Intracranial Meningioma in a Dog - Treatment with Radiotherapy

Background: The most common primary brain neoplasm is meningioma. Dolichocephalic breeds are predisposed and there is no sexual predilection. Clinical signs depend on the location and size of the tumor and have a progressive course. Primary treatement includes surgery, radiotherapy or both.  This study aimed to describe the treatment of a dog with suspected intracranial meningioma with definitive radiotherapy, which resulted in significant clinical improvement and prolonged survival. Case: A 9-year-old Shetland Shepherd bitch was diagnosed with a head tilt to the left side that progressed over a few weeks. She previously received corticosteroid therapy, which resulted a clinical improvement that worsened after treatment was discontinued. Computed tomography revealed an extra-axial brain mass in the caudal fossa, lateralized to the right, well-delimited, and measuring approximately 1.5 × 1.4 × 1.7 cm, suggestive of intracranial meningioma. The patient was treated with radiotherapy using Cobalt-60 equipment, with 18 daily fractions of 2.5 Gy at a total dose of 45 Gy using parallel and opposite technique fields. A new tomography performed 30 days after treatment showed a remission of 85% of the initial brain mass measuring approximately 0.9 × 1.0 × 0.5 cm, as well as complete resolution of the clinical signs initially presented. After 14 months, the patient presented with signs of lethargy and ataxia and was medicated with hydroxyurea at a dose of 50 mg/kg 3 times a week and corticosteroid therapy. However, the patient’s neurological condition deteriorated, and she was subjected to reirradiation using the same protocol used previously, which resulted in clinical improvement and a 54% reduction in tumor volume on magnetic resonance. As a late side effect, only permanent alopecia in the irradiated region was observed. The patient died of disease 330 days after the second course of radiotherapy, with a total survival time of 1087 days. Discussion: Meningiomas are extra-axial neoplasms of the central nervous system that grow inside the dura mater. The literature shows that meningiomas are more common in dolichocephalic races with a mean age of 9 years, which supports our findings. Meningiomas most commonly affect the cortical thalamus and cerebellopontine region in dogs, which are normally associated with vestibular symptoms, as seen in this case. Diencephalic damage can result in vestibular signals since the thalamus functions as a relay station for vestibular afferent stimuli that are relayed to the cerebral cortex. In addition to the vestibular syndrome, common clinical signs associated with meningiomas in dogs include seizures, behavioral changes, and walking in circles, which are frequently misinterpreted due to tumor-induced side effects, such as cerebral edema, obstructive hydrocephalus, and cerebral hernia. Advanced imaging techniques should be used to diagnose intracranial neoplasms. In this case, computed tomography was critical for diagnosis and treatment planning. Meningioma treatment may comprise palliative measures, surgery, and radiotherapy. Radiotherapy as a single treatment can improve the quality of life with a decrease in clinical signs and a median survival time of approximately 250-536 days, as reported in the literature. Hydroxyurea can be a therapeutic option in inoperable cases and for patients with clinical limitations to undergo successive anesthesia during radiotherapy. Its most serious side effect is progressive myelosuppression. It can cause temporary partial tumor remission and improvement in clinical signs. As previously stated, radiotherapy can be an effective primary treatment option for treating intracranial meningiomas in dogs, with significant improvement in neurological clinical signs and mild side effects. Keywords: dogs, central nervous system, radiotherapy, reirradiation, oncology. Título: Meningioma intracraniano em cão - tratamento com radioterapia Descritores: cães, sistema nervoso central, radioterapia, reirradiação, oncologia

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 pre-anesthetic 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. Keywords: canine, urethral neoplasm, surgery, chemotherapy. Título: Carcinoma uretral primário em uma cadela - tratamento multimodal Descritores: canino, neoplasia uretral, cirurgia, quimioterapia

