TUMORS OF THE FEMALE GENITAL TRACT

Camila Valbuena

• Mammary tumors are the second most common tumours of dogs (second to skin tumours). (Multon, 1999).

• Early OHE protects female dogs from developing mammary cancer in later life. (Schneider, 1969)

• Preventable condition

PATHOGENESIS

(Misdorp, Stoving & Grace, 1917).

Under hormonal influence

OHE

Protection against

developing mammary tumours

The exact mechanism and

interactions at the celullar level that

lead to development of malignant

mammary tumors are unknown.

Prolonged, dose-related exposure to

synthetic progestins

Induce proliferation of mammary

epithelial cells

Genetic Errors

Development of mammary

tumors (benign and malignant)

(Misdorp, Stoving & Grace, 1917).

HORMONAL THERAPY (ANTI-

OESTROGEN DRUGS)

METASTASIC DISEASE IN

OESTROGEN- RECEPTOR-POSITIVE

TUMOURS

MALIGNANT PRIMARY TUMORS

MALIGNANT PRIMARY TUMORS

positive to oestrogen,

progesterone and prolactin receptors on

canine mammary tumours.

(Rutteman & Misdorp, 1993).

Clinical signs

• Presence of a mass associated with the mammary tissue.

• Caudal mammary glands are more frequently involved than the cranial glands

• Tumours can be present as either isolated lumps or multiples.

• Usually these lumps are not painful• Lumps may appear and remain static or grow

rapidly

Evaluation of the patient Signalment • females between 6 and 10 years of age

• In males is rare (-1%) , affected male dogs may have an oestrogen-secreting sertoli cell tumour of the testis.

• Mammary neoplasia is rarely seen in young dogs• Bening hyperplasia can be seen in dogs during metoestrus,

pregnancy or after treatment with preogestins

History • reproductive status of the patient• stage of oestrus cycle• time the lumb has been present • if it has grown since first noticed

Physical examination

palpated for size, any enlargement of the draining lymph nodes and any ulceration

Incisional biopsies staging and surgical planning

Excisional biopsies appropiate to provide diagnosis, prognosis and treatment in one step

Staging the patient

• Establish a minimun database of routine biochemistry, haematology and urinalysis

• Physically check the draining lymph nodes for any enlargement. Evaluation for neoplastic cells.

• Thoracic radiographs, CT for detection of pulmonary metastatic disease.

Carcinomas Most common

Simple (epithelium alone) or complex (myoepithelium)

Draining lymph nodesLungsBoneLiverBrain

INFLAMMATORY CARCINOMAS

Severe and rapid spread (legs)

Red, hot, painfulInoperable

Sarcomas, poor prognosis, dogs die within 9 to 12 months Extraskeletal

osteosarcoma Mast cell tumours Lymphoma

Guarded prognosis due to early metastatic spread

(lungs)

Treated as any mast cell tumor

Isolated mass

Epithelial tissue

Connective tissue

Carcino sarcomas

Surgery Chemotherapy Radiotherapy Hormonal Therapy

- Lumpectomy- Mamectomy

- Regional masectomy

Reserved for patients at risk of

metastes- Dexorubicin- Dexorubicin

and cyclophospham

ide- Dexorubicin

and docetaxel

Locally recurrent diseases that ir

not amenable to surgery

Patients with regional

metastases to lymph nodes

also not ameneable for

surgery

In study

Treatments

Pain?

MAMMARY CARCINOMA IN A FEMALE DOG• Signalment: 10-year-old entire basset hound

• Presenting signs: a rapidly growing mass affecting her second mammary gland on the left-hand side

• Case history: full vaccinated, had not travelled outside the uk, history of recurrent otitis externa, mass (initially was 2 cm in diameter, firm, movable, underneath the skin), over the following next 12 weeks the mass grew so much that it started to touch the floor

• Clinical evaluation: she allowed palpation without any apparent signs of discomfort, the mass measured 15 cm in diameter, it was firm and irregular without skin abrasions or discharge from the nipple. Cardiopulmonary auscultation andabdominal palpation were unremarkable, palpation of the axillary lymph node failed to reveal any enlargement.

• Diagnostic evaluation: left and right lateral thoracic rafiographs were obtained which revealed no evidence of metastic disease, abdominal ultrasound in inguinal nodes, liver and spleen were normal.

• Diagnosis: high grade complex mammary carcinoma, stage III (histopathology)

• Treatment: regional mastectomy during which glands 1,2 and 3 on the left-hand side were all excised. Active suction drains to reduce the risk of fluid accumulation

• Outcome: postoperative recovery was good, she was discharged 3 days later. The owners declined any adjunctive treatment and the dog remained well, she´s still well (till written).

BIBLIOGRAPHY

• SMALL ANIMAL ONCOLOGY, Saunders (ELSEVIER) solutions in veterinay practice. FOALE, ROB. DEMETRIOU, JACKOE. 2010

• AN INTRODUCTION, SMALL ANIMAL ONCOLOGY. Saunders, Elsevier. NORTH, SUSAN. BANKS, TANIA.

• ONCOLOGY FOR VETERINARY TECHINICIANS AND NURSES. Wiley-Blackwell. MOORE, ANTONY. FRIMBERGER, ANGELA.

• CANCER MANAGEMENT IN SMALL ANIMAL PRACTICE. Saunders, Elsevier. HENRY, CAROLYN. HOGGINBOTHAN, MARY LINN.