Nasal Transmissible Venereal Tumor (TVT) with Bone Metastasis in a Dog

Background: Transmissible venereal tumor (TVT) is a highly contagious round cell neoplasm that affects dogs, and it is usually transmitted through coitus. The tumor is mainly located in the genital area; however, the neoplasm can also be extragenital, affecting the nose, mouth, and eyes, as well as the skin and superficial lymph nodes. Cytological examination is the most commonly used method for definitive diagnosis due to its low cost and fast execution. Chemotherapy, radiotherapy, surgical resection, and other procedures such as cryosurgery are the possible treatment options. The objective of this report was to describe a case of extragenital TVT with nasal primary site and metastasis in the bone tissue in a dog treated at a private veterinary hospital in the city of Belém, Pará, Brazil.Case: A 6-year-old male domiciliary Labrador Retriever dog, weighing 24.2 kg, received oncologic treatment in a private veterinary hospital in the city of Belém, Pará, Brazil. The animal had a history of neoplastic disease, and he had undergone TVT resection associated with chemotherapy treatment more than 3 years ago. The clinical examination revealed a volume increase in the periorbital region, left lateral ocular displacement, left nostril excessive epistaxis, recurrent sneezing, cough, and pain signs, and tumor metastasis was suspected. Complementary exams of oncological cytology, computed tomography (CT), hemogram, and serum biochemistry were requested for diagnosis and staging of the condition, and supportive therapy was prescribed. The cytological report showed a dense population of neoplastic round cells with characteristics of TVT. CT indicated the presence of a heterogeneous hypodense mass with irregular contours and partially defined limits, with slight uptake of the intravenously injected contrast medium that obliterated the nasal cavity, maxillary recess, nasopharyngeal meatus, frontal sinus, and sphenoid sinus on the left side. The hematological analysis revealed mild anemia, neutrophilia, and lymphopenia, while the biochemical analysis only showed hypocalcemia. The prescribed therapy was amoxicillin + potassium clavulanate, omega-3, firocoxib, tranexamic acid, and finally chemotherapy with lomustine. Since the patient did not return for follow-up, the outcome could not be determined.Discussion: The patient described in this report was a domiciliary dog who did not live with other pets, but had access to the community environment and contact with other animals. The animal’s history, clinical signs, and cytological and imaging findings were consistent with those of TVT. In extragenital presentations of TVT, the inguinal and sublumbar lymph nodes, lungs, and abdominal organs are most commonly affected. Furthermore, bone involvement is rare, as this has not been commonly described in the literature as compared to the other sites of metastases. An abrasive brush was used for the cytological sample collection, because it provides slides with richer cells as compared to the imprint samples. CT is an important tool for the diagnosis of neoformations in the skeleton, and this method demonstrated high efficiency in identifying the bone involvement and the degree of the invasion and lesion in this case. The therapeutic agents used in this case were different from the usual, since the patient was given lomustine (40 mg/capsule, orally) in the metronomic chemotherapy. This drug has been previously used as an alternative in a canine TVT case resistant to vincristine.Keywords: neoplasm, extragenital, computed tomography, TVT.Título: Tumor Venéreo Transmissível (TVT) nasal com metástase óssea em um cãoDescritores: neoplasia, extragenital, tomografia computadorizada, TVT.

Subcutaneous extraskeletal osteosarcoma of the foot: A case report

Extraskeletal osteosarcoma (ESOS) is a rare variant of osteosarcoma which occurs exclusively in the soft tissue without any bone involvement. Subcutaneous ESOS, in particular, is very rare and is seen in <10% of cases. Here, we report a case of a subcutaneous tumor in the fourth web space of the left foot in a 73-year-old man. The diagnosis of ESOS was made on histology and by immunohistochemical reactivity to special AT-rich sequence-binding protein 2 (SATB2), which is a sensitive, nuclear marker of osteoblastic differentiation. We present this case because of its rarity and the use of SATB2 immunohistochemistry to confirm the diagnosis.

High-output heart failure associated with primary plasma cell leukaemia due to arteriovenous shunting: a case report

Background Primary plasma cell leukaemia is rarely associated with high-output heart failure, and the underlying mechanism is not well understood. We encountered a rare case of high-output heart failure caused by primary plasma cell leukaemia. Its underlying mechanism was clarified through imaging studies. Case Summary A 49-year-old man with no specific medical history was admitted to our hospital because of heart failure that did not improve with diuretic therapy. His condition was diagnosed as high-output heart failure and primary plasma cell leukaemia after admission. Extensive bone involvement in primary plasma cell leukaemia and arteriovenous shunts in the same lesion were suspected after various imaging studies. The first cycle of chemotherapy with bortezomib, adriamycin, and dexamethasone led to remission of primary plasma cell leukaemia and improved heart failure symptoms. The patient received further chemotherapy in addition to autologous peripheral blood stem cell transplantation and maintenance therapy and had no recurrence of pPCL or heart failure for 1 year to date. Discussion : Primary plasma cell leukaemia can be associated with high-output heart failure, which is caused by arteriovenous shunting at the lesion site with diffuse bone involvement. Imaging studies may lead to the early diagnosis of aetiology and treatment of patients with high-output heart failure associated with primary plasma cell leukaemia.

A Single Nail Dystrophy as a Unique Manifestation of Sarcoidosis: A Case Report

Sarcoidosis with nail involvement is rare and most commonly affecting plural digits. Nail changes are frequently an indication of systemic disease and underlying bone involvement, thus complete clinical evaluation with bone and thorax radiological examination is a necessity in suspected cases. We report a case of onychodystrophy with osseous involvement of only one finger as unique manifestation of sarcoidosis, which is very rare.