc de mieux comprendre ce type tumoral, ce qui, à l'avenir, pourra aider à le diagnostiquer plus facilement et à le traiter plus efficacement.(Traduit par les auteurs).

Laparoscopic resection of retroperitoneal paraganglioma close to caudal vena cava in a dog.

OBJECTIVE: To report laparoscopic resection of retroperitoneal paraganglioma close to the caudal vena cava in a dog. STUDY DESIGN: Case report. ANIMAL: Twelve-year-old, neutered male Jack Russell terrier. METHODS: The dog had undergone three previous cystotomies for bladder stones. On follow-up ultrasonographic evaluation, a 14-mm × 17-mm tumour was incidentally detected in the dorsal midline of the caudal abdomen. The dog underwent computed tomography (CT) imaging and ultrasound-guided fine needle aspiration of the tumour under general anaesthesia. CT imaging showed that the tumour was close to the caudal vena cava. There was no evidence of metastasis. Neuroendocrine tumour was suspected on cytologic examination. Based on these findings, laparoscopic tumour resection was performed using a vessel-sealing device. The operation time was 136 minutes. RESULTS: The dog was stable after recovery from anaesthesia and discharged to home the next day. Histopathological diagnosis of the tumour was a paraganglioma. The dog remained without clinical evidence of recurrent tumour or metastasis for 670 days after the surgery. CONCLUSION: Retroperitoneal paraganglioma in dogs is uncommon, but it is one of the differential diagnoses of a retroperitoneal tumour. Laparoscopic resection of a retroperitoneal paraganglioma was successfully performed in the dog. Laparoscopic resection conferred the advantages over open surgery of being minimally invasive, providing better visualization of the surgical field through pneumoperitoneum and semisternal patient recumbency, and allowing for magnification of the operative field, which facilitated the ease and safety of the procedure.

Retroperitoneal lymphatic malformation in a dog.

BACKGROUND: Lymphatic vascular malformations are rare findings in canine patients with six reports available in veterinary literature. Retroperitoneal cystic lymphatic malformations have not been described previously in canine patients and neither has the use of immunohistochemistry to determine their origin, i.e. vascular versus lymphatic. CASE PRESENTATION: An 8-year-old neutered female Cocker spaniel was referred for pollakiuria, dysuria and a painful abdomen. Computed tomography scanning of the abdomen showed a fluid filled structure adjacent to the urinary bladder. During surgical exploration, a thin walled cystic structure with sero-haemorrhagic fluid was found, extending from the retroperitoneal space into the abdomen. The mass was excised and submitted for histopathology, revealing a cystic mass lined by a fibrovascular capsule within the retroperitoneal/mesenteric adipose tissue. The inner surface of the cyst was lined by a single layer of bland, flattened spindle cells. Intramural blood vessels were well differentiated, with perivascular haemorrhage. On recurrence 11 months later, the mass was excised for the second time and a PleuralPort (Norfolk Animal products) was placed. Fifteen months after initial presentation, progression occurred with haemorrhagic fluid in the cystic space, pleural- and abdominal cavities and the owners opted for euthanasia. Histopathology and positive immunohistochemistry for lymphatic markers lymphatic vessel endothelial hyaluronic acid receptor-1 (LYVE-1) and prospero homeobox protein-1 (PROX-1) confirmed a lymphatic vascular origin of the cystic structure. CONCLUSIONS: To our experience, a definitive diagnosis of retroperitoneal cystic malformation of lymphatic origin could be done only by combining the clinical presentation, advanced imaging, histopathology and LYVE-1 and PROX-1 immunohistochemistry. This is the first report of a vascular malformation in a dog where immunohistochemistry was used to make a final diagnosis. A lymphatic malformation, even if rare, should be added on the list of the differential diagnosis in a patient with a retroperitoneal cystic structure containing serohaemorrhagic fluid. Results of this case report can aid in diagnosis of future cases, however, further studies on therapy and management are needed to provide additional information about optimal treatment of these patients.

Spontaneous retroperitoneal liposarcoma in a free-ranging juvenile golden-headed lion tamarin (Leontopithecus chrysomelas).

