Sertolioma in a Canadian Husky: Relationship between Tumor, Hormones, Neurons and Skin

Background: Sertolioma is a slow-growing, non-invasive, firm and nodular tumor, malignant in 10% to 22% of cases and with low metastatic potential. Old age and cryptorchidism increase up to 26 times its chances of development and associates it with malignancy. Paraneoplastic syndrome, shown in 20% to 30% of the animals, is due to the aromatization of testosterone or the direct production of estrogen by tumor cells, leading to signs of feminization and bone marrow aplasia. The objective of this article is to report a case of sertolioma in a dog with dermatological characteristic symptoms, but presenting an unusual aggressive behavior, both completely reverted after castration.Case: A 9-year-old, uncastrated, aggressive and uncontrollable Canadian Husky dog was treated at the Institutional Veterinary Hospital with parapenial volume increase and generalized alopecia. A scrotal testis of reduced size and flaccid consistency and a mass in a parapenial region of 11 x 7.5 x 8 cm in diameter, with a cystic contour, adhered to the abdominal musculature and painless to palpation were detected. Cytology of the parapenial mass presented an image compatible with seminoma or sertolioma, and the preputial smear revealed a predominance of superficial cells. Ultrasound examination showed a heterogeneous inguinal mass, with expansive cystic area, compatible with mass in retained inguinal testis. Therapeutic course consisted of bilateral orchiectomy. Ectopic testis was firm to the cut, had whitish to yellowish coloration and was surrounded by a tunica containing 200 mL of serosanguinolent liquid. The histology of the mass revealed sertolioma-compatible cell characteristics, with cell proliferation circumvented by fibrous connective tissue forming poorly delimited lobes, moderate polymorphism with elongated cells, arranged in a palisade at the periphery of the lobes, vacuolated eosinophilic cytoplasm and vesiculous round nuclei. The unretained testicle revealed signs of atrophy. After surgery the patient showed a progressive improvement of the dermatological symptoms. However, what most caught the attention was the change in aggressive behavior, and fifteen days after surgery the animal was extremely docile and easily restrained during the clinical examination.Discussion: Hyperesthyrogenism due to sertolioma results from: 1) direct synthesis of estrogen by neoplastic tumor cells 2) increase in metabolism by central conversion (testicular cells) or peripheral hepatocytes, myocytes, adipocytes, hair follicles and neural tissue) androgens into estrogen through the aromatization of testosterone and 3) androgen and estrogen rate imbalance. Testosterone is considered responsible for the aggressive behavior in males, evidenced by the decrease of this behavior when the testicles are removed, and by the reinstallation of this behavior when the hormonal replacement is done. However, research on mice showed that estrogen-sensitive regulatory pathways also play a role in promoting this behavior. Although practically undetectable in male circulation, its presence stems from in vivo synthesis from the aromatization of testosterone, and it is this local estrogen, peripherally synthesized in the brain, that would be responsible for the control of dimorphic behaviors in males. The importance of the estrogen signaling pathway in aggression has also been reported in a study in knockout mice for estrogen receptors, in which males rarely exhibited aggressiveness. Such information is sufficient to support the hypothesis that the disappearance of the aggressiveness of the reported animal was obtained due to castration and correction of hyperestrogenism, showing the importance of including it as an important cause of aggressive behavior in uncastrated male dogs

PYOMETRA IN BITCHES: RELATIONSHIP BETWEEN CLINICAL PROGNOSIS AND LABORATORY DIAGNOSIS

Pyometra is a disease resulting from bacterial interaction with cystic endometrial hyperplasia. The aim of this study was to identify bacteria under aerobic and anaerobic conditions of intrauterine secretion of bitches with pyometra, Systemic Inflammatory Response Syndrome, status of the cervix, peritonitis, serum biochemical measurements and to compare the prognosis of surgically treated bitches. We used 15 bitches with pyometra, undergoing ovariohysterectomy. Blood count and dosage of serum biochemicals were performed preoperatively. Urine was collected by cystocentesis during surgery. After the uterus was removed, intrauterine secretion was aspirated; the samples were grown aerobically and anaerobically, and urine aerobically. The animals were divided into two groups, G1 (hospital discharge until 48 hours) and G2 (discharged after 48 hours or death). Eleven samples of intrauterine content (73.3%) had bacterial growth in aerobic and anaerobic conditions, and Arizona hinshawii was isolated in a sample. Four urine samples (26.6%) had bacterial growth. There were significant differences in status of the cervix, urea, creatinine, alkaline phosphatase between G1 and G2. Although the etiology diversity found in intrauterine cultures was high, the evaluation of azotemia, status of the cervix, and serum alkaline phosphatase dosage proved to be good prognostics markers in female dogs with pyometra.  Keywords: anaerobic; creatinine; cystic endometrial hyperplasia; microbiology; SIRS

