Systemic blastomycosis in a horse.

Progressive multisystemic disease caused by Blastomyces dermatitidis was diagnosed in a 17-year-old Quarter horse broodmare. The mare had been treated unsuccessfully with antibiotics for mastitis 3 months postpartum. The disease progressed to exudative cutaneous lesions affecting the ventrum, pectoral region, and limbs accompanied by weight loss across several months. Yeast bodies were observed in swabs of the cutaneous exudate, suggesting a clinical diagnosis of blastomycosis. Following referral, pleural effusion, cavitated lung lesions, and hyperproteinemia were identified, and the mare was euthanized because of poor prognosis. Necropsy revealed extensive pyogranulomas in the mammary gland, skin, subcutaneous tissues, and lungs, accompanied by thrombi in major blood vessels of the lungs and hind limbs. Histologically, pyogranulomatous inflammation was evident in many tissues, and fungal organisms were seen in sections of mammary gland, skin, subcutis, pericardium, and lung. Blastomyces dermatitidis was cultured from mammary tissue, lungs, lymph node, and an inguinal abscess. Although blastomycosis is endemic in the area of origin of the mare in northwestern Wisconsin, the disease is extremely rare in horses and hence easily misdiagnosed. Unique features of this case included the extent of mammary gland involvement and the presence of thrombi in multiple sites.     

Pleural effusion secondary to metastasis of an ovarian adenocarcinoma in a horse

An 11-year-old Quarter Horse mare was presented with ventral edema and pleural effusion, secondary to a disseminated ovarian adenocarcinoma. Bilateral thoracocentesis yielded 30 L of thin, blood-tinged fluid, which was a modified transudate. Cytologic examination of the fluid revealed large atypical cells, suggestive of carcinomatous neoplasia. Similar cells were found in the peritoneal fluid. The mare was euthanatized. Necropsy revealed a 35-cm diameter mass in the cranial mediastinum, ventral to the trachea. The left ovary was 25 cm in diameter and most of the parenchyma was replaced by red or brown friable tissue, containing numerous 1-to 3-mm cysts. Papillary adenocarcinoma of the ovary was diagnosed, based on the appearance and arrangement of tumor cells in the ovary, sublumbar and tracheobronchial lymph nodes, and mediastinal mass. Ovarian neoplasia should be considered in the differential diagnosis of pleural effusion in the horse.     

Mammary adenocarcinoma in four mares.

Mammary gland adenocarcinoma in 4 horses was characterized by firm swelling of the gland and serosanguineous discharge from the teat orifice. Two of the mares had ulcerative lesions of the mammary gland. Palpation of the affected gland typically elicited signs of pain. Diagnosis was assisted by cytologic evaluation of the fluid discharge, but definitive diagnosis was based on histologic examination. Treatment included mastectomy and lymphadenectomy.     

Bilateral ovarian adenocarcinoma in a mare causing haemoperitoneum and colic

Abstract

CASE HISTORY: A 13-year-old Thoroughbred mare was presented with a history of mild colic over 3 days. This colic had acutely exacerbated and was unresponsive to analgesic treatment, and was referred to Massey University Veterinary Teaching Hospital.

CLINICAL FINDINGS: On examination the heart rate was 100 beats per minute, and mucous membranes were pale and tacky. A large mass was detected on transrectal palpation in the caudal abdomen to the left of midline. Explorative laparotomy revealed severe haemoperitoneum and several masses that were associated with the reproductive tract. The mare was then subject to euthanasia. On post-mortem examination, adjacent and attached to each ovary were soft, lobulated dark red masses up to 200 mm in diameter. Similar masses were present in the omentum and on the peritoneal surface of the diaphragm and the serosa of the spleen and liver. Histopathology revealed that the neoplastic component of the masses comprised proliferating cuboidal to columnar cells forming disorganised acini and cords separated by dense collagenous stroma. Immunohistochemistry showed the neoplastic cells were positive for cytokeratin AE1/AE3 and vimentin, but negative for cytokeratin 7 and inhibin α.

DIAGNOSIS: Bilateral ovarian adenocarcinoma with transcoelomic metastasis and terminal decompensation due to rupture of a neoplastic mass and consequent haemoperitoneum.

CLINICAL RELEVANCE: To the authors' knowledge, bilateral ovarian adenocarcinoma has not been previously reported in a horse. Ovarian adenocarcinoma should be considered when horses present with haemoperitoneum and colic. Further research is required on the immunohistochemical differentiation of adenocarcinoma of ovarian and intestinal origin in the horse.     

