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.

Terapia multimodal no tratamento de hemangiossarcoma cutâneo canino / Multimodal therapy in the treatment of cutaneous canine hemangiosarcoma

O hemangiossarcoma é uma neoplasia mesenquimal maligna de origem endotelial. Quando manifestada em região cutânea, os sinais clínicos estão ligados a variações hemostáticas, como petéquias e hemorragias. O diagnóstico definitivo é obtido por exame histopatológico. A conduta cirúrgica é a terapia de escolha, podendo ser necessária a realização de técnicas reconstrutivas a depender da localização da neoplasia. A quimioterapia adjuvante, metronômica ou convencional, pode ser empregada. Um canino, fêmea, sem raça definida, de oito anos de idade, atendido com um nódulo cutâneo em região ventro abdominal. O animal foi submetido a protocolo quimioterápico metronômico, devido à extensão do tumor que impedia a exérese cirúrgica em um primeiro momento. O tratamento levou à citorredução, viabilizando a exérese tumoral, desconsiderando as margens de segurança, em caráter paliativo. Após a cirurgia o protocolo quimioterápico foi retomado e mantido nos dois meses seguintes. O animal permaneceu livre da doença nos seis meses seguintes, realizando revisões periódicas. O presente trabalho relata a abordagem multimodal aplicada em um caso de hemangiossarcoma cutâneo, atingindo qualidade de vida e sobrevida satisfatórias.(AU)

Hemangiosarcoma is a malignant mesenchymal neoplasm of endothelial origin. When manifested in the cutaneous region, clinical signs are linked to hemostatic variations, such as petechiae and hemorrhages. The definitive diagnosis is obtained by histopathological examination. Surgical management is the therapy of choice, and reconstructive techniques may be necessary depending on the location of the neoplasia. Adjuvant chemotherapy, either metronomic or conventional, can be used. An eight-year-old female, mixed-breed canine was treated with a cutaneous nodule in the abdominal ventral region. The animal was submitted to a metronomic chemotherapy protocol, due to the extension of the tumor that prevented surgical excision at first. The treatment led to cytoreduction, making the tumor excision feasible, disregarding the safety margins, in a palliative character. After surgery, the chemotherapy protocol was resumed and maintained for the next two months. The animal remained free of the disease for the following six months, undergoing periodic reviews. The present work reports the multimodal approach applied in a case of cutaneous hemangiosarcoma, achieving satisfactory quality of life and survival.(AU)

Terapia multimodal no tratamento de hemangiossarcoma cutâneo canino / Multimodal therapy in the treatment of cutaneous canine hemangiosarcoma

O hemangiossarcoma é uma neoplasia mesenquimal maligna de origem endotelial. Quando manifestada em região cutânea, os sinais clínicos estão ligados a variações hemostáticas, como petéquias e hemorragias. O diagnóstico definitivo é obtido por exame histopatológico. A conduta cirúrgica é a terapia de escolha, podendo ser necessária a realização de técnicas reconstrutivas a depender da localização da neoplasia. A quimioterapia adjuvante, metronômica ou convencional, pode ser empregada. Um canino, fêmea, sem raça definida, de oito anos de idade, atendido com um nódulo cutâneo em região ventro abdominal. O animal foi submetido a protocolo quimioterápico metronômico, devido à extensão do tumor que impedia a exérese cirúrgica em um primeiro momento. O tratamento levou à citorredução, viabilizando a exérese tumoral, desconsiderando as margens de segurança, em caráter paliativo. Após a cirurgia o protocolo quimioterápico foi retomado e mantido nos dois meses seguintes. O animal permaneceu livre da doença nos seis meses seguintes, realizando revisões periódicas. O presente trabalho relata a abordagem multimodal aplicada em um caso de hemangiossarcoma cutâneo, atingindo qualidade de vida e sobrevida satisfatórias.

Hemangiosarcoma is a malignant mesenchymal neoplasm of endothelial origin. When manifested in the cutaneous region, clinical signs are linked to hemostatic variations, such as petechiae and hemorrhages. The definitive diagnosis is obtained by histopathological examination. Surgical management is the therapy of choice, and reconstructive techniques may be necessary depending on the location of the neoplasia. Adjuvant chemotherapy, either metronomic or conventional, can be used. An eight-year-old female, mixed-breed canine was treated with a cutaneous nodule in the abdominal ventral region. The animal was submitted to a metronomic chemotherapy protocol, due to the extension of the tumor that prevented surgical excision at first. The treatment led to cytoreduction, making the tumor excision feasible, disregarding the safety margins, in a palliative character. After surgery, the chemotherapy protocol was resumed and maintained for the next two months. The animal remained free of the disease for the following six months, undergoing periodic reviews. The present work reports the multimodal approach applied in a case of cutaneous hemangiosarcoma, achieving satisfactory quality of life and survival.