Lung-Digit Syndrome Related to an Adenosquamous Feline Lung Carcinoma

Background: The lung-digit syndrome is a rare syndrome characterized by the presence of a primary pulmonar neoplasia manifesting metastasis to the digit, occurring exclusively in felines. The diagnosis is based on the clinical signs, associated with radiographic and histopathological exams. There are no therapeutic protocols well-established, and surgical excision is considered controversial due to high recurrence and metastasis rates. The prognosis is considered poor, with low survival rates. The aim of this paper is to report a case of lung-digit syndrome attended in Rio de Janeiro.Case: A 12-year-old female cat, no defined race, was attend with the complaint of weight loss and injury in the right thoracic limb, already having histopathological diagnosis of squamous differentiation adenocarcinoma through biopsy. Physical examination showed no other clinical signs at first, including no signs of respiratory disease. Laboratory and imaging exams were performed, and the radiographic examination showed alterations in the pulmonary parenchyma showing a nodular area of increased radiographic density. Followed up by the manifestation of breathing noise at rest, as the first respiratory signs. The association of the clinical evaluation, medical history, and histopathological report from the limb lesion, lead to the suspicion diagnostic of lung-digit syndrome. The owners decide for the palliative treatment with chemotherapy, using carboplatin and prednisolone. Only the first session was performed, with the animal being euthanized due to clinical worsening 48 days after the initial manifestation of clinical signs. The diagnosis was confirmed by post mortem exams, and the pulmonary nodule were diagnosed as adenocarcinoma with squamous differentiation in concordance with the limb lesion diagnosis.Discussion: The lung-digit syndrome is still poorly studied in the veterinary medicine, with few reports published. Epidemiological data shows major incidence in elderly cats, with no racial or sexual predisposition, occurring in a 12-year-old cat in the present case. There are few theorys to explain the etiopathogenesis of the syndrome, however, none have been fully comproved. The clinical symptomatology varies from asymptomatic animals to those manifesting nonspecific systemic signs and respiratory signs. In this case the animal initially manifested only the presence of the digit injury and weight loss, with respiratory signs manifesting later. The digital lesion local signs usually include swelling, ulceration, purulent discharge, nail loss, and pain, occurring more frequently in the thoracic limbs, involving weight-bearing digits, as in the present report that occurred in the right thoracic limb, with involvement of the first and third digits. Radiographic findings may help in the diagnosis suspicion, having the confirmation by histopathological examination. The most frequent histological types involved in the syndrome are the adenocarcinoma, bronchoalveolar carcinoma, squamous cell carcinoma and adenosquamous carcinoma. The squamous-differentiated adenocarcinoma or adenosquamous carcinoma, as described in the histopathological report in the present case, is the least frequent. The treatment protocol is not well-established with no proven effective treatment. Surgical excision is not recomended as a palliative method, and the chemotherapy and radiotherapy sucess rates are still unknown. The prognosis is considered extremely unfavorable and early diagnosis represents the best attempt to control the disease

Canine Transmissible Venereal Tumor in the Larynx with Pulmonary Metastasis

Background: Canine transmissible venereal tumor (TVT) is one of the most common canine neoplasms in Brazil. Lesions develop mainly in the genital tissue and less frequently in other areas, in the extragenital form. Metastasis is rare, and the disease progression depends on the patient's immune status. The treatment of choice is chemotherapy with vincristine sulfate, considered an effective and safe modality. The present work describes the first case of extragenital TVT in the larynx with pulmonary metastasis at the time of diagnosis. Case: An approximately 4-month-old mixed-breed bitch was attended manifesting acute clinical respiratory signs. The patient had been rescued from the street 2 months beforehand. Physical examination revealed pale mucous membranes and crackling pulmonary auscultation. Thoracic radiography was performed in 3 projections, showing multiple nodules in the lung parenchyma, followed by cytopathological examination using fine needle puncture guided by thoracic ultrasound, confirming the diagnosis of TVT. Considering the cytological finding and the absence of primary tumor lesions in the genital, oral, cutaneous or nasal regions, endoscopy was performed in order to locate a possible primary focus. The exam revealed a small erythematous tumor with smooth and regular surface, measuring approximately 2.5 cm, located in the larynx, between the arytenoid cartilages. Chemotherapy was performed with vincristine sulfate with radiographic follow-up throughout the treatment. Full remission of the pulmonary and laryngeal nodules was achieved at the end of the protocol. The animal remained in complete remission for a period of 2 years. Discussion: TVT is more frequently observed in animals of active reproductive age, and rarely in animals under 1 year of age, as in the case described here. When considering extragenital lesions, the manifestation can be single or multiple, occurring more frequently in the cutaneous, oral and nasal forms. This case describes a laryngeal lesion with pulmonary involvement, without lesion in the genitalia or any other site. Cases of TVT in young and prepubescent animals, associated with extragenital involvement and aggressive behavior, similar to this case, have been described in literature, but never in this location. Literature suggests there is a relationship with the immune status of such patients, which do not have a well-developed immune system, facilitating disease progression. In these animals, transmission can be maternal, since in some cases the patient develops the disease without having contact with other animals except the mother. This form of transmission would facilitate the extragenital form in the oral cavity, airways and ocular region, related to licking, lactation and direct contact. Vincristine sulfate chemotherapy, considered the treatment of choice, was effectively used in this case, despite the atypical form. The TVT prognosis tends to be favorable, with the exception of the aggressive presentations with the presence of distant metastases. However, in the case described here, even though metastatic pulmonary nodules were present, complete remission was achieved, with survival exceeding 2 years. The development of TVT in the larynx is a rare form of the disease, and this report is possibly the first description of this tumor location. Thus, we highlight the importance of a complete investigation of the patient and of TVT as a differential diagnosis in this location. Keywords: dog, bitch, coitus, neoplasm, round cells, extragenital. Título: Tumor venéreo transmissível canino em laringe com metástase pulmonar Descritores: cão, cadela, coito, neoplasia, células redondas, extragenital