Two rare cutaneous neoplasms in horses: apocrine gland adenocarcinoma and carcinosarcoma

Two rare equine cutaneous neoplasms, an apocrine gland adenocarcinoma and a carcinosarcoma were diagnosed in a 17-year-old pony and a 14-year-old mare, respectively. The apocrine gland adenocarcinoma was present on the prepuce. Histologically, papillary projections of low cuboidal to columnar epithelial cells were generally well differentiated, and surrounded dilated acini. Stromal invasion was present, but vascular and lymphatic invasion was not seen. The carcinosarcoma was present in the right flank of the mare. Two discrete cell populations were characterized histologically. One portion of the mass was composed of elongated, loosely arranged mesenchymatous cells; the second population consisted of dense sheets of pleomorphic, basophilic cells forming irregular acini.     

Localised radiotherapy for a ferret with possible anal sac apocrine adenocarcinoma

A seven-year-old, neutered male ferret was referred to our hospital with two perianal masses (2.4x3.0 and 2.4x3.5 cm, respectively) that had recurred after initial surgical excision. Complete resection of the masses was impossible as there was deep invasion along the rectum. On histopathology, the masses were diagnosed as apocrine adenocarcinoma possibly of anal gland origin based on tumour location. There was marked response to localised radiotherapy using an orthovoltage unit at 4 Gy, twice weekly. No visible mass was detectable after six doses of radiation. However, at that time, pleural effusion was diagnosed and radiotherapy was discontinued. Cytology of a sample of the pleural effusion suggested mesothelioma, and no obvious pulmonary metastasis of anal sac adenocarcinoma were identified on thoracic radiography. The ferret died at home on day 71 after the first admission.     

Hematuria and weight loss in a mare with pancreatic adenocarcinoma.

This clinical report describes an 11-yr-old Thoroughbred mare that presented with clinical signs of weight loss and hematuria. History and clinical findings suggested the mare had neoplasia of the urogenital system. Although ultrasound-guided biopsy of the perirenal mass did not yield abnormal cells, large irregular cells were isolated from the thoracic and peritoneal fluid. At necropsy, multiple firm nodules were disseminated throughout the peritoneal cavity. Histological examination of the nodules revealed cells that were consistent with a pancreatic exocrine adenocarcinoma. This is the first report of pancreatic adenocarcinoma causing dysfunction of the urogenital system.     

Surgical treatment of a mammary gland comedocarcinoma in an Arabian mare: Post-operative management,and histopathological and immunohistochemical features

A lactating 20-year-old, brown, Arabian mare, weighing about 300 kg, presented for bleeding from one teat and severe swelling of the entire mammary gland. The mare had untreated mastitis 10 months before. Consequently, a gangrenous teat developed after chronic bloody and purulent discharges. The teat was removed surgically by the field veterinarian. At that time, the mammary gland increased in size. Bloody and purulent discharges restarted 10 days previously. Under general anaesthesia, the entire mammary gland was removed. Comedocarcinoma was diagnosed by histopathological assessment. Immunohistochemical staining was performed for pan-cytokeratin and vimentin. Microscopic examination of immunohistochemical stained slides revealed expression of pan-cytokeratin. In conclusion, this report describes clinical, macroscopic, histopathological and immunohistochemical characteristics of comedocarcinoma that did not metastasise to regional lymph nodes. Reports in the field of equine oncology contribute to improved general knowledge in equine medicine, contributing to better diagnosis and treatment.     

Gastric adenocarcinoma in a horse with portal vein metastasis and thrombosis: a novel cause of hepatic encephalopathy

A 17-year-old Quarter horse mare was referred to Cornell University for postmortem examination after 72 hours of encephalopathy that consisted of depression, mania, and blindness. A plasma sample and cerebral spinal fluid demonstrated hyperammonemia. Gross necropsy examination findings included the following: mild icterus, a transmural mass in the glandular portion of the gastric fundus, multiple masses throughout the liver, and a large tumor thrombus in the portal vein. Microscopically, the gastric mass, hepatic masses, and portal vein thrombus were composed of similar neoplastic epithelial cells that formed variably sized acini and branching cords separated by a dense desmoplastic stroma. Throughout the cerebral frontal cortex were numerous Alzheimer type II astrocytes. Hepatic encephalopathy was caused by gastric adenocarcinoma, with metastasis to the liver and the portal vein. The clinical and pathologic lesions from this unique case, as well as hyperammonemia and portal vein thrombosis in the pathogenesis of hepatic encephalopathy, are discussed.     

