PET metabolic tumor volume as a new prognostic factor in childhood rhabdomyosarcoma

Purpose Childhood RMS is a rare malignant disease in which evaluation of tumour spread at diagnosis is essential for therapeutic management. F-18 FDG-PET imaging is currently used for initial RMS disease staging. Materials and methods This multicentre retrospective study in six French university hospitals was designed to analyse the prognostic accuracy of MTV at diagnosis for patients with RMS between 1 January 2007 and 31 October 2017, for overall (OS) and progression-free survival (PFS). MTV was defined as the sum of the primitive tumour and the largest metastasis, where relevant, with a 40% threshold of the primary tumour SUVmax. Additional aims were to define the prognostic value of SUVmax, SUVpeak, and bone lysis at diagnosis. Results Participants were 101 patients with a median age of 7.4 years (IQR [4.0-12.5], 62 boys), with localized disease (35 cases), regional nodal spread (43 cases), or distant metastases (23). 44 patients had alveolar subtypes. In a univariate analysis, a MTV greater than 200 cm3 was associated with OS (HR = 3.47 [1.79;6.74], p<0.001) and PFS (HR = 3.03 [1.51;6.07], p = 0.002). SUVmax, SUVpeak, and bone lysis also influenced OS (respectively p = 0.005, p = 0.004 and p = 0.007) and PFS (p = 0.029, p = 0.019 and p = 0.015). In a multivariate analysis, a MTV greater than 200 cm3 was associated with OS (HR = 2.642 [1.272;5.486], p = 0.009) and PFS (HR = 2.707 [1.322;5.547], p = 0.006) after adjustment for confounding factors, including SUVmax, SUVpeak, and bone lysis. Conclusion A metabolic tumor volume greater than 200 cm3, SUVmax, SUVpeak, and bone lysis in the pre-treatment assessment were unfavourable for outcome.

Nasal Transmissible Venereal Tumor (TVT) in Dogs

Background: Transmissible venereal tumors (TVT) are naturally occurring neoplasms that can be transmitted through copulation or cell transplantation. It is a disease that affects canines, has no preference for sex or breed, and generally noticed in the external genital apparatus. Extragenital occurrence may eventually be seen; however, nasal involvement has been described in only a few reports of studies conducted in Brazil. Therefore, the objective of this study is to report 3 cases of nasal TVT in dogs who were treated in 2 municipalities in the mountainous region of Santa Catarina, Brazil.Cases: This case report includes 3 male mixed-breed canines of age 3-13. Only 1 of the animals was castrated. As per the medical history, some points, such as an enlarged nasal region, sneezing, nasal discharge, and hoarseness, reported by the dogs’ respective owners were similar among all the dogs. Likewise, nosebleed was observed on physical examination in all the cases. The result of cytological examination was inconclusive only in 1 case. Rhinoscopy, incisional biopsy, and histopathological examination were then performed for achieving a definitive diagnosis. In the 2 cases wherein cytology gave conclusive results, the cytological smears showed changes suggestive of TVT, such as cells with eccentric nuclei and little cytoplasm, which had vacuoles inside them. In 2 cases, radiographic examinations of the skull were also performed. The images showed changes in bone radiopacity, conformation of trabeculae with areas of bone lysis and cell proliferation, and irregularity in the contour of the nasal bone. After TVT diagnosis was confirmed, chemotherapy was initiated using vincristine at a dose of 0.75 mg/m2 for 2 cases and 0.025 mg/kg for the remaining case. The number of chemotherapy sessions and duration of treatment until the resolution of lesions and clinical signs varied as per the differences in the patients’ blood counts performed prior to each session.Discussion: TVT occurs between 1 and 7 years of life. It occurs more frequently in sexually active animals and has no preference for breed. Of the 3 cases reported herein, only one of the patients was elderly. All the patients were male mixed-breed dogs, and only 1 of them was castrated. The implantation of neoplastic cells through natural mounts, licks, scratches, or bites of affected areas are the most widely accepted reasons for the transmission of this neoplasm. With regard to the nasal presentation described in the present report, it is hypothesized that the smelling or licking of the neoplastic areas by the animal may favor cell implantation, leading to the subsequent development of a tumor. Nasal TVT should be considered as a differential diagnosis for dogs with chronic symptoms of the upper respiratory tract, such as increased local volume, nasal discharge, nosebleed, and sneezing. These signs are consistent with those described in this report. Radiographic evaluation was performed in 2 cases and both showed changes in bone radiopacity and trabeculae conformation, in addition to areas of bone lysis and cell proliferation, which are common in neoplastic processes. A presumptive diagnosis can be achieved from the medical history, clinical signs, and physical examination. Cytological and histopathological examination are the confirmatory methods; however, it is used less frequently and especially when cytological evaluation does not provide a definitive diagnosis. Antineoplastic chemotherapy with vincristine is the first-choice treatment protocol, which also proved to be effective for the patients in this report. Although TVT commonly affects the external genitalia of dogs, in the cases reported herein, it was located exclusively in the nasal region. Keywords: TVT, dog, nasal, vincristine.Título: Tumor venéreo transmissível (TVT) nasal em cãesDescritores: TVT, cão, nasal, vincristine.

