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Adenocarcinoma


Bisart Dobes
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A friend of mine with a recent litter has had this diagnosis on her bitch. Her vet has never seen this before and this is an experienced repo/breeder vet and I have spoken to a couple of the vets I worked with and they haven't either.

I have her permission to post the path report which is below. On dicussing this and what course to take with her girl I thought it might be helpful if someone out there in DOL world had first hand experience they could share.

PM me if you don't want it public.

* This was found while doing a required C-Section as her bitch didn't go into labour. This bitch was bred 12 months ago and it didn't take (or did and they died which seems to be this mass found - or they could be this litter, they can't tell). The vet just took a section of it out to send to path - why they didn't suggest to the owner they should remove the entire horn & ovaries while they were in there I don't know. The suggestion now is that it needs to be removed and the vet wanted to do this 2 days after the bitches C-Section !!. My friend is waiting - I have suggested that gland and lymph node systems be tested prior to any surgery as the path report says it has likely spread and if it is lymphathic, well we know what that means.

The bitch is happy and not in any pain - enjoying mothering her 3 surviving puppies etc etc. If you didn't know this was there you would say she is a perfectly healthy happy girl. The breeder of the bitch has not had anything like this prior and it is not suggested here that it is a genetic issue or their reponsibility at all.

Upset for my friend and dreading the bad news day :(.

Report.

CLINICAL HISTORY

Combination pregnancy/pyometrial/foetal re-absorption. Mass in

(illegible) horn of pyohorn. Hyperplasia of os of fallopian tube or query

tumour.

MACROSCOPY

Container unlabelled as to site - A polycystic tissue mass 22 x 17 x

12mm. 1 central TS + 2LS. Part processed. 1 block. ebl

MICROSCOPY

The tissue consists of multiple variably-sized cystic lobular

structures, partially bound together by loose connective tissue which

contains glandular acini. Cystic lobules are lined by single to

multi-layered cuboidal to plump and crowded epithelium, around lumina

filled with basophilic secretion, containing eosinophilic globular

material and desquamated lining cells. Often, epithelial cells form

complex papillary intraluminal structures. Epithelial cells have a

moderate volume of eosinophilic cytoplasm, often with large clear

vacuoles. Nuclei are round to oval with stippled coarse chromatin, and

prominent central eosinophilic nucleoli, particularly in larger cells.

There is moderate to marked anisocytosis and anisokaryosis, with

frequent areas of karyomegaly and multiple nucleoli. Mitotic rate is up

to 4 per high-power field including atypia. There are occasional foci of

coagulative necrosis, sometimes forming the cyst contents. While most

cystic lobules are bound by a thick capsule-like structure, additional

lobules of dysplastic tissue are present outside and within the capsular

tissue (local invasion).

DIAGNOSIS

Adenocarcinoma

COMMENTS

The mass is consistent with an adenocarcinoma. Tumour extends to all

margins, as discussed with you on the phone today, excision appears

incomplete, and regrowth is expected. Endometrial adenocarcinoma is

poorly described in the bitch, with only sporadic case reports published

widely. In this animal I advise a thorough check for more widespread

disease including the abdominal lymph nodes and lung in particular. The

potential of this tumour to spread is speculative; while the

histological features would suggest a low grade malignancy in terms of

invasiveness, being a visceral adenocarcinoma, the potential for

metastasis is definitely there. Further tissue resection to acheive

complete excision is recommended sooner rather than later.

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