Reed L T, Knapp D W, Miller M A
Department of Comparative Pathobiology, Purdue University, Animal Disease Diagnostic Laboratory, 406 S University St, West Lafayette, IN 47907, USA.
Vet Pathol. 2013 Jul;50(4):676-81. doi: 10.1177/0300985812465326. Epub 2012 Nov 6.
In humans, cutaneous metastasis of transitional cell carcinoma (TCC) has been attributed to direct extension, lymphatic or hematogenous dissemination, or surgical implantation. The purpose of this study was to characterize the clinical and histologic features of cutaneous TCC metastasis, confirmed by uroplakin-III immunohistochemistry, in dogs. The 12 cases were 9 spayed female and 3 neutered male dogs, 6 to 14 years old (mean, 11 years). Four dogs had a history of urinary incontinence. Three had undergone abdominal surgery for TCC diagnosis or treatment. The primary neoplasms were 7 papillary infiltrating and 5 nonpapillary infiltrating TCC. Cutaneous lesions were detected at a mean of 123 days (median, 38 days) after diagnosis of the primary TCC and appeared as plaques, papules, or nodules in, with 1 exception, perineal, inguinal, or ventral abdominal dermis or subcutis. Of 8 dogs with dermal TCC, 5 had epidermal erosion or ulceration. In 10 dogs, TCC was detected in cutaneous lymphatic vessels, identified by endothelial immunoreactivity for Prox1. Metastases were also detected in lymph nodes in all dogs and at distant noncutaneous sites, usually the lungs, in 10 dogs. Mean survival after diagnosis was 162 days (median, 90 days). Despite medical treatment of 10 dogs after the development of cutaneous metastasis, remission was not achieved; 4 dogs had stable disease. Although TCC could have spread to skin by direct extension or lymphatic or vascular dissemination, the proximity of most cutaneous metastases to the vulva or prepuce raises the additional possibility of transepidermal spread through urine-scalded skin.
在人类中，移行细胞癌（TCC）的皮肤转移归因于直接蔓延、淋巴或血行播散或手术植入。本研究的目的是通过尿路上皮蛋白III免疫组化确诊犬皮肤TCC转移的临床和组织学特征。12例病例为9只绝育雌性犬和3只去势雄性犬，年龄6至14岁（平均11岁）。4只犬有尿失禁病史。3只犬因TCC诊断或治疗接受过腹部手术。原发性肿瘤为7例乳头状浸润性TCC和5例非乳头状浸润性TCC。皮肤病变在原发性TCC诊断后平均123天（中位数38天）被检测到，表现为斑块、丘疹或结节，除1例外在会阴、腹股沟或腹侧腹部真皮或皮下组织。8只患有皮肤TCC的犬中，5只出现表皮糜烂或溃疡。10只犬中，通过Prox1内皮免疫反应性鉴定出皮肤淋巴管中有TCC。所有犬的淋巴结以及10只犬的远处非皮肤部位（通常是肺）也检测到转移。诊断后的平均生存期为162天（中位数90天）。尽管10只犬在皮肤转移发生后接受了药物治疗，但未实现缓解；4只犬病情稳定。尽管TCC可能通过直接蔓延、淋巴或血管播散扩散到皮肤，但大多数皮肤转移灶靠近外阴或包皮提示了通过尿液烫伤皮肤经表皮扩散的额外可能性。
