Clinicopathological Evaluation of Disseminated Metastases of Transmissible Venereal Tumor in a Spayed Bitch

Background: Although transmissible venereal tumor (TVT, transmissible venereal sarcoma, Sticker’s sarcoma) that affects dogs and other canids can be seen in many countries, it especially emerges in the countries which homeless dog population is very high. Female dogs are more susceptible than males. Transmissible venereal tumor is usually transmitted to genital organs during coitus and occasionally by social behavior such as sniffing and licking. The tumor is generally observed in the posterior part of the vagina. The tumor usually appears in various sizes, in the appearance of cauliflower, red and fragile. Metastases are rarely reported in cases with TVT. Metastases have been detected in lung, liver, tonsils, skin, lymph nodes, muscles, spleen. The diagnosis of transmissible venereal tumor is achived by considering the history of the animal, gross lesions, cytological examination and histopathology. Chemotherapy is frequently used in the treatment of TVT. In addition, radiotherapy, cryosurgery, surgical incision and immunotherapy are rarely applied for treatment. Chemical agents such as doxorubicin, vincristine sulfate, cyclophosphamide, methotrexate are preferred for chemotherapy.Case: Metastases to all mammary lobes, cervix uteri, neck, skin, gluteal muscles, the oropharyngeal region, and primary vaginal mass were described in spayed bitch, a 10-year old and mixed breed. The clinical examination manifested, fragile and hemorrhagic masses which resemble cauliflower in the vagina, neck, and inguinal region. Furthermore firm and multilobular masses in all mammary lobes, oropharyngeal region, and gluteal muscles of right leg were detected. Firstly, vaginal cytology was performed in order to confirm. In vaginal cytology, round to polyhedral shaped transmissible venereal tumor cells including cytoplasmic vacuoles and polychromatic nuclei were identified. Histopathologically, solid areas included oval- to round-shaped cells with prominent, hyperchromatic nuclei in all masses. Also, some of them comprised mitotic figures in their nuclei. In general, the tumor cells were separated by thin fibrous septa. Additionally, the cells were completely infiltrated to the mammary gland. In contrast, oropharyngeal and subdermal region of neck consisted more solid areas under the epidermis. There was lymphocyte infiltration at the periphery of the cells. For gluteal mass, TVT cells were confined in muscle bundles. Transmissible venereal tumor cases are often located in genital organs and their metastases are rarely encountered in comparison with other tumors. In this case report, metastases to cervical tissue, neck skin, oropharyngeal mucosa and gluteal muscles, mammary lobes are found.Discussion: When the sexual activity is high, the incidence of TVT increases. It especially develops in bitches in estrus. Breed, sex and age are not a cause of predisposition for TVT. Transmissible venereal tumors’ malignancy can increase in some cases, although TVT is known as a benign tumor. Prevalence of metastases was found fairly low in the studies. Metastases to mammary region, to subcutaneous region, to brain, to eye, to lung, to uterus, to ovary, to liver, to spleen have been reported. In conclusion, even if a bitch is acyclic, transmissible venereal tumor can be developed and thus the risk of its disseminated metastasis must be considered. Moreover, since the masses have not regresed for a long time, this situation may be related to severe immunosupression in the bitch

The Effect of Size and Clinical Staging of Mammary Tumors on Blood Parameters in Bitches

