Occult metastatic intestinal adenocarcinoma resulting in pathological fracture of the proximal humerus

Intestinal adenocarcinomas are rare but have been described in the literature. The present case is unusual in both its clinical presentation and in the distribution of metastatic lesions. The sequestrum formation and pathological fracture present are most commonly associated with osteomyelitis in horses and the details of the case highlight the need for differential diagnosis in these particular circumstances and of which clinicians should be aware.     

Ocular manifestations of a metastatic adenocarcinoma in a horse

A 10‐year‐old German Warmblood gelding was referred to the Equine Department of the Vetsuisse Faculty, University of Zurich, Switzerland, for an iris mass OD, lethargy, intermittent fever, and coughing. Ophthalmic examination revealed a 7 × 9 mm raised, fleshy, whitish to pinkish, vascularized iris mass at the 2 o`clock position OD. Fundic examination showed multifocal round, brown to black, slightly raised lesions with indistinct margins and a surrounding hyperreflective zone OU. Physical examination revealed a temperature of 39.2 °C, sinus tachycardia, preputial and ventral edema, and an enlarged right mandibular lymph node. Results of a complete blood count and plasma biochemical profile showed mild anemia, leukocytosis, and thrombocytopenia. Severe splenopathy, moderate splenomegaly, and severe pulmonary pathology with nodules and large areas of consolidated lung parenchyma were observed on abdominal ultrasound and thoracic radiographs, respectively. Fine needle aspirates of the enlarged mandibular lymph node showed malignant epithelial neoplastic cells. The horse was euthanized because of the poor prognosis and subsequently underwent postmortem examination. Macroscopic necropsy and histopathology revealed an adenocarcinoma of suspected pulmonary origin with involvement of eyes, heart, liver, kidneys, spleen, diaphragm, skeletal muscles, mandibular, pulmonary, and internal iliac lymph nodes. Metastatic adenocarcinoma should be considered as a differential diagnosis in horses with iris masses, multifocal chorioretinal infiltrates, and clinical signs that conform to a paraneoplastic syndrome.     

Bilateral pyelonephritis and hydroureter associated with metastatic adenocarcinoma in a dog

Metastatic adenocarcinoma, involving the trigone of the urinary bladder, resulted in bilateral pyelonephritis and hydroureter in an aged dog. Salient physical examination and clinicopathologic findings included bacterial urinary tract infection, renal pain response to abdominal palpation, and the observation of WBC casts in urine sediment. A good response to antimicrobial drug administration was observed initially; however, the dog later was euthanatized because of progressive renal disease. Necropsy revealed extensive peritoneal carcinomatosis with metastatic lesions causing occlusion of both ureters. Ostensibly, metastatic carcinoma involving the trigone resulted in urine stasis and enhanced the development of renal infection and hydroureter.     

Partial intestinal obstruction due to colonic adenocarcinoma in a cat.

An abdominal mass was palpated in a 14-year-old, spayed female cat with unresolving diarrhea and decreased appetite. A stricture of the ascending colon was confirmed radiographically, identified upon laparotomy, and resected. Colonic adenocarcinoma with infiltration into lymphatics was diagnosed histologically. Eight months postoperatively, the subject was clinically normal.     

Ocular manifestations of a metastatic pulmonary adenocarcinoma in a cat

A primary pulmonary bronchogenic adenocarcinoma originating from an intramediastinal accessory lung was diagnosed in a 14.5-year-old cat. The cat had been admitted because of a cloudy right eye. Physical examination revealed a thin cat with severe iritis, aqueous flare, and a fibrin clot in the anterior chamber of the right eye. Right fundic examination revealed bullous retinal detachment superior to the optic disc. Euthanasia and necropsy were requested when FeLV test results were positive. Metastatic neoplastic cells similar to those of the primary tumor were detected in the choroid, ciliary body, and ciliary processes of the right eye. Ciliary and iridic stromal necrosis attributable to neoplastic embolization of uveal vessels had led to severe uveitis. Foci of metastasis were also in the heart, kidney, and cerebral meninges.     