Tumor venéreo transmissível canino com remissão espontânea: estudo de caso com ênfase aos exames clínico e citopatológico para monitoramento da evolução tumoral

O tumor venéreo transmissível canino (TVTC) é uma neoplasia transmitida principalmente através da cópula, com elevada incidência em cães errantes no Brasil. No processo de evolução tumoral do TVTC, são reconhecidas as fases de progressão, estacionária e de regressão. O estado imunológico do hospedeiro está relacionado ao comportamento biológico da doença, contudo, a observação de regressão espontânea em casos de TVTC de ocorrência natural é incomum. Foi atendida uma paciente canina, resgatada da rua, por apresentar massa ulcerada na genitália externa e infestação por carrapatos. Foram realizados exame citopatológico, que diagnosticou TVTC, e exames laboratoriais que evidenciaram anemia discreta e grave trombocitopenia. Com isso e diante da impossibilidade de realizar outros exames, foi também estabelecido o diagnóstico presuntivo de erlichiose monocítica canina (EMC) e instituído tratamento para a hemoparasitose. Durante o acompanhamento, foi observada rápida melhora dos sinais clínicos e das alterações laboratoriais, bem como a redução espontânea da massa tumoral. Em sequência, foi realizada nova avaliação citopatológica do TVTC e verificado o aumento quantitativo de linfócitos maduros e plasmócitos, em meio as células tumorais, achado compatível com a fase estacionária da doença. A partir desse momento, optou-se por realizar apenas acompanhamento clínico e avaliação citopatológica da neoplasia. Foram observados contínua remissão clínica e achados microscópicos compatíveis com a fase de regressão do tumor, até sua remissão completa. Pondera-se que a melhora na saúde geral da paciente após o tratamento da EMC esteja relacionada à regressão espontânea do TVTC, e que realização simultânea de exames clínico e citopatológico seriados pode ser viável e útil ao acompanhamento das fases de evolução do TVTC. Palavras-chave: cães; células redondas; citopatologia; ehrlichiose; neoplasia

SARCOMA FUSOCELULAR COM METÁSTASE PULMONAR E ESPLÊNICA EM CANINO - RELATO DE CASO

Os sarcomas de tecidos moles (STM) são neoplasias mesenquimais malignas, que acometem principalmente a pele e o subcutâneo, respondendo por 8 a 15% dos tumores cutâneos caninos (Liptak; Christensen, 2020). O grupo é composto por uma série de neoplasias mesenquimais que possuem comportamento biológico, macroscopia e microscopia semelhantes entre si, e a ressecção cirúrgica é a terapia de eleição devido a sua agressividade local e baixa taxa de metástases (Liptak; Christensen, 2020). O presente trabalho relata um caso de um canino, fêmea, sem raça definida, de 11 anos de idade, atendido no Hospital Veterinário da Universidade Federal Rural do Rio de Janeiro, apresentando um tumor ulcerado em região perianal, com evolução rápida e crescimento progressivo. Durante o atendimento, o animal manifestava prostração, hiporexia, normodipsia, normoúria, normoquesia, e apresentava massa em região perianal direita, de consistência firme, aderida e ulcerada, medindo aproximadamente 9,0 cm em sua maior dimensão. Foi realizado exame citopatológico com a amostra coletada através de técnica aspirativa, com microscopia sugestiva de sarcoma de tecidos moles. Foram solicitados exames de radiografia torácica, ultrassonografia abdominal e hemograma para estadiamento clínico e avaliação da condição geral do animal. Durante radiografia foi evidenciada massa em região de mediastino aproximadamente 6 cm. Foi realizada coleta de amostra para exame citopatológico guiada por ultrassonografia com diagnóstico sugestivo de sarcoma de tecidos moles. Os tutores optaram pela eutanásia do animal. Foi realizado exame de necropsia evidenciando massa de 7,0 x 6,0 x 4,0 cm em lobo pulmonar cranial esquerdo, múltiplos nódulos esplênicos variando entre 2,0 x 2,0 cm a 4,0 x 3,0 cm, além da massa de 9,0 x 8,0 x 5,0 cm em região perianal. O diagnóstico histopatológico foi de sarcoma fusocelular, com metástases em pulmão e baço, sugerindo diagnóstico diferencial de fibrossarcoma. Os sarcomas de tecidos moles se manifestam majoritariamente como massas de tamanhos variados, crescimento lento, localizadas principalmente em tronco e membros (Dennis et al., 2011), contrariando a descrição do relato, em que o crescimento foi acelerado e em região atípica. As metástases são incomuns, ocorrendo em até 20% dos casos, principalmente para pulmões (Liptak; Christensen, 2020; Dennis et al., 2011), conforme caso apresentado, porém com metástase incomum em baço. O diagnóstico histopatológico pode ser dificultado em casos de baixa diferenciação, com difícil distinção da origem neoplásica, podendo ser necessário exame de imunoistoquímica (Liptak; Christensen, 2020). No relato o diagnóstico histopatológico foi de sarcoma fusocelular, sugestivo de fibrossarcoma. É importante considerar a possibilidade de disseminação mesmo em tumores que possuem baixos índices metastáticos, obtendo um estadiamento clínico fidedigno, de forma a estabelecer a melhor conduta terapêutica para o paciente

