Department of Veterinary Clinical Sciences, Tufts University Cummings School of Veterinary Medicine, North Grafton, Massachusetts 01536, USA (Fontes, Topulos); Zoetis Reference Laboratories, San Diego, California 92121, USA (Jennings).
Can Vet J. 2023 Feb;64(2):132-136.
A 13-year-old spayed female Labrador retriever cross dog was referred to the Foster Hospital for Small Animals at Tufts University for evaluation of a metastatic carcinoma discovered at the site of a previous tibial plateau leveling osteotomy (TPLO). The dog was previously evaluated at the primary care veterinarian for a complaint of lameness, and radiographs of the previous TPLO site revealed bony lysis associated with the TPLO plate. Surgical exploration of the site by the primary veterinarian provided evidence of osteolysis. The lytic area of the proximal tibia was biopsied, and a metastatic carcinoma was confirmed. The patient was referred for further evaluation. Following consultation and examination, a full body computed tomography (CT) scan was performed to determine the source of the carcinoma. A well-defined soft tissue attenuating mass effacing the right thyroid gland was located, along with 3, well-defined soft tissue attenuating nodules within the pulmonary parenchyma, consistent with metastatic disease. The previously diagnosed osteolytic, aggressive bone lesion of the proximal left tibia was visualized. Following the CT scan, palliative left hind-limb amputation coxofemoral disarticulation was performed. Histological examination of the hind limb revealed neoplastic epithelial cells admixed with reactive bone. Neoplastic cells were arranged in packets with rare colloid-filled microfollicles consistent with a diagnosis of metastatic thyroid carcinoma. To the authors' knowledge, this is the first clinical report of metastatic thyroid carcinoma in the appendicular skeleton and TPLO site of a dog. Key clinical message: Our findings emphasized that thyroid carcinoma may metastasize to the appendicular skeleton, and causes other than osteomyelitis or implant-associated osteosarcoma should be considered when evaluating osteolytic lesions at a TPLO site.
一只 13 岁已绝育的雌性拉布拉多猎犬杂交犬因先前胫骨平台平整术 (TPLO) 部位发现转移性癌而被转诊至 Tufts 大学福斯特动物医院进行评估。该犬先前因跛行在初级保健兽医处接受评估,先前 TPLO 部位的射线照相显示与 TPLO 板相关的骨溶解。初级兽医对该部位进行的手术探查提供了骨溶解的证据。对该部位进行了活检,确认了转移性癌。将患者转介进行进一步评估。在咨询和检查后,进行了全身计算机断层扫描 (CT) 扫描以确定癌的来源。定位到了一个明确的软组织衰减肿块,使右侧甲状腺受压,并且在肺实质内有 3 个明确的软组织衰减结节,符合转移性疾病。先前诊断的左侧胫骨近端溶骨性侵袭性骨病变也可见。在 CT 扫描后,进行了姑息性左后肢截肢 - 髋关节离断。后肢的组织学检查显示混合有反应性骨的肿瘤上皮细胞。肿瘤细胞呈包裹状排列,罕见的胶体填充微滤泡,符合转移性甲状腺癌的诊断。据作者所知,这是第一例犬附肢骨骼和 TPLO 部位转移性甲状腺癌的临床报告。关键临床信息:我们的发现强调了甲状腺癌可能转移到附肢骨骼,并且在评估 TPLO 部位的溶骨性病变时,除骨髓炎或植入物相关骨肉瘤外,还应考虑其他原因。