Caracterização anatomopatológica e imuno-histoquímica dos tumores das glândulas cutâneas em cães / Anatomopathological and immunohistochemical characterization of skin gland tumors in dogs

O presente estudo objetivou caracterizar os aspectos anatomopatológicos e imuno-histoquímicos dos tumores das glândulas cutâneas em cães. A caracterização morfológica seguiu a classificação atualizada da Organização Mundial de Saúde. Para a caracterização imuno-histoquímica, utilizaram-se anticorpos monoclonais primários anti-citoqueratina 14 (CK14), vimentina, p63, calponina, EGFR e Ki-67. Dos animais examinados, 66,67% (18/27) eram machos e 33,33% (9/27) fêmeas, 21 tinham raça definida e seis eram sem raça definida (SRD), com idade variando entre sete e 15 anos. Dos tumores caracterizados, 40,74% eram hepatoides (11/27), 29,63% sebáceos (8/27), 25,92% apócrinos (7/27) e 3,70% meibômio (1/27). Os tumores malignos representaram 55,56%, e os benignos 44,44%. Com esses resultados, foi possível demonstrar que os tumores das glândulas cutâneas em cães são frequentes, sem predileção por raça, sexo e com idade superior ou igual a sete anos. Os anticorpos CK 14, p63, vimentina e EGFR foram imunoexpressos nas células basais, células de diferenciação sebácea dos tumores hepatoides e de meibômio e células mioepiteliais. Entretanto, a vimentina e o EGFR não demonstraram imunomarcação para os tumores sebáceos. A calponina foi um bom marcador para as células mioepiteliais. O índice de Ki-67 foi mais acentuado nos tumores malignos em relação aos benignos. No entanto, estudos futuros utilizando maior número de casos se fazem necessários.(AU)

The present study aimed to characterize the anatomopathological and immunohistochemical aspects of cutaneous glandular tumors in dogs. Tumours were diagnosed according to the WHO criteria for canine skin neoplasms. For the immunohistochemical characterization, the primary monoclonal antibodies anti-cytokeratin 14 (CK14), vimentin, p63, calponin, EGFR and Ki-67 were used. Males were 66.67% (18/27) and females 33.33% (9/27), 21 had a defined race and 6 were mixed breed, with ages varying from 7 to 15 years. The tumors characterized were 40.74% hepatoid (11/27), 29.63% sebaceous (8/27), 25.92% apocrine (7/27) and 3.70% Meibômio (1/27). Malignant tumors accounted for 55.56% and benign tumors 44.44%. With these results it was possible to demonstrate that tumors of cutaneous glands in dogs are frequent, with no predilection for race, sex and with an age ≥ seven years. The CK 14 antibodies, p63, vimentin, and EGFR were imunoexpressed in the basal cells of the sebaceous cell differentiation and Meibomian hepatoides tumors and myoepithelial to cells. However, vimentin and EGFR did not demonstrate immunostaining for sebaceous tumors. Calponin was a good marker for myoepithelial cells. The Ki-67 index was more pronounced in malignant tumors compared to benign tumors. However, more studies are needed mainly using a higher number of tumors.(AU)

Malignant perineal tumors in dogs: the contribution of computed tomography for staging and surgical planning / Tumores perineais malignos em cães: contribuição da tomografia computadorizada para estadiamento e planejamento cirúrgico

The contribution of computed tomography for staging and surgical planning of malignant perineal tumors in dogs is discussed. Five dogs diagnosed with malignant perineal neoplasms underwent to computed tomography (CT) examination. The CT image enabled investigation of cleavage planes between neoplastic lesions and adjacent structures such as the rectum, anus, vagina, urethra and perineal muscles. Accurate assessment regional lymph nodes and adjacent bone structures was also possible. All tumors evaluated in this region presented heterogeneous appearance in pre and postcontrast CT images, but only the anal sac adenocarcinomas presented lymphadenopathy. Computed tomography proved to be a valuable tool for tumor staging and determination of lesion extension and invasion of adjacent tissues, providing significant contributions to clinical and surgical therapeutic planning.(AU)

