A Retrospective Study of Clinical and Histopathological Features of 81 Cases of Canine Apocrine Gland Adenocarcinoma of the Anal Sac: Independent Clinical and Histopathological Risk Factors Associated with Outcome

Canine apocrine gland anal sac adenocarcinoma (AGASAC) is a malignant tumour with variable clinical progression. The objective of this study was to use robust multivariate models, based on models employed in human medical oncology, to establish clinical and histopathological risk factors of poor survival. Clinical data and imaging of 81 cases with AGASAC were reviewed. Tissue was available for histological review and immunohistochemistry in 49 cases. Tumour and lymph node size were determined using the response evaluation criteria in the solid tumours system (RECIST). Modelling revealed tumour size over 2 cm, lymph node size grouped in three tiers by the two thresholds 1.6 cm and 5 cm, surgical management, and radiotherapy were independent clinical variables associated with survival, irrespective of tumour stage. Tumour size over 1.3 cm and presence of distant metastasis were independent clinical variables associated with the first progression-free interval. The presence of the histopathological variables of tumour necrosis, a solid histological pattern, and vascular invasion in the primary tumour were independent risk factors of poor survival. Based upon these independent risk factors, scoring algorithms to predict survival in AGASAC patients are presented.

New therapeutic approaches in hidradenitis suppurativa

Complex multifactorial pathogenesis of hidradenitis suppurativa eventually results in chronic inflammation of the apocrine gland-bearing areas of the skin. However, the pathogenesis is not fully understood, there are many immune cells and inflammatory pathways of which role is clearly defined in the last years in HS, such as interleukin 1β (IL-1β), tumour necrosis factor alpha (TNFα), IL-17, IL-12 and IL-23. These pathways provide multiple targets for medical treatment. Currently, only adalimumab is licenced in HS, but the numerous ongoing clinical trials promise huge potential therapeutic options in this debilitating disease.

Unilateral anal sacculectomy for anal sac apocrine gland adenocarcinoma with urethral involvement

The patient presented to a veterinary hospital with a month-long history of ‘scooting’ and a right-sided anal gland mass. A diagnosis of a stage 2 anal sac apocrine gland adenocarcinoma was confirmed, and the patient underwent a right-sided anal sacculectomy. There was involvement of the urethra and adherence to the rectum and a subsequent urethral incision was necessary, which was surgically repaired at the time of surgery. The patient was hospitalised for several weeks postoperatively for urinary catheter care and further nursing interventions. The patient was discharged from hospital 3 weeks after surgery once the urethra had healed sufficiently enough to enable normal micturition and subsequently made a full recovery.

Prognostic Value of Ki67 and Other Clinical and Histopathological Factors in Canine Apocrine Gland Anal Sac Adenocarcinoma

Apocrine gland anal sac adenocarcinoma (AGASACA) is locally aggressive and highly metastatic to regional lymph nodes. The aim of this study was to evaluate the prognostic significance of Ki67 in surgically excised AGASACA. Prognostic impact of size, regional lymph nodes metastasis, hypercalcemia, histologic pattern, mitotic count, necrosis, inflammatory and lympho-vascular invasion, anisokaryosis and anisocytosis was also evaluated. Thirty-five dogs were included, twenty-four of which also had metastatic lymph nodes. When the entire population was evaluated, only metastatic disease spread to regional lymph nodes, and necrosis and inflammatory infiltration were correlated to prognosis. When only dogs with metastatic disease were evaluated, size, solid histologic pattern, presence of lymphatic and vascular invasion showed influence on prognosis. Ki67 index was not associated with survival time and disease free interval in any case. The results of this study showed that lymph nodes metastasis at diagnosis reduced disease free interval. Moreover, tumor size greater than 5.25 cm, presence of lymphatic and vascular invasion and a solid histologic pattern were associated with a shorter survival time in dogs with metastasis to regional lymph nodes. Ki67 expression was not significantly associated with prognosis, therefore it could not be considered as a prognostic factor in this tumor type, while the role of hypercalcemia remained unclear.

