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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

Protection
against
developing
mammary
tumours

Under
hormonal
influence

The exact
mechanism and
interactions at the
celullar level that
lead to development
of malignant
mammary tumors
are unknown.

OHE

(Misdorp, Stoving & Grace, 1917).
Prolonged,
dose-related
exposure to
synthetic
progestins

Induce
proliferation
of mammary
epithelial
cells

(Misdorp, Stoving & Grace, 1917).

Genetic
Errors

Development
of mammary
tumors
(benign and
malignant)
HORMONAL
THERAPY (ANTIOESTROGEN
DRUGS)

METASTASIC
DISEASE IN
OESTROGENRECEPTORPOSITIVE TUMOURS
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

History

Physical
examination

• females between 6 and 10 years of age
• In males is rare (-1%) , affected male dogs may have an oestrogensecreting 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

•
•
•
•

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

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

Draining lymph nodes

Epithelial
tissue
INFLAMMATORY
CARCINOMAS

Connective
tissue

Lungs
Bone
Simple (epithelium
alone) or complex
(myoepithelium)

Liver

Severe and rapid
spread (legs)

Brain

Red, hot, painful
Inoperable

Carcino
sarcomas

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
Treatments
Surgery

- Lumpectomy
- Mamectomy
- Regional
masectomy

Chemotherapy Radiotherapy

Reserved for
patients at risk of
metastes
- Dexorubicin
- Dexorubicin
and
cyclophospham
ide
- Dexorubicin
and docetaxel

Hormonal
Therapy

Locally recurrent
diseases that ir
not amenable to
surgery
Patients with
regional
metastases to
lymph nodes
also not
ameneable for
surgery

In study
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.

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Tumors of the female genital tract

  • 1. TUMORS OF THE FEMALE GENITAL TRACT Camila Valbuena
  • 2. • 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
  • 3. PATHOGENESIS Protection against developing mammary tumours Under hormonal influence The exact mechanism and interactions at the celullar level that lead to development of malignant mammary tumors are unknown. OHE (Misdorp, Stoving & Grace, 1917).
  • 4. Prolonged, dose-related exposure to synthetic progestins Induce proliferation of mammary epithelial cells (Misdorp, Stoving & Grace, 1917). Genetic Errors Development of mammary tumors (benign and malignant)
  • 6. MALIGNANT PRIMARY TUMORS positive to oestrogen, progesterone and prolactin receptors on canine mammary tumours. (Rutteman & Misdorp, 1993).
  • 7. 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
  • 8. Evaluation of the patient Signalment History Physical examination • females between 6 and 10 years of age • In males is rare (-1%) , affected male dogs may have an oestrogensecreting 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 • • • • reproductive status of the patient stage of oestrus cycle time the lumb has been present if it has grown since first noticed 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
  • 9. 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.
  • 10.
  • 11.
  • 12.
  • 13. Carcinomas Most common Draining lymph nodes Epithelial tissue INFLAMMATORY CARCINOMAS Connective tissue Lungs Bone Simple (epithelium alone) or complex (myoepithelium) Liver Severe and rapid spread (legs) Brain Red, hot, painful Inoperable Carcino sarcomas 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
  • 14. Treatments Surgery - Lumpectomy - Mamectomy - Regional masectomy Chemotherapy Radiotherapy Reserved for patients at risk of metastes - Dexorubicin - Dexorubicin and cyclophospham ide - Dexorubicin and docetaxel Hormonal Therapy Locally recurrent diseases that ir not amenable to surgery Patients with regional metastases to lymph nodes also not ameneable for surgery In study
  • 15. Pain?
  • 16. 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).
  • 17. 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.