Use of chemotherapy for treatment of a mixed-cell thoracic lymphoma in a horse

A 4-year-old Oldenburg mare was evaluated because of signs of lower airway disease and subsequently developed bilateral pleural effusion. Neoplastic cells were not identified in the fluid sample obtained via the initial thoracocentesis. A thoracic mass was detected radiographically, but its location prevented collection of a tissue sample. A diagnosis of lymphoma was made on the basis of results of immunophenotyping of pleural fluid specimens. Treatment of thoracic lymphoma in horses has been attempted, but there are limited data regarding chemotherapeutic-induced remission. In this horse, remission was achieved by use of a chemotherapeutic protocol consisting of administration of cytarabine, cyclophosphamide, and prednisolone. No adverse drug reactions were encountered during treatment. Immunophenotyping of cells in specimens of pleural fluid could be used to determine lymphocyte lineage and may be a useful alternative diagnostic modality when morphologic and cytologic examination of tissue specimens obtained via invasive techniques is not feasible.     

Pseudohyperparathyroidism in a mare associated with squamous cell carcinoma of the vulva

An 18-year-old Appaloosa mare was examined because of squamous cell carcinoma of the vulva, anorexia with pronounced weight loss, and hypercalcemia. The tumor had developed rapidly over a period of 3 months and externally extended ventrally involving the perineum and the dorsal aspect of the udder. Necropsy examination demonstrated a large primary squamous cell carcinoma of the vulva, perineum, and mammary gland with metastases to the supramammary, sublumbar, deep inguinal, and mediastinal lymph nodes. No gross renal lesions were observed and, histologically, there was only mild vacuolation of renal tubular epithelium. Based on the normal concentration of serum parathyroid hormone, the absence of evidence of hypervitaminosis D, and normal renal function, a diagnosis was made of hypercalcemia of malignancy or pseudohyperparathyroidism. The mechanism responsible for hypercalcemia was not determined, but the histologic type of the neoplasm and the clinical course suggested possible production of a humoral hypercalcemic factor by the neoplasm, similar to that demonstrated in certain types of human squamous cell carcinoma.     

Mammary carcinoma with sebaceous differentiation in a dog

This report describes an invasive mammary carcinoma with a rare distinctive feature characterized by sebaceous differentiation of tumor cells. This tumor occurred in a 10-year-old female mixed breed dog. The patient had two masses in the left fifth mammary gland. Grossly, the masses were firm, whitish to light brown, and superficially ulcerated. On cut surface, they were multilobulated with foci of necrosis. Microscopically, the tumors were composed of two distinctive neoplastic components, intraductal papillary adenocarcinoma and sebaceous carcinoma. The regions of sebaceous tumor were clumped separately, contained well-developed sebaceous cells and keratinized epithelial cells, and were surrounded by few to several layers of basaloid cells. The cells with abundant foamy cytoplasm that resembled sebaceous cells were also found within the intraductal papillary-like nests of mammary carcinoma, providing evidence of sebaceous metaplasia. Sebaceous differentiation in a mammary gland tumor is possible, because skin appendages and ductal apparatus of the mammary gland share a common anlagen. This tumor had an aggressive behavior with lymphatic metastasis. Consequentially, the dog had a poor prognosis.     

Prostatic Masses in Geldings: Two Cases

Prostatic masses were detected in two geldings that were presented to our referral hospital for evaluation of dysuria. The masses were detected during transrectal palpation and ultrasonography of the prostate gland and were further evaluated using urethral endoscopy. A 10-year-old gelding underwent intraurethral debulking of the prostatic mass. Histopathological diagnosis was prostatic cystadenoma. The mass regrew within 9 months, and the horse was euthanized due to deteriorating clinical control of urinary continence. In another case, a 12-year-old gelding was scheduled for transurethral debulking; however, the owners decided against treatment and the horse was euthanized due to progression of clinical disease. Postmortem examination revealed the prostate to be nearly completely obliterated by the mass. Histopathological diagnosis was adenocarcinoma incorporated into a spindle cell population of unknown histogenesis. To our knowledge, these represent the first reported cases of equine prostatic cystadenoma and adenocarcinoma. In both horses, referring complaint was dysuria, and identification of the prostatic mass was made on palpation and ultrasonographic examination per rectum. Treatment options for prostatic masses in horses are limited because of the difficulty of obtaining prostatic tissue via biopsy, the surgical inaccessibility of the gland, and the apparent low incidence of occurrence. We have subsequently identified prostatic masses in two additional geldings, both also presenting for dysuria. However, the exact nature of these two apparent prostatic masses has not been definitively diagnosed with histopathological examinations to date. The prostate should be evaluated in male horses presenting for dysuria.     