Apocrine Gland Anal Sac Adenocarcinoma in Dogs: 22 Cases (2015-2020)

Background: Apocrine gland anal sac adenocarcinoma (AGASACA) is a highly malignant disease mostly invading regional lymph nodes at the time of disease diagnosis.Methods: Twenty- two cases of Apocrine gland anal sac adenocarcinoma (AGASACA) were treated during five years. Contrast radiography with Iohexol and Lipidol were carried out to detect primary anal sac mass and regional lymph node through indirect lymphography technique. For clinical staging, ultrasonography, fine-needle aspiration cytology, histopathology of both primary tumor mass and regional lymph node were performed. Closed anal Sacculectomy was performed as curative therapy for anal sac adenocarcinoma.Result: The median age and weight of dogs at presentation were 8.4 years and 20.9 kg, respectively. Diagnostic radiology, histopathology and biochemical assay confirm twenty-two cases of anal sac adenocarcinoma and medial iliac lymph node to be sentinel lymph node. Carcinoma was of unilateral occurrence in all the dogs. Four (18%) dogs had hypercalcemia and twelve (54%) had metastases to the regional lymph nodes with clinical signs of tenesmus or constipation, polyuria -polydipsia and anorexia. Apocrine gland Adenocarcinoma of anal sac was found to initially metastasize to the medial iliac lymph node. Survival times of dogs treated with the surgical procedure only (8 out of 22 dogs) were appreciably longer than the dogs with therapeutic only. Animals with metastasis to regional lymph nodes or lymphadenopathy had poor prognosis.

Evaluation of electrochemotherapy in the management of apocrine gland anal sac adenocarcinomas in dogs: A retrospective study

Background: Electrochemotherapy (ECT) combines the administration of anticancer drugs with the delivery of electric pulses, thus increasing the drug uptake through the cell membranes, resulting in increased efficacy. Aim: The aim of our study was to describe the tolerability and efficacy of ECT alone or in association with other treatment modalities for the management of apocrine gland anal sac adenocarcinoma (AGASAC). Methods: Medical records of dogs with a diagnosis of AGASAC that were treated with ECT alone or in combination with surgery/chemotherapy were retrospectively evaluated. Each dog received 20 mg/m2 of bleomycin intravenously. Based on the clinician’s decision, the primary tumor or tumor bed was also infiltrated with cisplatin at the dose of 0.5 mg/cm2. Trains of permeabilizing biphasic electric pulses were then applied under general anesthesia. Results: Ten dogs were enrolled in the study. Of those 10 dogs, only one received ECT for treatment of microscopic local disease, while in six cases ECT was the only treatment modality. In three dogs, ECT was followed by systemic medical treatment. Six dogs (60%) had a partial response (PR), three dogs (30%) had stable disease, and one dog treated for microscopic disease did not show any sign of local relapse for 305 days after treatment, being still alive and in complete remission at the time of writing this article. The median time to progression was 303 days and the median survival time was 365 days. The treatment was well tolerated and local side effects were minimal. No systemic effects were documented. Conclusion: This preliminary study suggests that ECT may be beneficial for dogs with AGASAC and could be a useful addition to the current therapeutic options in consideration of its low cost, limited toxicity, and ease of administration.

Una ragazzina che suda pus: l’idrosadenite suppurativa

Hidradenitis suppurativa (HS) is a chronic or recurrent autoinflammatory skin disease that affects apocrine gland-bearing regions. Typical lesions are nodules and abscesses that often result in sinus tracts and fistulas. The paper describes a case of recurrent inguinal HS in a 12-year-old girl with Down syndrome. A stable remission was achieved with a systemic corticosteroid therapy (prednisone).

Expression of E-cadherin and Ki-67 in canine apocrine and sebaceous gland tumors

A histopathological analysis of 13 apocrine gland tumors and 22 sebaceous gland tumors in dogs was performed, which were submitted to the Department of Veterinary Pathology from 1 January 2010 to 31 December 2012. An association between the immunohistochemical expression of E-cadherin and Ki-67, the type, and the biological behavior of the tumors was investigated. The mean age of dogs with apocrine gland tumors was 10.15 years, and 10.91 years for sebaceous gland tumors. According to the histopathological analysis, 53.8% carcinomas and 46.2% adenomas of the apocrine glands were found. In the sebaceous gland tumors, epitheliomas were dominant (50.0%), followed by adenomas (36.4%) and carcinomas (13.6%). Survival time in dogs with sebaceous gland tumors was shortest in patients with diagnosed epitheliomas, intermediate in adenomas, and longest in carcinomas. The incidence of metastases was low in the groups with sebaceous adenomas and epitheliomas, and recurrence was most common in carcinomas. The average survival time was about the same for apocrine gland adenomas and carcinomas, with a higher incidence of metastases and recurrence for carcinomas. Immunohistochemical analysis of E-cadherin and Ki-67 expression confirmed the efficiency of this method for the accurate histological classification of apocrine and especially sebaceous gland tumors. The analyzes performed showed that the location and intensity of E-cadherin expression can be helpful in predicting the biological behavior of sebaceous gland tumors. In contrast to sebaceous gland tumors, the analysis of apocrine gland tumors showed that there was no correlation between E-cadherin expression and the biological behavior of apocrine gland tumors.