Preclinical Testing of New Hydrogel Materials for Cartilage Repair: Overcoming Fixation Issues in a Large Animal Model

Reinforced hydrogels represent a promising strategy for tissue engineering of articular cartilage. They can recreate mechanical and biological characteristics of native articular cartilage and promote cartilage regeneration in combination with mesenchymal stromal cells. One of the limitations of in vivo models for testing the outcome of tissue engineering approaches is implant fixation. The high mechanical stress within the knee joint, as well as the concave and convex cartilage surfaces, makes fixation of reinforced hydrogel challenging. Methods. Different fixation methods for full-thickness chondral defects in minipigs such as fibrin glue, BioGlue®, covering, and direct suturing of nonenforced and enforced constructs were compared. Because of insufficient fixation in chondral defects, superficial osteochondral defects in the femoral trochlea, as well as the femoral condyle, were examined using press-fit fixation. Two different hydrogels (starPEG and PAGE) were compared by 3D-micro-CT (μCT) analysis as well as histological analysis. Results. Our results showed fixation of below 50% for all methods in chondral defects. A superficial osteochondral defect of 1 mm depth was necessary for long-term fixation of a polycaprolactone (PCL)-reinforced hydrogel construct. Press-fit fixation seems to be adapted for a reliable fixation of 95% without confounding effects of glue or suture material. Despite the good integration of our constructs, especially in the starPEG group, visible bone lysis was detected in micro-CT analysis. There was no significant difference between the two hydrogels (starPEG and PAGE) and empty control defects regarding regeneration tissue and cell integration. However, in the starPEG group, more cell-containing hydrogel fragments were found within the defect area. Conclusion. Press-fit fixation in a superficial osteochondral defect in the medial trochlear groove of adult minipigs is a promising fixation method for reinforced hydrogels. To avoid bone lysis, future approaches should focus on multilayered constructs recreating the zonal cartilage as well as the calcified cartilage and the subchondral bone plate.

Unusual Location of a Recurrent Epidermoid Cyst

Introduction: Epidermoid cysts of the temporal bone are rare, benign and slow-growing lesions. Patient and Methods: We report the case of a 69-year-old female patient followed up for a symptomatic intradiploic epidermoid cyst of the temporal scale and left mastoid region, which had been operated on but recurred. Results: MRI demonstrated a well-limited lesion seen as a hyposignal on T1-weighted images, hypersignal on T2-weighted images, on FLAIR and on diffusion-weighted images not enhanced by gadolinium. The tumour was compressive, and bone lysis was seen on CT. Conclusion: Epidermoid cysts of the temporal bone are rare, benign lesions whose diagnosis is based on fluid signals seen on MRI but absent on FLAIR sequences.

Bone Damage in Chronic Otitis Media

The middle ear bone destruction in chronic otitis media is activated and regulated by inflammation. Chronic otitis media with granulation is a highly active inflammatory process in which many cytokines are released. The bone is degraded by osteoclasts but, at the same time, protected by cytokines, growth factors, adhesion molecules and osteotropic hormones. Tumor necrosis factor-α, interleukin (IL)-1, IL-6, and OPG/RANKL present in cholesteatoma and granulation accelerate bone lysis and increase the destructive effect on the middle ear.

