jurnal bronchogenic adenocarcinoma

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Acta Scientiae Veterinariae, 2015. 43(Suppl 1): 94.

CASE REPORT

Pub. 94

ISSN 1679-9216

1

Received: 10 February 2014 Accepted: 12 July 2015 Published: 3 August 2015

1Universidade Federal Rural do Rio de Janeiro (UFRRJ), Seropdica, RJ, Brazil. 2Bichos e Caprichos Veterinria, Rio de Janeiro, RJ, Brazil 3Universidade

Federal Fluminense (UFF), Niteri, RJ, Brazil. CORRESPONDENCE: K.B. Corgozinho [[email protected] - Tel.: +55 (21) 99136-6367). Praa

Aquiles n. 50. CEP 21931573 Rio de Janeiro, RJ, Brazil.

Bronchogenic Adenocarcinoma with Unusual Metastasis in Cat

Katia Baro Corgozinho1, Cristiane Belchior2, Marcus Andr de Freitas Caloeiro2,Simone Carvalho dos Santos Cunha3& Heloisa Justen Moreira de Souza1

ABSTRACT

Background:Primary lung tumors in the cats are rare and pulmonary metastatic cancer is more common. Primary lung

neoplasms are highly aggressive and tend to metastasize particularly to the regional lymph nodes, pleura, mediastinum

bones, muscles, heart, brain and spleen. Digital is the most common metastatic site of primary lung tumors in cats. How-

ever, cutaneous metastases of internal tumors are rare in cats. This case reported an unusual cutaneous metastasis in a cat

with bronchogenic adenocarcinoma.

Case:A 6-year-old, spayed, female, persian cat was presented for vomiting and anorexia. On physical examination, dys-

pnea was observed and respiratory sounds were decreased in the caudal portion of the right side of the chest on thoracic

auscultation. A nodular lesion was found in the skin extending into the subcutaneous tissue of the chest on fifth thoracic

vertebra. On lateral and ventrodorsal radiographs of the thorax, a diffuse interstitial pattern involving the medial and

right-caudal lung lobes was noted. Hematological and biochemistry analysis were normal. Antigen and antibody tests for

feline leukemia virus (FeLV) and feline immunodeficiency virus (FIV) were negative. Pulmonary edema was suspected,

but respiratory efforts became worse despite medication. Due to the progressive severity of clinical signs, refractory to

medication, an exploratory intercostal thoracotomy was indicated. Surgical findings included pulmonary congestion, nu-

merous small white nodules with an average diameter of 1-2 mm, disseminated in the pulmonary parenchyma and a larger

nodule (1.5 cm) in the right medial lung lobe. Samples from subcutaneous nodule were also collected to histopathology.

Histologic evaluation of lung samples indicated a bronchogenic adenocarcinoma with metastasis to the skin. Based on

severity of clinical signs and diagnosis of a bronchial adenocarcinoma, the owners elected for euthanasia.

Discussion:The median age in cats with primary lung tumors is approximately 12 years and sex and breed predisposition

have not been reported. The cat was a Persian and was younger than other reports. Cutaneous metastasis of primary lung

tumors in cats is rare. One report describes painful erythematous papules and pustules in a cat with pulmonary adenocarci-

noma. Skins histopathological examination confirmed cutaneous metastasis. The metastasis clinically resembled primary

dermatitis. Two other reports observed a firm mass attached to muscles with final diagnosis of cutaneous metastasis of

pulmonary carcinoma. In this report, a nonpainful, and freely moveable nodular lesion was found in the skin extending

into the subcutaneous tissue of the chest. The clinical presentation is uncommon in cats with cutaneous metastasis of

bronchogenic carcinoma. Radiographically, the appearance of primary lung tumors in cats tends to be variable, including

presence of a solitary mass, multiple masses, consolidated lung lobes, nodular interstitial pattern, pleural effusion, or even

a normal appearance. In this cat, radiographs revealed a diffuse interstitial pattern involving the medial and right-caudal

lung lobes. Exploratory thoracotomy was very important for definitive diagnosis. The presence of dilated cardiomyopathy,

the patient`s age and radiographic findings did not lead to the first suspicion of pulmonary tumor. Subcutaneous nodule was

not thought to be connected to pulmonary condition. Cats with firm soft tissue masses should have metastatic pulmonaryneoplasia added to the list of differential diagnoses.

Keywords:cat, bronchogenic adenocarcinoma, dyspnea, cutaneous metastasis.


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K.B. Corgozinho, C. Belchior, M.A.F. Caloeiro, S.C.S. Cunha & H.J.M. Souza. 2015. Bronchogenic Adenocarcinoma with

Unusual Metastasis in Cat. Acta Scientiae Veterinariae. 43(Suppl 1): 94.

INTRODUCTION

Primary lung tumors in cats are rare and

pulmonary metastatic cancer is more common [1,7].

Primary lung neoplasms are highly aggressive and tend

to metastasize particularly to the regional lymph nodes,

pleura, mediastinum bones, muscles, heart, brain and

spleen [2,9], Metastasis to the digits is common in

cats [6,9]. However, cutaneous metastases of internal

tumors are rare in cats [13], differently from humans

[8], who frequently have skin metastasis of lung car-

cinoma in 66% of cases [8].