Malignant adipocytic neoplasia is rare among nonhuman primates. We report the gross and microscopic features of a retroperitoneal liposarcoma with myxofibrosarcoma-like dedifferentiation in a free-ranging juvenile golden-headed lion tamarin (Leontopithecus chrysomelas). To our knowledge, this is the first report of such tumor subtype in New World primates.

Subcutaneous ureteral bypass for treatment of bilateral ureteral obstruction in a cat with retroperitoneal paraganglioma.

CASE DESCRIPTION A 7-year-old female domestic shorthair cat was referred for evaluation of azotemia and unilateral hydronephrosis. CLINICAL FINDINGS Abdominal ultrasonography revealed right-sided hydronephrosis and dilation of the proximal aspect of the ureter; the left kidney was small with irregular margins. A highly vascular, irregular retroperitoneal mass, not clearly associated with the ureteral obstruction, was also visualized. Surgical exploration confirmed a retroperitoneal mass involving the caudal mesenteric artery and both ureters, with hydroureter on the right side. TREATMENT AND OUTCOME A subcutaneous ureteral bypass (SUB) device was surgically implanted to treat right ureteral obstruction, and the mass was biopsied. Shortly after surgery, progressive azotemia and hyperkalemia were detected; ultrasonographic examination revealed left-sided hydronephrosis and hydroureter, which was suspected secondary to inflammation of the mass causing a left-sided ureteral obstruction. A second surgery was performed to place an SUB device for the left kidney and remove the retroperitoneal mass; both ureters were ligated at the mid- and distal aspects and then transected and removed with the mass. A neuroendocrine paraganglioma was identified by histopathologic evaluation of the mass. Hydronephrosis improved (right kidney) or resolved (left kidney) after surgery, and azotemia improved. Chemotherapeutic intervention was declined. Markers of renal function were static during the 14-month follow-up period. At the last follow-up evaluation, the patient was reportedly doing well, and both SUB devices were patent. CLINICAL RELEVANCE This was the first report of retroperitoneal paraganglioma in a domestic cat causing bilateral ureteral obstruction. Bilateral SUB device placement enabled en bloc mass resection and provided long-term relief of ureteral obstruction.

Metastatic myxosarcoma in a Quarter Horse gelding.

A 22-y-old Quarter Horse gelding was presented to the University of Illinois Veterinary Teaching Hospital for evaluation of increased heart rate and mild colic signs. Rectal examination revealed a large left perirenal mass. Abdominal ultrasonography further confirmed this finding. Thoracic ultrasonography indicated multifocal irregularities on the pleural surface suggestive of consolidation and possibly masses in the lungs. The animal was euthanized. Autopsy findings included a large, firm, expansile, gelatinous retroperitoneal mass that surrounded both kidneys, as well as nodules with similar morphology in the lungs, liver, intestinal mesentery, cecum, and caudal mesenteric artery. Histologically, the masses were composed of neoplastic stellate-to-spindloid cells in abundant mucinous stroma. Neoplastic cells exhibited strong immunoreactivity for vimentin and were negative for pancytokeratin (A1/A3), CD3, CD20, melan A, and synaptophysin. Mucinous stroma was strongly positive with alcian blue and weakly positive with periodic acid-Schiff histochemical staining. These findings are consistent with metastatic myxosarcoma. Myxosarcoma is a rare neoplasm in horses, and metastasis to tissues other than sentinel lymph nodes has not been described previously to our knowledge.

Congenital infiltrative lipomas and retroperitoneal perirenal lipomas in a calf.