Background: Mammary tumors are the most common type of tumor in female dogs and account for 50% of all tumors in dogs. The clinical prognosis of canine mammary tumors is strongly affected by the size, stages, histological type, and grade of tumor; mitotic index; and nearby and distant metastasis. In canine mammary tumors, it is recommended that prognostic evaluation should also include complete blood count, serum biochemistry, and blood gases in addition to tumor size and stage. This study aimed to investigate the effect of tumor size, volume, and clinical stage on complete blood count, blood gas analysis, and serum biochemical parameters in bitches with mammary tumors and the correlation between them. Materials, Methods & Results: The study included a total of 18 bitches of different breeds, aged 6-15 years, of which 12 had mammary tumors and 6 were healthy. Thoracic X-rays were performed on bitches with mammary tumors in ventrodorsal and laterolateral positions to evaluate lung metastasis. Blood samples were collected from the cephalic vein from bitches in both groups in 2 different tubes (with plastic gel and ethylenediaminetetraacetic acid), 5 mL each, to perform complete blood count and evaluate blood gases and serum biochemical parameters. Blood samples were collected from the animals at the time of initial examination without any intervention. Analysis of the blood showed that bitches with mammary tumors had decreased levels of RBC, HCT, HGB, potassium, TCO2, base excess, THbc, and ALT enzyme activity and increased levels of lactate, total protein, cholesterol, triglyceride, LDL, uric acid, and ALP and LDH enzyme activities compared with those in the control group. Furthermore, the dogs with a primary tumor of > 5 cm were found to have significantly higher levels of WBC, lactate, total protein, triglyceride, LDL, uric acid, and ALP and LDH enzyme activities and significantly lower levels of RBC and THbc compared with those in the control group. Bitches with tumors in multiple mammary lobes were found to have significantly higher levels of WBC, total protein, triglyceride, LDL, and ALP and LDH enzyme activities and significantly lower levels of RBC, HCT, HGB, TCO2, THbc, and ALT enzyme activity compared with those in the control group. Based on the laboratory findings and approval of the owners of the dogs, mammary tissues containing the tumor and lymph nodes were surgically removed. After the operation, the removed mammary tissues were evaluated for size and volume. Clinical staging of the tumors was performed based on the size of the primary tumor (T), nearby lymph nodes (N), and metastasis (M) in accordance with the criteria set by WHO. Clinical staging of the tumors was, thus, based on the tumor, nodes, and metastases (TNM) score obtained according to the following system: Stage I: T1N0M0, Stage II: T2N0M0, Stage III: T3N0M0, Stage IV: TanyN1M0, Stage V: Made as TanyNanyM1. Discussion: Mammary tumors are the most common type of neoplasm in bitches and, thus, cause serious problems in veterinary medicine. Tumors are significantly correlated with better prognosis compared with larger tumors. Based on this finding, this study investigated the effect of size, volume, and stage of mammary tumors in bitches on some blood parameters and the correlation between them. It was, thus, concluded that clinical staging and evaluation of blood parameters could be useful in the diagnosis, treatment, and prediction of prognosis in canine mammary tumors. This study found that bitches with mammary tumors exhibited significant changes in their blood parameters (complete blood count, blood gas analysis, and serum biochemistry). The results obtained from this study may contribute to the development of approaches to the diagnosis, prediction of prognosis, and treatment of canine mammary tumors. Keywords: blood gas analysis, complete blood count, dogs, mammary tumor, serum biochemistry, tumor volume

Clinicopathological Evaluation of Disseminated Metastases of Transmissible Venereal Tumor in a Spayed Bitch