Clinicopathological evidence of pseudomyxoma peritonei in a dog with intestinal mucinous adenocarcinoma

An 11-year-old, intact female Pekingese dog was presented because of chronic vomiting. Clinical examination and diagnostic imaging suggested the presence of an intestinal mass. Laparotomy was performed, and a gelatinous effusion associated with a suspected jejunal neoplasm was found. Accumulation of gelatinous material was grossly evident in several abdominal organs and parietal peritoneum. Cytopathological smears from this material showed macrophages, reactive mesothelial cells, and spindle cells embedded in a mucinous basophilic background. After spontaneous death, necropsy and histopathology were performed and showed the presence of an invasive mucinous adenocarcinoma with visceral and peritoneal metastases. The clinicopathological findings of this case report closely resemble those reported in human cases of pseudomyxoma peritonei.     

Small intestine adenocarcinoma in conjunction with multiple adenomas causing acute colic in a horse.

An 11-year-old Andalusian stallion developed marked signs of colic associated with an acute small intestine obstruction. Exploratory laparotomy revealed a distal jejunum full-thickness wall induration and multiple small adherent intraluminal masses. Fifteen centimeters of jejunum, including the induration, and several intraluminal masses were resected. Histologic examination revealed an adenocarcinoma and multiple polypoid adenomas. The horse was discharged, and no complications were reported 12 months postoperatively. Colic was considered secondary to partial jejunal lumen obstruction by the adenocarcinoma. Adenocarcinoma recurrence or transformation from remaining adenomas into an adenocarcinoma is still a major risk.     

Establishment of a pair of novel cloned tumour cell lines with or without metastatic potential from canine mammary adenocarcinoma

We produced 23 cloned cell lines from parental CHMp, which was previously established from a canine mammary adenocarcinoma patient in our laboratory. Two representative cloned cell lines, namely, CHMp-5b and -13a, were selected and characterized for cellular morphology, growth potential and expression of some tumour-related proteins. Subsequently, we transplanted the 2 tumour cell lines orthotopically into female nude mice to examine their tumorigenicity and metastatic potential. Interestingly, despite sharing the same origin, only CHMp-5b cells metastasized to the lung. Our results indicate that a comparison between these 2 cell lines at the molecular level will help us understand mechanisms of tumour progression, especially in the context of distant metastases originating from canine mammary gland tumours.     

Generalized metastatic intestinal and cutaneous calcinosis in a Hovawart puppy with leptospirosis

A 10-week old male Hovawart presented with acute renal failure. Based on clinical symptoms, blood analysis results and serology, a diagnosis of leptospirosis was made. Besides being acotemic, the puppy was initially also severely hypercalcemic. The dog was treated successfully, but developed widespread cutaneous and visceral calcifications. Severe pyloric calcification resulted in functional pyloric obstruction, which was successfully treated by pyloromyotomy. All skin lesions were cured with topical therapy within a few weeks. To the authors' knowledge, this is the first report of generalized intestinal and cutaneous calcification associated with acute renal failure due to Leptospirosis.     

Management of pleural effusion secondary to metastatic adenocarcinoma in a dog

A 4-year-old spayed Collie-type dog was evaluated for pleural effusion secondary to metastatic adenocarcinoma with no identifiable primary tumor. For 48 weeks, chemotherapy and thoracentesis palliated clinical signs associated with pleural effusion. At week 49, 5 mCi of chronic phosphate P32 (32P) suspension was injected into the right pleural space. Pleural effusion was not detected for 14 weeks after 32P administration (week 63). In week 64, 32P suspension was readministered by injecting 7.5 mCi into the right hemithorax and 2.5 mCi into the left. Pleural effusion was again detected 3 weeks later (week 67), and the dog was treated with additional chemotherapy. Death, at week 72, was caused by disseminated intravascular coagulopathy.     