PIOMETRAS EM CADELAS: RELAÇÃO ENTRE O PROGNÓSTICO CLÍNICO E O DIAGNÓSTICO LABORATORIAL

Piometra é uma afecção resultante da interação bacteriana com a hiperplasia cística do endométrio. O objetivo deste estudo foi identificar bactérias em condições de aerobiose e anaerobiose da secreção intrauterina de cadelas com piometra, presença da síndrome da resposta inflamatória sistêmica, status da cérvix, peritonite, dosagens bioquímicas séricas e comparar com o prognóstico de cadelas tratadas cirurgicamente. Utilizaram-se 15 cadelas com piometra, submetidas à ovariohisterectomia. Hemogramas e dosagens séricas de ureia, creatinina, FA e ALT foram realizados no pré-operatório imediato. Coletou-se urina por cistocentese. Após a remoção do útero e ovários, a secreção intrauterina foi aspirada; as amostras foram então cultivadas em aerobiose e anaerobiose, as amostras de urina em aerobiose. Os animais foram divididos em dois grupos, G1 (alta hospitalar em até 48 horas) e G2 (alta hospitalar após 48 horas ou óbito). Onze amostras de conteúdo intrauterino (73,3%) apresentaram crescimento bacteriano em aerobiose e anaerobiose e em uma amostra isolou-se Arizona hinshawii. Quatro amostras de urina (26,6%) tiveram crescimento bacteriano. Houve diferença significativa das variáveis status da cérvix, ureia, creatinina e fosfatase alcalina entre G1 e G2. Embora a diversidade etiológica encontrada nas culturas de conteúdo intrauterino tenha sido alta, a avaliação da azotemia, status da cérvix e dosagem de FA sérica mostraram-se bons marcadores prognósticos em cadelas com piometra.  Palavras-chave: Anaerobiose; Creatinina; Hiperplasia Endometrial Cística; Microbiologia; SIRS

Sertolioma in a Canadian Husky: Relationship between Tumor, Hormones, Neurons and Skin

Background: Sertolioma is a slow-growing, non-invasive, firm and nodular tumor, malignant in 10% to 22% of cases and with low metastatic potential. Old age and cryptorchidism increase up to 26 times its chances of development and associates it with malignancy. Paraneoplastic syndrome, shown in 20% to 30% of the animals, is due to the aromatization of testosterone or the direct production of estrogen by tumor cells, leading to signs of feminization and bone marrow aplasia. The objective of this article is to report a case of sertolioma in a dog with dermatological characteristic symptoms, but presenting an unusual aggressive behavior, both completely reverted after castration.Case: A 9-year-old, uncastrated, aggressive and uncontrollable Canadian Husky dog was treated at the Institutional Veterinary Hospital with parapenial volume increase and generalized alopecia. A scrotal testis of reduced size and flaccid consistency and a mass in a parapenial region of 11 x 7.5 x 8 cm in diameter, with a cystic contour, adhered to the abdominal musculature and painless to palpation were detected. Cytology of the parapenial mass presented an image compatible with seminoma or sertolioma, and the preputial smear revealed a predominance of superficial cells. Ultrasound examination showed a heterogeneous inguinal mass, with expansive cystic area, compatible with mass in retained inguinal testis. Therapeutic course consisted of bilateral orchiectomy. Ectopic testis was firm to the cut, had whitish to yellowish coloration and was surrounded by a tunica containing 200 mL of serosanguinolent liquid. The histology of the mass revealed sertolioma-compatible cell characteristics, with cell proliferation circumvented by fibrous connective tissue forming poorly delimited lobes, moderate polymorphism with elongated cells, arranged in a palisade at the periphery of the lobes, vacuolated eosinophilic cytoplasm and vesiculous round nuclei. The unretained testicle revealed signs of atrophy. After surgery the patient showed a progressive improvement of the dermatological symptoms. However, what most caught the attention was the change in aggressive behavior, and fifteen days after surgery the animal was extremely docile and easily restrained during the clinical examination.Discussion: Hyperesthyrogenism due to sertolioma results from: 1) direct synthesis of estrogen by neoplastic tumor cells 2) increase in metabolism by central conversion (testicular cells) or peripheral hepatocytes, myocytes, adipocytes, hair follicles and neural tissue) androgens into estrogen through the aromatization of testosterone and 3) androgen and estrogen rate imbalance. Testosterone is considered responsible for the aggressive behavior in males, evidenced by the decrease of this behavior when the testicles are removed, and by the reinstallation of this behavior when the hormonal replacement is done. However, research on mice showed that estrogen-sensitive regulatory pathways also play a role in promoting this behavior. Although practically undetectable in male circulation, its presence stems from in vivo synthesis from the aromatization of testosterone, and it is this local estrogen, peripherally synthesized in the brain, that would be responsible for the control of dimorphic behaviors in males. The importance of the estrogen signaling pathway in aggression has also been reported in a study in knockout mice for estrogen receptors, in which males rarely exhibited aggressiveness. Such information is sufficient to support the hypothesis that the disappearance of the aggressiveness of the reported animal was obtained due to castration and correction of hyperestrogenism, showing the importance of including it as an important cause of aggressive behavior in uncastrated male dogs