Sobrevida de 574 dias em paciente canino com linfoma linfoblástico submetido a protocolos quimioterápicos relato de caso / 574-day survival time in canine patient with lymphoblastic lymphoma and treated with chemotherapy protocols - case report / Supervivencia de 574 días en un paciente canino con linfoma lifoblásticotratado con protocolos de quimioterapia - relato de un caso

Os caninos domésticos são animais muito suscetíveis ao aparecimento de neoplasias, estando os linfomas entre as mais comuns. O linfoma é caracterizado por uma proliferação aumentada de linfócitos anormais, interferindo diretamente na dinâmica hematopoiética. Sua causa é considerada multifatorial e não existe confirmação de predileção por sexo ou raças especificas, porém foi sugerido que cães geriatras são mais suscetíveis. O prognóstico é desfavorável e a sobrevida tende a ser reduzida. O presente artigo relata um caso de linfoma linfoblástico em um cão da raça labrador, macho, de quatro anos, que teve sobrevida de 574 dias, sendo submetido a quatro protocolos quimioterápicos com apresentação de três recidivas, e encaminhado à eutanasia após o quarto protocolo.(AU)

Domestic canines are very susceptible to developing cancer, and Iymphoma is the most common type of canine neoplasia. Lymphomas are characterized by the fast proliferation of abnormal Iymphoid cells, which interferes directly in hematopoietic dynamics. Lymphomas have multifactorial etiology and there is no confirmation of sexual or specific racial predilection, although it is suggested that older animals seem to be more susceptible. The prognosis is unfavorable and survival rates tend to be low. This article relates the case of a Iymphoblastic Iymphoma in a four-year-old male Labrador that survived for 574 days while treated with four chemotherapy protocols. The animal suffered three relapses, been subjected to euthanasia after the fourth.(AU)

Los caninos domésticos son animales muy susceptibles a la presentación de neoplasias, siendo los linfomas unas de las más frecuentes. El linfoma se caracteriza por una proliferación aumentada de linfocitos anormales, interfiriendo directamente en la dinámica hematopoyética. Su causa es considerada multifactorial y no existe predilección por sexo o raza, aunque ha sido sugerido que los perros viejos son más susceptibles. El pronóstico es desfavorable y la supervivencia tiende a ser reducida. El presente trabajo relata el caso de un perro labrador macho de cuatro años con linfoma linfoblástico, que tuvo una supervivencia de 574 días, y que fue sometido a cuatro protocolos quimioterápicos, presentando tres recidivas; el paciente fue llevado a eutanasia después del cuarto protocolo.(AU)

Sobrevida de 574 dias em paciente canino com linfoma linfoblástico submetido a protocolos quimioterápicos relato de caso / 574-day survival time in canine patient with lymphoblastic lymphoma and treated with chemotherapy protocols - case report / Supervivencia de 574 días en un paciente canino con linfoma lifoblásticotratado con protocolos de quimioterapia - relato de un caso

Os caninos domésticos são animais muito suscetíveis ao aparecimento de neoplasias, estando os linfomas entre as mais comuns. O linfoma é caracterizado por uma proliferação aumentada de linfócitos anormais, interferindo diretamente na dinâmica hematopoiética. Sua causa é considerada multifatorial e não existe confirmação de predileção por sexo ou raças especificas, porém foi sugerido que cães geriatras são mais suscetíveis. O prognóstico é desfavorável e a sobrevida tende a ser reduzida. O presente artigo relata um caso de linfoma linfoblástico em um cão da raça labrador, macho, de quatro anos, que teve sobrevida de 574 dias, sendo submetido a quatro protocolos quimioterápicos com apresentação de três recidivas, e encaminhado à eutanasia após o quarto protocolo.

Domestic canines are very susceptible to developing cancer, and Iymphoma is the most common type of canine neoplasia. Lymphomas are characterized by the fast proliferation of abnormal Iymphoid cells, which interferes directly in hematopoietic dynamics. Lymphomas have multifactorial etiology and there is no confirmation of sexual or specific racial predilection, although it is suggested that older animals seem to be more susceptible. The prognosis is unfavorable and survival rates tend to be low. This article relates the case of a Iymphoblastic Iymphoma in a four-year-old male Labrador that survived for 574 days while treated with four chemotherapy protocols. The animal suffered three relapses, been subjected to euthanasia after the fourth.

Los caninos domésticos son animales muy susceptibles a la presentación de neoplasias, siendo los linfomas unas de las más frecuentes. El linfoma se caracteriza por una proliferación aumentada de linfocitos anormales, interfiriendo directamente en la dinámica hematopoyética. Su causa es considerada multifactorial y no existe predilección por sexo o raza, aunque ha sido sugerido que los perros viejos son más susceptibles. El pronóstico es desfavorable y la supervivencia tiende a ser reducida. El presente trabajo relata el caso de un perro labrador macho de cuatro años con linfoma linfoblástico, que tuvo una supervivencia de 574 días, y que fue sometido a cuatro protocolos quimioterápicos, presentando tres recidivas; el paciente fue llevado a eutanasia después del cuarto protocolo.