Thyroid Carcinosarcoma in a Dog

Diagnostic Findings and Surgical Management of Three Dogs Affected by Osseous Metaplasia Secondary to a Salivary Mucocele

Saliva is an irritant of the subcutaneous tissue, thus causing the development of a non-epithelial reactive pseudocapsule. Metaplastic ossification of the pseudocapsule is a condition rarely described in the veterinary literature. The main causes of calcification are trauma, tumours, various chronic inflammatory conditions and fibrodysplasia ossificans progressiva. The aim of the present case series was to describe three dogs affected by a calcified salivary mucocele. The medical records of dogs affected by a cervical sialocele were retrospectively evaluated, and three cases met the inclusion criteria. All the dogs in this study were referred to the Veterinary Teaching Hospital (VTH) of the Department of Veterinary Sciences of the University of Turin (Turin, Italy) for a large solid mass in the intermandibular region. The diagnosis of a mucocele was confirmed clinically by centesis and by radiography or CT. Complete excision of both the pseudocyst and the ipsilateral mandibular/monostomatic sublingual salivary gland was performed in all cases. The histological report showed large areas of bone metaplasia within the pseudocapsule and chronic sialadenitis. Based on this limited case series, complete excision of the pseudocyst and a concurrent sialoadenectomy provided an effective treatment for this rare salivary mucocele disorder.

Clinical outcomes of thyroid tumours with concurrent epithelial and mesenchymal components in 14 dogs (2006-2020)

Background

While rare, multiple individual case reports have described mixed thyroid tumours in dogs containing both epithelial and mesenchymal neoplastic components.

Objectives

In this retrospective case series, we describe the clinical presentation, treatment and outcome of 14 dogs of canine thyroid tumours with concurrent mesenchymal and epithelial neoplastic populations.

Methods

Fourteen cases were retrospectively abstracted from nine institutions. Histopathologic samples and reports were collected from 10/14 dogs and reviewed by a single board‐certified anatomic pathologist.

Results

All 14 dogs had curative‐intent surgery to remove the thyroid neoplasm. The most common surgery performed was a unilateral thyroidectomy (10/14 dogs). Postoperatively, systemic therapy was administered in eight dogs. Six dogs developed local recurrence with a median time to loco‐regional recurrence of 53 days. Ten dogs developed metastatic disease with the most common metastatic site being the lungs (6/10 dogs), with a median time to metastasis of 93 days. Ten dogs were euthanised due to locoregional or distant progression of their mixed thyroid neoplasm. The overall median survival time was 156 days (95%CI: 49–244). The median survival time for dogs treated with adjuvant therapy was 189 days (95%CI: 24–244), whereas dogs without adjuvant therapy had a median survival time of 156 days (95%CI: 35‐upper limit could not be calculated; p = 0.62).

Conclusion

The thyroid tumours with both mesenchymal and epithelial components in this small sample set were associated with a poor prognosis after surgical excision with or without adjunctive therapy.

Bilateral Thyroid Carcinosarcoma in a Cat

A neutered female domestic shorthaired cat was presented for a rapidly growing left cervical mass and a 6-month history of primary hyperthyroidism. Cytological examination of the mass was consistent with a sarcoma. Due to poor clinical response the cat was humanely destroyed and a post-mortem examination was performed. This revealed a markedly enlarged, irregularly shaped left thyroid gland with signs of infiltration of the trachea. The contralateral (right) thyroid was also moderately enlarged and irregularly shaped. Histopathological examination of the cervical masses indicated bilateral thyroid carcinosarcomas, evidenced by positive immunohistochemical labelling for vimentin, pan-cytokeratin and thyroid transcription factor-1 of the appropriate cell populations. The cat also had a concurrent pulmonary adenocarcinoma (papillary-lepidic type), unrelated to the thyroid neoplasm. Thyroid carcinosarcoma is an uncommonly recorded canine and human neoplasm and this is the first case of this entity to be reported in a cat.

A Comparative Review of Mixed Mammary Tumors in Mammals

Mixed tumors are characterized by the histological identification of two or more cell types. Commonly, a mixture of epithelial and myoepithelial cells is included in abundant stroma, which can consist of myxoid, chondroid or bony matrices. Spontaneously arising mixed tumors are rare lesions in the human breast but are common in human salivary glands and canine mammary glands. Subtle histopathological characteristics and overlapping attributes of malignant lesions with other benign lesions can lead to a diagnostic challenge. Mixed tumors can present as benign or malignant. While malignant mixed tumors are quite rare in the human breast they have a poor prognosis. Benign mixed mammary tumors occur more frequently in female dogs than in humans and are usually associated with a good prognosis. This review will provide a comprehensive overview of mixed mammary tumors, across various mammalian species.

