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犬双侧输尿管梗阻行皮下输尿管旁路装置置入后,发生移行细胞膀胱癌皮肤种植。

Cutaneous seeding of transitional cell carcinoma of the urinary bladder after placement of a subcutaneous ureteral bypass device in a dog with bilateral ureteral obstruction.

出版信息

J Am Vet Med Assoc. 2021 Apr 15;258(8):877-882. doi: 10.2460/javma.258.8.877.

DOI:10.2460/javma.258.8.877
PMID:33825539
Abstract

CASE DESCRIPTION

A 12-year-old spayed female Jack Russell Terrier was presented with pollakiuria and stranguria.

CLINICAL FINDINGS

Transitional cell carcinoma (TCC) of the urinary bladder trigone and urethra was diagnosed via CT, cystoscopic, and histologic examinations. Azotemia developed 2 weeks following diagnosis, secondary to bilateral ureteral obstruction.

TREATMENT AND OUTCOME

Percutaneous antegrade ureteral stenting was unsuccessful; therefore, a subcutaneous ureteral bypass (SUB) device with 2 nephrostomy and 1 cystostomy catheters was surgically placed. Two months following placement of the SUB device, the dog developed a firm, multilobulated cutaneous mass at the site of the subcutaneous access port of the SUB device. Results of cytologic examination of cells aspirated from the mass were consistent with TCC. Within 1 month of confirmation of TCC of the cutaneous mass, the mass was ulcerated and infected, and the dog was euthanized because of signs of pain and perceived poor quality of life.

CLINICAL RELEVANCE

Seeding of neoplastic cells is a known complication of needle aspiration or biopsy or surgery in people and dogs with carcinomas. The occurrence of TCC at the SUB port site suggested caution with the placement of a SUB device in dogs with obstructive TCC.

摘要

病例描述

一只 12 岁已绝育的雌性杰克罗素梗犬出现多尿和排尿困难。

临床发现

通过 CT、膀胱镜和组织学检查诊断为膀胱三角区和尿道移行细胞癌(TCC)。诊断后 2 周出现氮质血症,继发于双侧输尿管梗阻。

治疗和预后

经皮顺行输尿管支架置入术不成功;因此,手术放置了皮下输尿管旁路(SUB)装置,带有 2 个肾造口和 1 个膀胱造口导管。在 SUB 装置放置后 2 个月,狗在 SUB 装置皮下进入部位出现一个坚硬的多叶状皮肤肿块。从肿块中抽吸的细胞的细胞学检查结果与 TCC 一致。在皮下接入端口 TCC 皮肤肿块得到确认后的 1 个月内,肿块出现溃疡和感染,由于疼痛迹象和生活质量差,狗被安乐死。

临床意义

在人和患有癌症的狗中,肿瘤细胞的播种是已知的针吸或活检或手术的并发症。SUB 端口部位发生 TCC 提示在患有梗阻性 TCC 的狗中放置 SUB 装置时应谨慎。

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Cutaneous seeding of transitional cell carcinoma of the urinary bladder after placement of a subcutaneous ureteral bypass device in a dog with bilateral ureteral obstruction.犬双侧输尿管梗阻行皮下输尿管旁路装置置入后,发生移行细胞膀胱癌皮肤种植。
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