A importância de bactérias Gram positivas como etiologia na piometra canina

E. coli is the main bacteria isolated from infected uterus and bacterial endotoxin can lead to fatal endotoxic shock. Systemic inflammatory response syndrome (SIRS) precedes the endotoxic shock. Thus, early recognition of SIRS is important for patient treatment and prognostic. In Brazil, Gram positive bacteria are responsible for approximately 20% of all pyometra cases, and there is limited information about pathophysiology of shock and tissue injury. The aim of this study was to investigate the capacity of Gram positive bacteria to cause SIRS in bitches with pyometra. A prospective follow-up of 67 bitches with pyometra was performed, which were classified as SIRS + and SIRS- on admission. All bitches were surgically treated (ovariohysterectomy), uterine contents were collected in a sterile manner and the material was submitted to microbiological evaluation. Were identified in 55.2% of bitches E. coli (G1), 23.9% other Gram negative bacteria (G2) and 20.9% Gram positive bacteria (G3). The leukocyte profile, serum biochemistry and prevalence of SIRS were similar between the groups. It is concluded that Gram positive bacteria have the capacity to promote tissue damage and can lead the patient to death after SIRS and shock, as well as by E. coli and other Gram negative.A Escherichia coli é reportada como principal agente etiológico da piometra canina e as endotoxinas bacterianas podem desencadear choque endotóxico e óbito. A síndrome da resposta inflamatória sistêmica (SIRS) antecede o choque e sua identificação pode predizer o prognóstico do paciente. No Brasil, bactérias Gram positivas são responsáveis por aproximadamente 20% dos casos de piometra, e informações a respeito da fisiopatologia do choque ou da lesão tecidual nesses casos são escassos. Assim, o objetivo foi investigar a capacidade de bactérias Gram positivas desencadear SIRS em cadelas com piometra. Foram acompanhadas de maneira prospectiva 67 cadelas com piometra, que na admissão passaram por exame clínico, exames laboratoriais e foram classificadas como SIRS+ e SIRS-. Todos os animais foram tratados cirurgicamente (ovariohisterectomia), o conteúdo uterino foi coletado de forma estéril e o material foi submetido à avaliação microbiológica. Em 55,2% das cadelas foi identificada E. coli (G1), 23,9% outras bactérias Gram negativas (G2) e 20,9% Gram positivas (G3). O perfil leucocitário, a bioquímica sérica e a prevalência de SIRS foram semelhantes entre os grupos. Conclui-se que bactérias Gram positivas possuem capacidade de promover dano tecidual podendo levar o paciente a óbito após desencadear SIRS e choque, assim como por E. coli e outras Gram negativas