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一匹母马双侧卵巢腺癌导致腹腔积血和绞痛。

Bilateral ovarian adenocarcinoma in a mare causing haemoperitoneum and colic.

作者信息

Pauwels F E T, Wigley S J, Munday J S, Roe W D

机构信息

Institute of Veterinary, Animal and Biomedical Sciences, Massey University, Palmerston North, New Zealand.

出版信息

N Z Vet J. 2012 May;60(3):198-202. doi: 10.1080/00480169.2011.647607.

Abstract

CASE HISTORY

A 13-year-old Thoroughbred mare was presented with a history of mild colic over 3 days. This colic had acutely exacerbated and was unresponsive to analgesic treatment, and was referred to Massey University Veterinary Teaching Hospital.

CLINICAL FINDINGS

On examination the heart rate was 100 beats per minute, and mucous membranes were pale and tacky. A large mass was detected on transrectal palpation in the caudal abdomen to the left of midline. Explorative laparotomy revealed severe haemoperitoneum and several masses that were associated with the reproductive tract. The mare was then subject to euthanasia. On post-mortem examination, adjacent and attached to each ovary were soft, lobulated dark red masses up to 200 mm in diameter. Similar masses were present in the omentum and on the peritoneal surface of the diaphragm and the serosa of the spleen and liver. Histopathology revealed that the neoplastic component of the masses comprised proliferating cuboidal to columnar cells forming disorganised acini and cords separated by dense collagenous stroma. Immunohistochemistry showed the neoplastic cells were positive for cytokeratin AE1/AE3 and vimentin, but negative for cytokeratin 7 and inhibin α.

DIAGNOSIS

Bilateral ovarian adenocarcinoma with transcoelomic metastasis and terminal decompensation due to rupture of a neoplastic mass and consequent haemoperitoneum.

CLINICAL RELEVANCE

To the authors' knowledge, bilateral ovarian adenocarcinoma has not been previously reported in a horse. Ovarian adenocarcinoma should be considered when horses present with haemoperitoneum and colic. Further research is required on the immunohistochemical differentiation of adenocarcinoma of ovarian and intestinal origin in the horse.

摘要

病例史

一匹13岁的纯种母马,有3天的轻度腹痛病史。此次腹痛急性加重,对镇痛治疗无反应,遂转诊至梅西大学兽医教学医院。

临床检查结果

检查时心率为每分钟100次,黏膜苍白且发黏。经直肠触诊在中线左侧的后腹部发现一个大肿块。剖腹探查显示严重的腹腔积血以及几个与生殖道相关的肿块。随后该母马实施了安乐死。尸检发现,每个卵巢附近及相连处有柔软、分叶状的暗红色肿块,直径达200毫米。网膜、膈肌腹膜表面、脾脏和肝脏浆膜上也有类似肿块。组织病理学显示,肿块的肿瘤成分由增生的立方体细胞至柱状细胞组成,形成杂乱无章的腺泡和索条,被致密的胶原性间质分隔。免疫组织化学显示肿瘤细胞细胞角蛋白AE1/AE3和波形蛋白呈阳性,但细胞角蛋白7和抑制素α呈阴性。

诊断

双侧卵巢腺癌伴经体腔转移,因肿瘤肿块破裂导致腹腔积血而出现终末期失代偿。

临床意义

据作者所知,此前尚未有马双侧卵巢腺癌的报道。当马出现腹腔积血和腹痛时,应考虑卵巢腺癌。关于马卵巢和肠道来源腺癌的免疫组织化学鉴别还需要进一步研究。

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