A contribuição da tomografia computadorizada para estadiamento e planejamento cirúrgico de tumores perineais malignos em cães é discutida. Cinco cães diagnosticados com neoplasias perineais malignas foram submetidos ao exame de tomografia computadorizada (CT). A imagem por TC permitiu a investigação de planos de clivagem entre as lesões neoplásicas e estruturas adjacentes, como o reto, o ânus, a vagina, a uretra e os músculos perineais. A avaliação precisa dos linfonodos regionais e estruturas ósseas adjacentes também foi possível. Todos os tumores avaliados nesta região apresentaram aspecto heterogêneo nas imagens de TC pré e pós-contraste, mas apenas os adenocarcinomas de saco anal apresentaram linfonodopatia. A tomografia computadorizada mostrou ser uma ferramenta valiosa para o estadiamento da neoplasia, determinação da extensão da lesão e invasão de tecidos adjacentes, proporcionando contribuições significativas para o planejamento terapêutico clínico e cirúrgico.(AU)

Localización inusual del hidradenoma papilífero / Unusual location of the papilliform hydradenoma

El hidradenoma papilífero es una tumoración benigna, rara, generalmente localizada en la región vulvar o perineal siendo la región perianal una localización poco frecuente. Su asociación con enfermedades de transmisión sexual y el carcinoma ductal es controvertida; es importante realizar el estudio histopatológico de cualquier tumoración en esta zona. Se reporta el caso de una paciente de 49 años de edad, con un nódulo en la región perianal de 2 años de evolución; el estudio histopatológico confirmó el diagnóstico de hidradenoma papilífero. (AU)

The papilliferous hidradenoma is a benign, rare tumor, usually located in the vulvar or perineal region and the perianal region is a rare site. Its association with sexually transmitted diseases and ductal carcinoma is controversial. It is important to perform the histopathological study of any tumor in this area. The case of a 49-year-old patient with a nodule in the perianal region of 2 years of evolution is reported. The histopathological study confirmed the diagnosis of papilliferous hidradenoma.

Amiloidosis primaria asociada a mieloma múltiple: reporte de caso / Primary systemic amyloidosis associated with multiple myeloma: a case report

El amiloide es un material proteináceo fibrilar que se deposita en los tejidos en diversas situaciones clínicas; en la piel puede ser hallado con o sin afectación sistémica concomitante. La amiloidois sistémica asociada a mieloma múltiple tiene un pronóstico sombrío y son las manifestaciones mucocutáneas las primeras en aparecer. Se presenta en el caso de un varón de 55 años que consultó por tumoraciones elevadas de superficie lisa en la región perinatal.

Amyloid is a fibrillar proteinaceous material is deposited in tissies in various clinical situations, the skin can be found with or without concomitant systemic involvement. systemic amyloidosis associated with multiple myeloma has a poor prognosis and mucocutaneous manifestations are the first to appear. We report the case of a 55 years old patient with high smooth surface tumors in the perinatal region.

Granular cell tumor on perianal region: a case report

Granular cell tumor [GCT] was first described by Abrikossoff in 1926. GCT is a rarely seen soft tissue tumor and is generally benign. While the tumor can be seen in all parts of the body it is generally located on the head and neck region, and especially on the tongue. GCT is rarely seen in the anal-perianal region. In accordance with literature this case was reported because it was thought to be the 27[th] anal-perianal located GCT case. In this case report, approximately 0,5-1 cm pedunculated polypoid lesion was determined in the perianal region during the physical examination of a 23 year old female patient who applied with palpable mass complaint in the perianal region. Lesion in the patient was totally excited with healthy skin-subcutaneous tissue under local anesthesia. A benign granular cell tumor was detected in the histopathological examination. Positive staining was monitored immunohistochemically with S-100 and neuron specific enolase [NSE]. GCT is a rarely seen tumor in the anal-perianal region and its malign transformation rate is very low. Even lesions seen in the perianal region have clinically a benign appearance, a histopathological examination should be conducted and also GCT should be kept in mind during diagnosis. Malign-benign separation of these lesions is difficult so histopathological examination should be conducted with great care. Large local excision in the treatment provides curative treatment. But for those presenting malign transformation further examination must be performed for metastasis. After the treatment local recurrence and metastasis should be considered carefully. Prognosis of metastatic disease is very bad