BACKGROUND: Congenital lipocytic tumours have rarely been reported in cattle. Lipomas are benign tumours, but infiltrative lipomas have significant health implications due to their aggressive infiltrative growth pattern. CASE PRESENTATION: A calf was born with skeletal malformations and soft tissue proliferations, primarily on the external thoracic wall. The calf was euthanized for welfare reasons and submitted for post mortem examination. Necropsy, histopathology and post mortem computed tomography scanning revealed two types of lipocytic tumours. Widespread infiltrative lipomas were present in the muscles and connective tissues along the vertebral column and diffusely invaded the external soft tissues of the right thoracic wall. The neoplastic lipocytes had invaded intervertebral spaces thus causing congenital vertebral malformations, and further invaded the vertebral canal and the bone marrow of coccygeal vertebrae. Periosteal localization of the tumour was associated with costal hyperostosis. Two large retroperitoneal lipomas enclosed the kidneys and occupied much of the abdominal space. CONCLUSION: The development of congenital bone malformation in this calf illustrates the severe consequences of the infiltrative and aggressive growth of infiltrative lipomas during foetal development. The congenital retroperitoneal lipomas occupied a large part of abdominal cavity, but did not invade the adjacent tissues. Due to their large size, perirenal lipomas should be considered in calves with distended abdomen, even in cases without other signs of tumours.

Retroperitoneal hemangiosarcoma in a common carp Cyprinus carpio: a case report.

A 7.5 kg common carp Cyprinus carpio presented with prominent localized swelling in the caudal right coelomic area, identified by ultrasound as a fluid filled mass. Fine needle aspirate (FNA) and culture results suggested a sterile seroma. Centesis removed 290 ml of serosanguinous fluid that returned within days. Recheck ultrasonography revealed a solid component within the cavity. Radiography demonstrated irregular lysis and misalignment of vertebrae adjacent to the mass, most suggestive of bacterial osteitis or neoplasia. Treatment with antibiotics followed for 2 mo but failed to resolve the lesion. Repeated radiography and ultrasonography showed progressive enlargement of the mass, with vertebral lysis and invasion characteristic of neoplasia. Ultrasound-guided FNA of the solid component of the mass was non-diagnostic. Euthanasia was elected due to the poor clinical response and primary differential of neoplasia. Post-mortem MRI and CT confirmed a retroperitoneal soft tissue mass, partially surrounded by a fluid-filled cavity, causing vertebral lysis and infiltration of the spinal canal. Expansion of the mass caused severe muscle loss and an associated elevation in creatine kinase (>120000 U l-1). Necropsy results corroborated the MRI and CT findings, revealing a retroperitoneal, multilobular, red and tan mass causing dorsal displacement of the vertebral column, with vertebral lysis, pathologic fracture and invasion of the spinal canal. Histopathologic examination revealed a locally aggressive neoplasm exhibiting multiple patterns of growth, including endothelial lined vascular channels and solid areas formed by more pleomorphic polygonal and spindle cells, consistent with hemangiosarcoma.

Extra-adrenal retroperitoneal paraganglioma in a dog.

An extra-adrenal retroperitoneal paraganglioma was observed in a 10.5-year-old male Boxer dog. Additionally, the dog had an aortic base tumor, multiple thyroid adenomas, multiple testicular interstitial cell tumors, bilateral nodular adrenal cortical hyperplasia, and parathyroid gland hyperplasia. The hypothesis that the retroperitoneal mass represents a primary extra-adrenal paraganglioma rather than metastatic mass from the aortic body tumor is considered. Either primary or metastatic extra-adrenal retroperitoneal paragangliomas are rarely reported in dogs.

Transdiaphragmatic extension of a retroperitoneal lipoma into the intrathoracic extrapleural space via the lumbocostal trigone in a dog.

CASE DESCRIPTION: An 8-year-old 12.2-kg (26.9-lb) spayed female American Cocker Spaniel was referred for evaluation of abdominal discomfort and a suspected intra-abdominal lipoma with possible invasion into the thorax. CLINICAL FINDINGS: Physical examination revealed a tense abdomen, and the margins of a large abdominal mass could be appreciated. Abdominal imaging revealed a mass of fat opacity in the abdominal and thoracic cavities. Computed tomography with precontrast and postcontrast peritoneograms was used to determine whether the masses connected via a diaphragmatic defect. TREATMENT AND OUTCOME: Exploratory laparotomy revealed a retroperitoneal lipomatous mass that had focally invaded the hypaxial musculature and had extended across the dorsolateral aspect of the diaphragm via the lumbocostal trigone into the intrathoracic extrapleural space. Surgical resection required transdiaphragmatic thoracotomy. Histologic examination of excised tissue confirmed the preoperative diagnosis of a lipoma. The dog recovered from surgery with no complications and had no disease recurrence for at least 32 months after surgical resection. CLINICAL RELEVANCE: The defect of the lumbocostal trigone is also called the foramen of Bochdalek in humans, and it is recognized as a common location for congenital diaphragmatic hernia. A lumbocostal trigone hernia may be considered as a differential diagnosis for bicavitary masses in dogs, particularly in the absence of a history of trauma.