TERAPIA MULTIMODAL NO TRATAMENTO DE HEMANGIOSSARCOMA CUTÂNEO CANINO

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.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

Fitoquímica e quimiossistemática de Conchocarpus marginatus e C. inopinatus (Rutaceae)

Phytochemical studies of the leaves and stem have led to the identification of the known acridone alkaloids arborinine, methyl-arborinine, 1-hydroxy-3-methoxy-N-methyl acridone, xanthoxoline, 1,2,3,5-tetramethoxy-N-methylacridone, toddaliopsin C and the new seco acridone alkaloid inopinatin. The known quinoline alkaloids 2-phenyl-1-methyl-quinolin-4(1H)-one, 2-phenyl-1-methyl-7-methoxy-quinolin-4(1H)-one, dictamnine, and the coumarins scopoletin and marmesin were also isolated. The isolated compounds and the distribution of secondary metabolites, which are systematically important, obtained from literature, clearly confirmed that some species formerly described in the genera Angostura and Galipea in fact shall belong to the genus Conchocarpus

Demodiciose canina: estudo retrospectivo dos casos atendidos no Hospital Veterinário da Universidade Federal Rural do Rio de Janeiro (2013-2017)

A demodiciose é uma das principais dermatopatias parasitárias atendidas na rotina de clínicas veterinárias, acometendo principalmente animais jovens, cujo diagnóstico pode ser realizado através do raspado cutâneo profundo, tricograma e fita de acetato. Os sinais dermatológicos, incluindo alopecia, eritema, crostas e pápulas localizam-se principalmente na face. O objetivo do trabalho foi realizar levantamento de casos de demodiciose canina diagnosticados no setor de Dermatologia do Hospital Veterinário da Universidade Federal Rural do Rio de Janeiro no período de janeiro de 2013 a abril de 2017. Foram utilizadas 125 fichas com diagnóstico de demodiciose de um total de 1282 animais atendidos. Foi encontrada uma ocorrência de 9,75%(125/1282) da doença em cães, predominantemente jovens, com idade inferior a um ano e sem predileção sexual. Com relação a distribuição racial, a de maior prevalência foi a sem raça definida (29,6%; 37/125), tendo como principal sinal clínico a hipotricose (60,8%; 76/125) e apresentando-se de forma generalizadas (76,8%; 96/125). O método diagnóstico mais utilizado foi o raspado cutâneo (61,6%; 77/125). Foi possível concluir que a demodiciose é uma doença que deve estar dentre os diagnósticos diferenciais na clínica de animais de companhia, principalmente em animais jovens, com idade inferior a 1 ano de idade. E que esta doença acomete principalmente região de cabeça com lesões mais frequentes de hipotricose e eritema

PERFIL HEMATOLÓGICO E BIOQUÍMICO DE CÃES INFECTADOS POR Dirofilaria immitis DA LOCALIDADE DA ILHA DE ALGODOAL, PARÁ

A dirofilariose é uma importante zoonose que tem no cão doméstico o seu principal hospedeiro. Apesar da maioria dos animais serem assintomáticos, possíveis alterações laboratoriais podem ser encontradas. O objetivo do trabalho foi avaliar o perfil hematológico e bioquímico de cães naturalmente infectados por Dirofilaria immitis da localidade da Ilha de Algodoal, Pará. O diagnóstico baseou-se na identificação das microfilárias pela técnica de Knott modificada. Dentre os 82 animais avaliados, 53 (64,63%) foram encontrados positivos e 29 (36,34%) negativos. No exame físico, todos os animais apresentaram assintomáticos. Os principais achados na hematologia foram anemia normocítica normocrômica, trombocitopenia, linfocitose e basofilia. Na bioquímica sérica apenas os valores de ureia estavam acima dos níveis de normalidade. Não foi possível identificar achados característicos da infecção nos exames dos cães. Entretanto, avaliações laboratoriais devem ser levadas em consideração para o diagnóstico e tratamento