Background: Although transmissible venereal tumor (TVT, transmissible venereal sarcoma, Sticker’s sarcoma) that affects dogs and other canids can be seen in many countries, it especially emerges in the countries which homeless dog population is very high. Female dogs are more susceptible than males. Transmissible venereal tumor is usually transmitted to genital organs during coitus and occasionally by social behavior such as sniffing and licking. The tumor is generally observed in the posterior part of the vagina. The tumor usually appears in various sizes, in the appearance of cauliflower, red and fragile. Metastases are rarely reported in cases with TVT. Metastases have been detected in lung, liver, tonsils, skin, lymph nodes, muscles, spleen. The diagnosis of transmissible venereal tumor is achived by considering the history of the animal, gross lesions, cytological examination and histopathology. Chemotherapy is frequently used in the treatment of TVT. In addition, radiotherapy, cryosurgery, surgical incision and immunotherapy are rarely applied for treatment. Chemical agents such as doxorubicin, vincristine sulfate, cyclophosphamide, methotrexate are preferred for chemotherapy.Case: Metastases to all mammary lobes, cervix uteri, neck, skin, gluteal muscles, the oropharyngeal region, and primary vaginal mass were described in spayed bitch, a 10-year old and mixed breed. The clinical examination manifested, fragile and hemorrhagic masses which resemble cauliflower in the vagina, neck, and inguinal region. Furthermore firm and multilobular masses in all mammary lobes, oropharyngeal region, and gluteal muscles of right leg were detected. Firstly, vaginal cytology was performed in order to confirm. In vaginal cytology, round to polyhedral shaped transmissible venereal tumor cells including cytoplasmic vacuoles and polychromatic nuclei were identified. Histopathologically, solid areas included oval- to round-shaped cells with prominent, hyperchromatic nuclei in all masses. Also, some of them comprised mitotic figures in their nuclei. In general, the tumor cells were separated by thin fibrous septa. Additionally, the cells were completely infiltrated to the mammary gland. In contrast, oropharyngeal and subdermal region of neck consisted more solid areas under the epidermis. There was lymphocyte infiltration at the periphery of the cells. For gluteal mass, TVT cells were confined in muscle bundles. Transmissible venereal tumor cases are often located in genital organs and their metastases are rarely encountered in comparison with other tumors. In this case report, metastases to cervical tissue, neck skin, oropharyngeal mucosa and gluteal muscles, mammary lobes are found.Discussion: When the sexual activity is high, the incidence of TVT increases. It especially develops in bitches in estrus. Breed, sex and age are not a cause of predisposition for TVT. Transmissible venereal tumors’ malignancy can increase in some cases, although TVT is known as a benign tumor. Prevalence of metastases was found fairly low in the studies. Metastases to mammary region, to subcutaneous region, to brain, to eye, to lung, to uterus, to ovary, to liver, to spleen have been reported. In conclusion, even if a bitch is acyclic, transmissible venereal tumor can be developed and thus the risk of its disseminated metastasis must be considered. Moreover, since the masses have not regresed for a long time, this situation may be related to severe immunosupression in the bitch

The Effect of Size and Clinical Staging of Mammary Tumors on Blood Parameters in Bitches

Background: Mammary tumors are the most common type of tumor in female dogs and account for 50% of all tumors in dogs. The clinical prognosis of canine mammary tumors is strongly affected by the size, stages, histological type, and grade of tumor; mitotic index; and nearby and distant metastasis. In canine mammary tumors, it is recommended that prognostic evaluation should also include complete blood count, serum biochemistry, and blood gases in addition to tumor size and stage. This study aimed to investigate the effect of tumor size, volume, and clinical stage on complete blood count, blood gas analysis, and serum biochemical parameters in bitches with mammary tumors and the correlation between them. Materials, Methods & Results: The study included a total of 18 bitches of different breeds, aged 6-15 years, of which 12 had mammary tumors and 6 were healthy. Thoracic X-rays were performed on bitches with mammary tumors in ventrodorsal and laterolateral positions to evaluate lung metastasis. Blood samples were collected from the cephalic vein from bitches in both groups in 2 different tubes (with plastic gel and ethylenediaminetetraacetic acid), 5 mL each, to perform complete blood count and evaluate blood gases and serum biochemical parameters. Blood samples were collected from the animals at the time of initial examination without any intervention. Analysis of the blood showed that bitches with mammary tumors had decreased levels of RBC, HCT, HGB, potassium, TCO2, base excess, THbc, and ALT enzyme activity and increased levels of lactate, total protein, cholesterol, triglyceride, LDL, uric acid, and ALP and LDH enzyme activities compared with those in the control group. Furthermore, the dogs with a primary tumor of > 5 cm were found to have significantly higher levels of WBC, lactate, total protein, triglyceride, LDL, uric acid, and ALP and LDH enzyme activities and significantly lower levels of RBC and THbc compared with those in the control group. Bitches with tumors in multiple mammary lobes were found to have significantly higher levels of WBC, total protein, triglyceride, LDL, and ALP and LDH enzyme activities and significantly lower levels of RBC, HCT, HGB, TCO2, THbc, and ALT enzyme activity compared with those in the control group. Based on the laboratory findings and approval of the owners of the dogs, mammary tissues containing the tumor and lymph nodes were surgically removed. After the operation, the removed mammary tissues were evaluated for size and volume. Clinical staging of the tumors was performed based on the size of the primary tumor (T), nearby lymph nodes (N), and metastasis (M) in accordance with the criteria set by WHO. Clinical staging of the tumors was, thus, based on the tumor, nodes, and metastases (TNM) score obtained according to the following system: Stage I: T1N0M0, Stage II: T2N0M0, Stage III: T3N0M0, Stage IV: TanyN1M0, Stage V: Made as TanyNanyM1. Discussion: Mammary tumors are the most common type of neoplasm in bitches and, thus, cause serious problems in veterinary medicine. Tumors are significantly correlated with better prognosis compared with larger tumors. Based on this finding, this study investigated the effect of size, volume, and stage of mammary tumors in bitches on some blood parameters and the correlation between them. It was, thus, concluded that clinical staging and evaluation of blood parameters could be useful in the diagnosis, treatment, and prediction of prognosis in canine mammary tumors. This study found that bitches with mammary tumors exhibited significant changes in their blood parameters (complete blood count, blood gas analysis, and serum biochemistry). The results obtained from this study may contribute to the development of approaches to the diagnosis, prediction of prognosis, and treatment of canine mammary tumors. Keywords: blood gas analysis, complete blood count, dogs, mammary tumor, serum biochemistry, tumor volume