Retroperitoneal teratoma in a domestic rabbit (Oryctolagus cuniculus).

Teratomas are histologically complex tumors arising from germ cells of two or three embryonic layers either in the gonads or occasionally from germ cells that mistakenly migrated to ectopic sites. A case of retroperitoneal teratoma in a regularly slaughtered 4-month-old, male domestic rabbit is reported. A pale reddish, 3 x 4 cm, fibrous mass was detected, loosely connected to the parietal wall in the retroperitoneal region cranial to the kidney. Histologically, the neoplasm contained tissues from ectodermal, endodermal and mesodermal germ layers: nerves and neurons simulating ganglia, cysts lined by squamous epithelium containing keratin and hair, skin adnexa; respiratory glandular epithelium, serous and salivary glands; collagenous connective tissue, muscle fibers, mature cartilage and bone, bone marrow, teeth and fat. To the authors' knowledge this is the first report of a retroperitoneal teratoma in the rabbit.

Retroperitoneal hemangiosarcoma causing chronic hindlimb lameness in a dog.

The clinical, radiographic, ultrasonographic, computed tomographic, surgical and histopathological findings in a Boxer dog with retroperitoneal hemangiosarcoma are described in this study. A seven-year-old, male, castrated Boxer dog was referred for evaluation of chronic hindlimb lameness. The physical examination revealed muscle atrophy and sciatic nerve deficits. Radiography and ultrasonography revealed a caudodorsal abdominal mass. Computed tomography revealed that the mass involved the left margin of the L7 vertebra, lumbosacral canal, and lumbosacral plexus. At surgery, a large retroperitoneal haematoma was removed. Histopathology of amorphous tissue found near the haematoma was consistent with haemangiosarcoma. The owner declined any further treatment. Ten weeks after discharge, the dog was euthanatized due to collapse and haemo-abdomen.

Retroperitoneal teratoma in a skunk (Mephitis mephitis).

A 4-yr-old striped skunk (Mephitis mephitis) developed an 11- x 7- x 7-cm retroperitoneal mass caudal to the left kidney. The mass was surgically excised and, on the basis of histology and immunohistochemistry, diagnosed as a benign teratoma. Six months later, a second histologically similar neoplasm was excised from the same location and was considered to represent local tumor recurrence. The skunk died 16 mo later without recurrence. Complete excision of the tumor appeared curative in this case and supported the benign diagnosis. An extragonadal teratoma should be considered as a differential diagnosis for an abdominal mass in a skunk.

Retroperitoneal sarcomas in dogs: 14 cases (1992-2002).

OBJECTIVE: To describe the clinical features, surgical and histologic findings, biological behavior, and outcome of dogs with retroperitoneal sarcomas. DESIGN: Retrospective study. ANIMALS: 14 dogs. PROCEDURES: Medical and pathology records from 1992 to 2002 of dogs with tumors originating in the retroperitoneal space were reviewed. Dogs with retroperitoneal tumors originating from the adrenal glands, kidneys, or ureters were excluded. Inclusion criteria included observation of a tumor arising from the retroperitoneal space during exploratory surgery or necropsy and histologic confirmation of tumor type. Details of clinical signs, diagnostic findings, surgical management, and outcome were determined from medical records and telephone interviews with veterinarians and owners. RESULTS: Retroperitoneal sarcoma was diagnosed in 14 dogs, 2 at necropsy and 12 during exploratory surgery. Hemangiosarcoma was the most common histologic diagnosis. Seven dogs had regional extension of the sarcoma into adjacent organs, and 4 dogs had metastatic disease. Grossly complete resection was possible in 6 dogs. Cytoreductive surgery or incisional biopsy was performed in the remaining dogs. Two dogs were treated with palliative radiation therapy (1 intraoperatively and 1 postoperatively). Three dogs received adjunctive chemotherapy, although none completed the targeted course because of development of local recurrence or metastatic disease. Local recurrence was reported in 2 of 12 dogs and metastasis in 10 of 14 dogs. Thirteen dogs died or were euthanatized as a result of the retroperitoneal sarcoma; 1 dog was alive and disease-free 410 days after surgery. Median survival time was 37.5 days. CONCLUSIONS AND CLINICAL RELEVANCE: In dogs, retroperitoneal sarcomas are aggressive tumors with a high rate of local recurrence and metastasis, and a poor survival time.