B‐cell intestinal lymphoma with Mott cell differentiation in a 1‐year‐old miniature Dachshund

Abstract: A 1‐year‐old intact female miniature Dachshund was presented with hematochezia, vomiting, and diarrhea of more than 1‐week duration. An abdominal mass was palpated, which at exploratory surgery was found to be a 7‐cm‐long thickened section of ileum. The thickened ileum was resected. Impression smears revealed numerous small‐ to medium‐sized lymphocytes, with a smaller number of cells resembling Mott cells. The Mott‐like cells contained multiple pale vacuoles that were positive for periodic acid‐Schiff (PAS) in wet‐fixed smears, consistent with Russell bodies. Histologic evaluation of the surgically excised ileum revealed 2 populations of neoplastic lymphoid cells. The majority were uniform medium‐sized lymphocytes with hyperchromatic oval or round nuclei and inconspicuous nucleoli. The remaining cells resembled Mott cells, which contained several PAS‐positive eosinophilic globules in the cytoplasm, occasionally compressing the nucleus. The majority of neoplastic cells stained positively for vimentin, CD20, CD79a, and Pax‐5, but were negative for CD3 and lysozyme; 43.5% of cells stained positively for Ki‐67. The Mott cells were strongly positive for immunoglobulin but were negative for Pax‐5. Using electron microscopy, a homogenous substance of intermediate electron density was observed frequently in the cisternae of rough endoplasmic reticulum in the cytoplasm of the Mott cells, and rarely in the perinuclear cisternae of the lymphoid cells, corresponding to the site of immunoglobulin staining. Monoclonal rearrangement of immunoglobulin heavy‐chain (IgH) gene was observed by PCR testing for lymphocyte–antigen receptor rearrangement. The morphologic features, immunophenotype, and IgH gene rearrangement verified the lymphoid cells were neoplastic (mature cell type) and had a B‐cell phenotype, with evidence of immunoglobulin production and differentiation into Mott cells. This case was unusual because of the age of the dog and because most intestinal lymphomas are T‐cell phenotype. The Mott cell morphology also differed from typical mature B‐cell lymphoma types and may be a unique B‐cell lymphoma variant.     

Hypocalcemia following surgical treatment of metastatic anal sac adenocarcinoma in a dog

A 9 yr old neutered male mixed-breed dog was presented for an anal sac apocrine gland adenocarcinoma with regional nodal metastases. At presentation, ionized calcium was 1.91 mmol/L (NOVA Stat reference range, 1.1-1.3 mmol/L). Surgical excision of the primary tumor and metastatic lymph nodes was performed. Following surgery, symptomatic hypocalcemia was noted. Repeated ionized calcium measurements confirmed hypocalcemia, and hypercalcemia of malignancy panels suggested parathyroid gland suppression as the cause. The calcium normalized with parenteral calcium administration, but calcium later became elevated with tumor recurrence and an increase in the parathormone-related peptide. Disrupted calcium homeostasis is a potential complication following the treatment of long-standing humoral hypercalcemia of malignancy.     

Gastritis-associated adenocarcinoma and intestinal metaplasia in a Syrian hamster naturally infected with Helicobacter species

The objective of this study was to evaluate stomachs of 2-year-old Syrian hamsters that were naturally colonized by multiple Helicobacter species including Helicobacter aurati. A previous report on 7- to 12-month-old Syrian hamsters described chronic gastritis and intestinal metaplasia, a putative preneoplastic lesion in the stomach, without cancer. This report describes an invasive adenocarcinoma at the pyloric-duodenal junction in one of nine hamsters at a site of helicobacter-associated inflammation and marked intestinal metaplasia. Ceca of nine of nine animals were culture positive and polymerase chain reaction positive for Helicobacter spp. Furthermore, immunohistochemical analysis of the stomach using a H. pylori polyclonal antibody detected positive-staining bacteria within the pyloric region of three of nine hamsters including the neoplastic glands. However, argyrophilic bacteria were demonstrated only within the stomach of the hamster with gastric adenocarcinoma. This is a first report of gastric adenocarcinoma in helicobacter-infected hamsters. Syrian hamsters appear suitable as potential model for studying development of helicobacter-associated gastric adenocarcinomas.     

Bleomycin chemotherapy for metastatic squamous cell carcinoma in a ferret.

Bleomycin, an antitumor antibiotic, was effective in temporarily reducing the size of a metastatic squamous cell carcinoma in a ferret. The tumor had recurred after previous excision and had metastasized to the right submandibular lymph node. The ferret was treated without effect at a dosage of 10 U/m2, sc, once a week. The dosage was increased to 20 U/m2 once a week, and reduction of tumor size was observed.