Primary lung tumors are more common in

geriatric animals and clinical signs on presentation

depend on the extent of the pulmonary involvement, the

presence of metastasis, and association with paraneo-

plastic syndromes [1,9]. On radiographic examination,

the appearance tends to be variable [1,3,5,10,11]. Theprognosis is considered unfavorable because of the

advanced stage of the disease at time of diagnosis and

the aggressive metastatic behavior of the tumor [9].

This case reported an unusual cutaneous me-

tastasis in a cat with bronchogenic adenocarcinoma.

CASE

A 6-year-old, spayed, female, persian cat was

presented for vomiting and anorexia. She was receiv-

ing treatment for foliaceus pemphigus and dilated

cardiomyopathy. On physical examination, dyspnea

was observed and respiratory sounds were decreased

in the caudal portion of the right side of the chest on

thoracic auscultation. A nodular lesion was found in

the skin extending into the subcutaneous tissue of the

chest on fifth thoracic vertebra (Figure 1). The nodule

was three centimeters in diameter, firm, nonpainful,

and freely moveable in the skin. Digits were normal.

On lateral and ventrodorsal radiographs of the

thorax, a diffuse interstitial pattern involving the medial

and right-caudal lung lobes was noted (Figure 2). Hema-

tological and biochemistry analysis were normal. Antigen

and antibody tests for feline leukemia virus (FeLV) and

feline immunodeficiency virus (FIV) were negative.

A pulmonary edema was suspected. Furose-mide (Furosen)12 mg/kg subcutaneous three times a

day, aminophylline (Aminofilina Sandoz)26 mg/kg

intramuscularly twice a day, clindamycin (Clindabi-

otic)310 mg/kg intravenous once a day and oxygen

supplementation were administered for three days.

However, there was no improvement in radiographic

pattern. Due of the progressive severity of clinical

signs, refractory to medication, an exploratory inter-

costal thoracotomy was indicated.

Surgical findings included pulmonary conges-

tion, numerous small white nodules with an average

diameter of 1-2 mm, disseminated in the pulmonary pa-

renchyma and a larger nodule (1.5 cm) in the right medial

lung lobe (Figure 3). Pulmonary tissue and subcutaneous

nodule were collected to histopathological examination.

Postoperatively, she was maintained on oxy-

gen supplementation fentanyl patch (Durogesic)4,

meloxicam (Maxican 0.2%)50.1 mg/kg once a day

and clindamycin. Three days after surgery, the his-

topathological examination revealed a bronchogenic

adenocarcinoma with metastasis to the skin. Based onseverity of clinical signs and diagnosis of a bronchial

adenocarcinoma, the owners elected for euthanasia.

DISCUSSION

The median age in cats with primary lung tu-

mors is approximately 12 years and sex and breed pre-

disposition have not been reported [3,5,7,10,12]. The cat

was a Persian and was younger than other reports [5,9].

Cutaneous metastasis of primary lung tumors

in cats is rare. One report describes painful erythema-tous papules and pustules in a cat with pulmonary

adenocarcinoma. The metastasis clinically resembled

primary dermatitis, but histopathology confirmed cu-

taneous metastasis. [5]. Two other reports observed a

firm mass attached to muscles, with final diagnosis of

cutaneous metastasis of pulmonary carcinoma [7,11].

In this report, a nonpainful, and freely moveable nodu-

lar lesion was found in the skin extending into the sub-

cutaneous tissue of the chest. This clinical presentation

is unusual in cats with metastatic primary lung tumor.Figure 1. Nodular lesion in the skin extending into the subcutaneous tissueof the chest in a cat with bronchogenic adenocarcinoma.


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Figure 2.Radiographic examination in a cat with bronchogenic adenocarcinoma. (A) Lateral and (B) Ventrodorsal radio-graphs with diffuse interstitial pattern involving the medial and right-caudal lung lobes.

Figure 3.Exploratory thoracotomy in a cat. Pulmonary lobes presentedto numerous small white nodules, with an average diameter of 1-2 mm,disseminated in the pulmonary parenchyma and a larger nodule (1.5 cm)in the right medial lung lobe.

Radiographically, the appearance of primary

lung tumors in cats tends to be variable, including

a solitary mass, multiple masses, consolidated lung

lobes, nodular interstitial pattern, pleural effusion, oreven a normal appearance [1,3-5,10-12]. In this cat,

radiographic examination revealed a diffuse interstitial

pattern involving the medial and right-caudal lung lobes.

This pattern could be confused with pulmonary edema.

Exploratory thoracotomy was very important

for definitive diagnosis. The presence of dilated car-

diomyopathy, the patient`s age and radiographic find-

ings did not lead to the first suspicion of pulmonary

tumor. The subcutaneous nodule was not thought to

be connected to pulmonary condition. Cats with firm

soft tissue masses should have metastatic pulmonary

neoplasia added to the list of differential diagnoses.

This report is an unusual cutaneous metastasis ofbronchogenic adenocarcinoma in a cat.

MANUFACTURERS1Pharlab Indstria Farmacutica S.A. Lagoa da Prata, MG, Brazil.2Novartis Sade Animal. So Paulo, SP, Brazil.3Unio Qumica Farmacutica Nacional S.A. So Paulo, SP, Brazil.4Janssen-Cilag Farmacutica Ltda. So Paulo, SP, Brazil.5Ourofino Qumica. So Paulo, SP, Brazil.

Declaration of interest.The authors report no conflicts of in-

terest. The authors alone are responsible for the contents and

writing of the paper


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www.ufrgs.br/actavetCR 94

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