Efficacy of subsequent treatments in patients with hormone-positive advanced breast cancer who had disease progression under CDK 4/6 inhibitor therapy

Background There is no standard treatment recommended at category 1 level in international guidelines for subsequent therapy after cyclin-dependent kinase 4/6 inhibitor (CDK4/6) based therapy. We aimed to evaluate which subsequent treatment oncologists prefer in patients with disease progression under CDKi. In addition, we aimed to show the effectiveness of systemic treatments after CDKi and whether there is a survival difference between hormonal treatments (monotherapy vs. mTOR-based). Methods A total of 609 patients from 53 centers were included in the study. Progression-free-survivals (PFS) of subsequent treatments (chemotherapy (CT, n:434) or endocrine therapy (ET, n:175)) after CDKi were calculated. Patients were evaluated in three groups as those who received CDKi in first-line (group A, n:202), second-line (group B, n: 153) and >= 3rd-line (group C, n: 254). PFS was compared according to the use of ET and CT. In addition, ET was compared as monotherapy versus everolimus-based combination therapy. Results The median duration of CDKi in the ET arms of Group A, B, and C was 17.0, 11.0, and 8.5 months in respectively; it was 9.0, 7.0, and 5.0 months in the CT arm. Median PFS after CDKi was 9.5 (5.0-14.0) months in the ET arm of group A, and 5.3 (3.9-6.8) months in the CT arm (p = 0.073). It was 6.7 (5.8-7.7) months in the ET arm of group B, and 5.7 (4.6-6.7) months in the CT arm (p = 0.311). It was 5.3 (2.5-8.0) months in the ET arm of group C and 4.0 (3.5-4.6) months in the CT arm (p = 0.434). Patients who received ET after CDKi were compared as those who received everolimus-based combination therapy versus those who received monotherapy ET: the median PFS in group A, B, and C was 11.0 vs. 5.9 (p = 0.047), 6.7 vs. 5.0 (p = 0.164), 6.7 vs. 3.9 (p = 0.763) months. Conclusion Physicians preferred CT rather than ET in patients with early progression under CDKi. It has been shown that subsequent ET after CDKi can be as effective as CT. It was also observed that better PFS could be achieved with the subsequent everolimus-based treatments after first-line CDKi compared to monotherapy ET

Efficacy of subsequent treatments in patients with hormone-positive advanced breast cancer who had disease progression under CDK 4/6 inhibitor therapy (vol 23, 136, 2023)

[No Abstract Available