Evaluation of an anal sac adenocarcinoma tumor in a Spitz dog

A 9-year-old emasculated male Spitz with tenesmus and constipation had a subcutaneous mass at the left ventral aspect of the anus with history of polyuria and polydipsia. A complete blood cell count, serum biochemistry panel, and urinalysis (cystocentesis sample) were evaluated. Abnormalities in the serum biochemistry panel included a mildly elevated serum cholesterol concentration (7.28 mmol/L; reference interval, 2.70-5.94 mmol/L), increased serum alkaline phosphatase activity (184 U/L; reference interval, 9-90 U/L), alanine transaminase (122 U/L; reference interval, 5-60 U/L) activity and aspartate aminotransferase (80 U/L; reference interval, 5-55 U/L) activity, severe increased total calcium concentration (16.3 mg/dL; reference interval, 8.2-12.4 mg/dL or 9.3-11.4 mg/dL), and decreased total calcium concentration (3.4 mg/dL, reference interval, 2.5-5.6mg/dL). Furthermore, testing revealed an increased intact parathyroid hormone concentration (38.6 pmol/L; reference interval, 3-17 pmol/L). On cytologic and histopathologic examinations, various types of cells were observed. Most of the cells were oval to polygonal and had elliptical or elongate nuclei and a moderate amount of pale to basophilic cytoplasm. The remaining cells had round to oval nuclei and pale to basophilic cytoplasm. Cells of both types were loosely adhered to each other and were arranged in rosette-like structures. Both neoplastic cell types had fine homogenous chromatin and either a small indistinct nucleolus or no visible nucleolus. Mild anisokaryosis and anisocytosis were observed. Histologically, the mass consists of glandular structures formed by cuboidal cells admixed with bundles of spindle cells. Based on location and histologic features, the final diagnosis was adenocarcinoma of the apocrine gland of the anal sac, which should be included as a cytologic differential diagnosis when spindle cells and typical epithelial cells are observed in masses in the region of the anal sac of dogs.

Perianal Rhabdomyosarcoma

Rhabdomyosarcoma can originate from every position in body but rarely in perianal position. The disease found in children and adolescents. It was very difficult to diagnose before operation due to misdiagnosis with common perianal disease as abscess beside anus, anus fistula. Histopathological examination plays role in diagnosis, but there are some difficulties with this. Sometimes the diagnosis have to made on immunohistochemistry and electronic microscopic findings. It is necessary to implement histopathological examination to diagnose this condition, including in-operation rapid test. Treatment by surgery combining with radiotherapy and chemotherapy produce high survival rate

Enfermedad de Bowen perianal / Perianal Bowen disease

Antecedentes: La Enfermedad de Bowen es un carcinoma intraepitelial, no queratinizado de células escamosas de la piel. La localización perineal es poco frecuente. Objetivos: Analizar su forma de presentación, el tratamiento implementado y los resultados obtenidos. Diseño: Trabajo retrospectivo. Población: Pacientes con Enfermedad de Bowen perianal asistidos en nuestro Hospital en los años 2000 y 2001. Método: En todos los casos el diagnóstico se realizó por biopsias de áreas condilomatosas; en 1 caso se realizó resección amplia de la lesión. Conclusiones: La escasa sintomatología de esta patología retrasan su diagnóstico. Ante su sospecha es fundamental el minucioso examen de toda la región anogenital y la biopsia de toda lesión sospechosa. En la actualidad el consenso general mantiene como tratamiento de elección a la resección ampliada. El curso clínico de la enfermedad de Bowen es relativamente benigno con un riesgo a desarrollar un carcinoma invasor que no supera el 2 al 6 por ciento. El seguimiento en el tiempo es imprescindible para prevenir recurrencias.