Hypercalcaemia associated with a retroperitoneal apocrine gland adenocarcinoma in a dog.

A seven-year-old, entire female golden retriever was presented with a history of polyuria/polydipsia and progressive dysuria. Clinical examination, radiography and ultrasonography demonstrated urinary retention due to a large soft tissue mass in the retroperitoneal space. Laboratory findings revealed paraneoplastic hypercalcaemia. Fine-needle aspiration cytology of the mass suggested an epithelial tumour, resembling an apocrine gland carcinoma of the anal sac. Following euthanasia and necropsy, the histopathological diagnosis of the retroperitoneal mass was apocrine gland adenocarcinoma. Despite ante- and postmortem examination, no perineal or anal sac tumour was found. The retroperitoneal tumour in this case could be a very large lymph node metastasis from an occult primary apocrine carcinoma of the anal sacs, or it could represent the first case of an ectopic apocrine gland carcinoma of the retroperitoneal space in a dog.

Analysis of 4.3 kilobases of divergent locus B of macaque retroperitoneal fibromatosis-associated herpesvirus reveals a close similarity in gene sequence and genome organization to Kaposi's sarcoma-associated herpesvirus.

We previously identified retroperitoneal fibromatosis-associated herpesvirus (RFHV) as a simian homolog of Kaposi's sarcoma-associated herpesvirus (KSHV) in a fibroproliferative malignancy of macaques that has similarities to Kaposi's sarcoma. In this report, we cloned 4.3 kb of divergent locus B (DL-B) flanking the DNA polymerase gene from two variants of RFHV from different species of macaque with a consensus degenerate hybrid oligonucleotide primer approach. Within the DL-B region of RFHV, viral homologs of the cellular interleukin-6, dihydrofolate reductase, and thymidylate synthase genes were identified, along with a homolog of the gammaherpesvirus open reading frame (ORF) 10. In addition, a homolog of the KSHV ORF K3, the modulator of immune recognition-1, was identified. Our data show a close similarity in sequence conservation, gene content, and genomic structure between RFHV and KSHV which strongly supports the grouping of these viral species within the same RV-1 rhadinovirus lineage and the hypothesis that RFHV is the macaque homolog of KSHV.

Malignant retroperitoneal paraganglial tumour in a cow.

A large primary retroperitoneal sublumbar neoplasm was identified in an 11-year-old Holstein cow, with metastases to the lungs, kidneys and lymph nodes. The tumour cells proliferated in a characteristic endocrine pattern, were argyrophilic and positive for neuron-specific enolase, and had membrane-bounded intracytoplasmic granules. In addition, the cells were occasionally positive for cytokeratin and had desmosome-like intercellular junctions. The primary tumour mass was diagnosed as a malignant paraganglial tumour of the aortico-sympathetic ganglion (organ of Zuckerkandl), and was considered to contain primitive cells with epithelial differentiation.

Retroperitoneal extraskeletal mesenchymal chondrosarcoma in a dog.

A young adult female Mastiff dog developed a large retroperitoneal mass, pleural effusion, and multiple pulmonary and pleural nodules. All masses were diagnosed as mesenchymal subtype chondrosarcomas, using histological and immunohistochemical criteria. Reports of canine extraskeletal mesenchymal chondrosarcomas (EMCs) are rare but involved animals less than 3 years of age in 60% of the cases. This is the first description of this type of tumor developing distant metastases. Evidence from this case and previous reports suggests that EMCs are associated with a poor prognosis.