Malignant fibrous histiocytoma of the mammary gland in a mare

Mammary tumours are uncommon in mares. Sarcomas of the breast account for less than 1% of all human primary malignancies and, among these types of tumours, malignant fibrous histiocytoma (MFH) is very rare. This report describes a 6‐year‐old uniparous Paint mare that was presented for investigation of right mammary gland enlargement of 3 weeks' duration. The clinical and histopathological findings in this mare with malignant fibrous histiocytoma of the mammary gland as well as complications of bilateral mastectomy are detailed. At one year follow‐up there were no clinical signs of recurrence.     

IMAGING DIAGNOSIS—DORSAL MEDIASTINAL T‐CELL LYMPHOMA IN AN ALPACA

A 14‐year‐old male alpaca had refractory pleural effusion. The cause of the effusion was not apparent either radiographically or sonographically, or following a pleural fluid cytologic examination. Using computed tomographic (CT) examination, a dorsal paravertebral mass was identified and similar masses were found in the cranial mediastinum, retroperitoneal space, and adjacent to the hepatic entry of the portal vein. The histopathologic diagnosis was multicentric T‐cell lymphoma. CT examination may prove to be a valuable imaging modality in the localization and staging of neoplasia in new world camelids.     

Gynecomastia and mammary gland adenocarcinoma in a Nubian buck.

A 6-year-old Nubian buck was presented for bilateral mammary gland enlargement. Gynecomastia and mastitis were diagnosed, and bilateral mastectomy was performed. Histological examination showed mammary adenocarcinoma, active lactation, hyperplasia, and abscessation. Karyotyping showed a normal male. Clinical, therapeutic, etiologic, and epidemiologic aspects of gynecomastia and mammary gland adenocarcinoma are discussed.     

Malignant mesothelioma in urban dogs

Clinical and postmortem materials from six dogs with a diagnosis of malignant mesothelioma were studied retrospectively. The dogs were urban pets with clinical signs of malignant effusions. Two mesotheliomas were pleural, one pericardial, and one peritoneal. Both pleura and pericardium were involved in one dog, and the pleura and peritoneum in another. On gross examination at necropsy, diffuse granular or velvety plaques covering mesothelial surfaces were found in all dogs; firm discrete pleural nodules also were present in two dogs. Neither distant metastases nor areas of deep lung invasion were found. The tumors varied histologically, but the most common type was epithelial with a papillary pattern. Ultrastructurally, the neoplastic cells had prominent surface microvilli, numerous desmosomes, and tonofilaments. Lung tissue from these dogs and from control dogs was evaluated for the presence of ferruginous bodies. Asbestos bodies were found in three of five dogs with mesotheliomas but rarely were found in control dogs. As a group, the mesothelioma cases had significantly more asbestos bodies and total ferruginous bodies than controls. The clinical and morphologic appearance of canine mesothelioma is similar to human mesothelioma and also may be associated with exposure to airborne fibers.     

Carcinoma of the mammary gland in a mare

A 20‐year‐old Quarter Horse mare was presented with a firm, nonpainful swelling near the axial margin of the left mammary gland. Ultrasound examination of the mass revealed a 35 mm poorly encapsulated, homogeneous mass within the parenchyma of the left mammary gland. Using histopathology and immunohistochemistry, the mass was diagnosed as a mammary carcinoma and showed positivity for cytokeratin 18 (CK18), vimentin and α‐smooth muscle actin. Additionally, the mRNA expression level of the oncogene cMyc did not show a significant upregulation, whereas p53, a well‐known tumour suppressor gene in breast cancer, was significantly reduced in comparison with healthy equine mammary gland tissue. To the authors' knowledge, this is the first report of a significant downregulation of p53 expression in a mammary carcinoma of a mare.     

Hypercalcemia and high parathyroid hormone-related peptide concentration in a dog with a complex mammary carcinoma

A 10-year-old female Dachshund was presented with a history of mammary masses, slight lethargy, polyuria, and polydipsia. Physical examination findings included masses involving the first, second, and fourth mammary glands of the left side. The mandibular, axillary, and right popliteal lymph nodes were mildly enlarged. Serum chemistry results included hypercalcemia (13.9 mg/dL, reference interval 8.0-11.5 mg/dL). Although intact parathyroid hormone (PTH) concentration (1.05 pmol/L) was below the reference interval (2-13 pmol/L), PTH-related protein (PTHrP) concentration was markedly increased (9.40 pmol/L, reference value < 2 pmol/L). The masses were surgically removed, and the histopathologic diagnosis was complex mammary carcinoma. Three weeks after surgery, serum total calcium concentration had decreased to 10.5 mg/dL. Resolution of the hypercalcemia and clinical signs supported a diagnosis of humoral hypercalcemia of malignancy associated with mammary gland carcinoma.