Prevalencia y tratamiento de la fístuila anorrectal en el Hospital provincial de Cotopaxi

La fístula anal frecuentemente está asociada a abscesos anorrectales. El trayecto supurante puede preexistir o ser la consecuencia de un absceso en la región anal, por lo que muchos autores hablan de un absceso fistuloso. La principal finalidad de nuestro estudio fue establecer su prevalencia y procedimientos quirúrgicos empleados en el Hospital Provincial de Cotopaxi. Se realizó un diseño retrospectivo, transversal, analítico y descriptivo, en base a una revisión de historias clínicas de todos los pacientes que ingresaron al servicio de cirugía de esta institución con el diagnóstico de fistula anal durante el período de enero de 1992 hasta diciembre de 1996. Los datos revelaron que esta patología fue frecuente en pacientes de sexo masculino (82 por ciento) y en la tercera década de vida (32.14 por ciento). El 14,28 por ciento presentó cirugía anal previa. El 50 por ciento estuvieron asociados a hemorroides, el 21,42 por ciento a abscesos anorrectales y el 3.57 por ciento a fisuras. Según la regla de Goodsall el 64.28 por ciento presentaron una localización posterior y la variedad interesfinteriana fue la más común en el 85,71 por ciento de casos. El drenaje quirúrgico y fistulotomía se realizó en el 21,42 por ciento es decir, en todos aquellos que presentaron también absceso; el 7,14 por ciento fueron a fistulectomía y curetaje, utilizado en el 71.42 por ciento. Complicaciones como retención urinaria y sangrado leve se presentaron solo en un 3 a 10 por ciento y fueron muy transitorios. Evolucionaron favorablemente con total remisión del cuadro clínico. Es importante considerar los antecedentes predisponentes y patología anal asociada en la etiología de la fisura anal. Previo a una delineación del trayecto fistuloso se debe utilizar cualquiera de los procedimientos quirúrgicos mencionados.

Tumor de Ebrikossoff perianal / Perianal Abrikossoff's tumor

Se comunica el caso clínico de una mujer de 57 años que consulta por masa perianal de dos años de evolución, de crecimiento lento. Al exámen físico, masa perianal en sector anterior derecho, de 4 x 3 cm. firme, adherida a planos superficiales y profundos, especialmente al esfínter anal. Biopsia incisional revela tumor benigno decéculas granulares. Se efctúa resección local amplia con excisión parcial de esfínter y sutura esfinteriana. La histología revela un tumor benigno de células granulares o tumor de Abrikossoff. Estudio inmunohistoquímico: Enolasa(++) y proteínas S/100(+) apoya el orígen neural del tumor. Este raro tumor, de histogénesis incierta, que puede presentarse en cualquier sitio del organismo, especilamente en cabeza y cuello(lengua), pared torácica y brazos. Es importante diferenciarlo de la variedad maligna del tumor de células granulares y de los carcinomas de células escamosas, por sus implicancias terapéuticas y pronósticas

Carcinoma do intestino grosso: análise de 93 caso / Large bowel carcinoma: a critical review of 93 cases

É apresentada a análise de 93 casos de carcinoma do intestino grosso. Os tumores foram divididos de acordo com a sua localizaçäo, havendo uma incidência maior dos mesmos no colón esquerdo. Dezessete casos eram de tumores inoperáveis. Entre os operáveis, 43 situavam-se no cólon, 27 no reto e junçäo retossigmoidiana e seis estavam no canal anal e regiäo perinatal. Cerca de 53 tumores do cólon e reto foram classificados no estágio C de Dukes. É feito um breve relato do método de preparo de cólon usado. A conduta cirúrgica nos tumores do intestino grosso é relatada, assim como o tratamento coadjuvante com quimioterapia. Em alguns pacientes foi realizada dosagem de antígeno cárcino-embrionário (CEA), para avaliar a evoluçäo

Bowenoid papulosis in the perianal region

A case is described of a patient who had numerous violaceous papular lesions around the anus which appeared benign clinically, but which on histological examination showed changes of carcinoma-in-situ. The case was followed up for three years after local excision but did not recur. Such cases need careful evaluation before radical operation in view of the recently recognised entity of "Bowenoid papulosis".