Nasal Adenocarcinoma in a 4-year-old Oriental Shorthair Cat

The aim of this case report is to present a case of nasal adenocarcinoma in a young adult cat with underlying feline asthma. A 4-year-old, 2.3 kg, female Oriental Shorthair was referred to Massey University Veterinary Teaching Hospital with a rapidly expanding mass on its left nasal bridge and nasal discharge. Physical examination revealed stertorous respiratory sounds and a mass on the left nasal bridge measuring 3.2cm x 2.5 cm. Computed tomography of the nasal cavity showed mass effect in the left frontal sinus with extensive orbital bone lysis and loss of calvarial bone. Radiographs of the thorax showed possible evidence of metastasis. Fine needle aspirate was performed on the mass and also regional lymph nodes. Subsequently, nasal adenocarcinoma was diagnosed through cytology. Prognosis of the patient was poor as the patient’s condition was significantly complicated by asthma and possible lung metastasis. Palliative treatment was pursued using meloxicam as radiotherapy was not a viable option in this case.

A feather cyst causing vertebral bone lysis and spinal cord compression in a Lohmann Brown layer

A feather cyst in the cervical region which, through complications of inward growth, resulted in compression of the cervical spinal cord of a Lohmann Brown layer is described. It is postulated that expansion of the cyst exerted pressure on the adjacent cervical vertebra and through bone lysis created an opening through which the cyst protruded, thereby exerting pressure on the spinal cord. The affected spinal cord segment was reduced to a fifth of its normal diameter. The bird most likely died of starvation because of limb and neck paralysis and disorientation. Although the cause of the feather cyst was not conclusively identified, moulting and trauma could have triggered its formation and subsequent growth.

Arthrectomy for traumatic proximal interphalangeal arthritis in the lateral digit in a heifer

Instructive information on the treatment for chronic deep infections of digital joints in a 9-month-old Holstein heifer is described in this report. Preoperative ultrasonographic and radiographic examinations revealed soft tissue swelling and subchondral bone lysis at the distal part of the proximal phalanx in the lateral digit. Arthrectomy was performed under xylazine sedation to remove infectious articular cartilage tissues. Immature callus formation was observed via radiography at the surgical site by the 28th postoperative day. On the 48th postoperative day, callus fellinto disrepair on the radiographs along with aggravation of the locomotion score. After the application of a half-limb cast, the immature callus formed again by the 62nd postoperative day (11 months), and bony callus formation was observed by the 74th postoperative day. Thereafter, the heifer could walk well with marked improvement in the locomotion score. The withers height of the heifer at 13 months (136 cm) was within the range of that in control heifers of the same age on this farm (133 ± 3 cm); however, the body weight (BW) of this heifer (322 kg) was lower than the BW of controls (384 ± 26 kg). The BW gain from 11 to 13 months of age seemed to be higher in the present heifer (+76 kg) than in controls (+55±20 kg), suggesting that BW of the present heifer was returning to the original BW. Based on these observations, we suggested that arthrectomy was an effective treatment option for the present case of digital joint arthritis.

Rhinosinusitis in an Australian mare caused by Flavodon flavus, a recently recognized invasive fungal pathogen of the horse

We describe herein the clinical, endoscopic, computed tomography (CT), pathologic, and microbiologic features of an infection caused by an under-recognized fungal pathogen, Flavodon flavus, in a 25-y-old Australian Quarter Horse. The horse had a unilateral obstructive nasal mass, resulting in stertor and dyspnea. On endoscopy, the mass was tan, multinodular, and completely obstructed the nasal passage. CT analysis revealed a large, soft tissue–attenuating and partially mineralized mass in the right nasal passage and dorsal-conchofrontal sinus, expanding into adjacent paranasal sinuses with associated bone lysis and rhinosinusitis. Histopathology of the mass on 2 occasions revealed suppurative inflammation initially, and pyogranulomatous inflammation subsequently. The inflammatory reaction surrounded numerous spherical fungal structures (~60–80 µm diameter) that stained positively on periodic acid–Schiff and Grocott methenamine silver stains. PCR for the fungal internal transcribed spacer 1 and 2 regions followed by Sanger sequencing on a cultured isolate identified the agent as F. flavus, which has only been reported previously as pathogenic in one horse in the United States, to our knowledge. Previous reports described this fungus as a nonpathogenic, environmental commensal fungus associated with insects and plants.