Uterine carcinosarcoma (malignant mixed Müllerian tumor): case report in a goat and literature review

Carcinosarcomas are biphasic malignant tumors composed of 2 distinct neoplastic cell populations, epithelial cells and mesenchymal cells. A 13-y-old, female, mixed-breed goat was presented with a 1-wk history of anuria and lethargy. Transabdominal ultrasonography showed an irregular and heterogeneous structure in the region of the bladder and uterus and changes in the echogenicity of both kidneys. Given the poor prognosis, euthanasia was elected. Autopsy revealed a large mass within the uterine cervix and confirmed the changes in the urinary tract. Histopathology and immunohistochemistry revealed a mixed, anti-cytokeratin AE1/AE3-positive epithelial, and vimentin-positive mesenchymal neoplasm consistent with a homologous carcinosarcoma, also called malignant mixed Müllerian tumor, with areas of double-labeling. We highlight the complexity of the diagnosis of uterine neoplasms in domestic animals and in goats in particular.

Neoplasmas da tireoide em cães: 26 casos

RESUMO: Foram revisados os protocolos de biópsias e necropsias do Laboratório de Patologia Veterinária da Universidade Federal de Santa Maria (LPV/UFSM) entre 2004 e 2014, e todos os casos de tumores que acometeram a glândula tireoide foram selecionados. A partir disso, foram anotados sexo, idade e raça dos cães afetados. Também foi avaliado o significado clínico dos tumores, presença de aumento de volume cervical, lobos afetados, tamanho dos tumores, presença e localização de metástases e padrão histológico dos neoplasmas. Nos 11 anos que compreenderam este estudo, foram diagnosticados 26 tumores de glândula tireoide (quatro eram provenientes de exames de biópsias e 22 de necropsias), 53,9% dos cães eram fêmeas e 46,1% eram machos; 65,4% eram cães com raça definida. Desses, Boxers foram os mais afetados (15,4% dos casos). Dos 23 protocolos em que a idade foi informada, 60,9% dos cães eram idosos e 39,1% eram adultos. A avaliação dos protocolos permitiu constatar que 38,5% dos animais haviam apresentado aumento de volume cervical no momento do exame clínico. Dos cães necropsiados 13,6% morreram ou foram submetidos à eutanásia em decorrência de complicações causadas por metástases dos tumores de tireoide. Dessa forma, em 86,4% dos cães, os neoplasmas foram considerados achados incidentais de necropsia. Nos quatro casos provenientes de material de biópsia, o desfecho não foi conhecido. Em nenhum cão os tumores causaram síndrome clínica devido à hipo ou hiperfunção da tireoide. Em 24 protocolos havia informação sobre os lobos afetados e 75% dos cães tiveram acometimento unilateral da glândula. Os diagnósticos histológicos dos tumores permitiram constatar que 16 (61,5%) neoplasmas eram carcinomas de células foliculares (nesses casos, o padrão folicular-compacto foi o mais frequente [43,75%]), seis (23,1%) eram adenomas de células foliculares, dois (7,7%) eram carcinossarcomas e dois (7,7%) eram tumores de células C (adenoma e carcinoma).

Canine Carcinosarcomas in the Head

Four cases of neoplasms in the heads of old dogs were studied. All the dogs showed both carcinomatous and sarcomatous malignant components in an admixed growing pattern. Histologic analysis of the tumors showed that the carcinomatous cells resembled squamous cell carcinoma in all dogs except one, where an adenoid arrangement of the neoplastic cells was also observed. The sarcomatous component showed osteoid matrix produced by pleomorphic poorly differentiated cells, which is regarded as a typical feature of osteosarcomas. Immunohistochemical analysis demonstrated that the components were positive only for cytokeratin (carcinomatous component) or vimentin (sarcomatous component). This observation led us to classify the neoplasms as true carcinosarcomas, thus providing evidence of a new preferential location for this unusual tumor in dog.

Thymic Carcinoma with Cartilage Formation in a Dog

An 11-year-old female Chihuahua exhibited respiratory distress and a computed tomography scan showed a large mass in the anterior thoracic cavity. During surgery, it was found that the mass was strongly adherent to surrounding tissue. A histopathological examination of a biopsy sample from the mass revealed proliferation of atypical epithelial cells and cartilage formation admixed with mature lymphocytes. Immunohistochemically, the tumour cells, as well as the normal canine thymic epithelial cells, were positive for pan-cytokeratin (CK), CK5/6, CK19, p63 and bone morphogenetic protein (BMP) 6. Foci of cartilage tissue were formed in association with the neoplastic epithelial tissue. In the normal canine thymus, the subcapsular epithelial cells are positive for both CK19 and BMP6. These findings indicate that the cartilage element within the tumour developed from CK19-positive neoplastic epithelial cells, which were derived from the thymic subcapsular epithelium. This case represents a novel variant of canine thymic epithelial tumour that exhibits cartilage differentiation.

Follicular thyroid carcinoma characterized by abundant stromal components with chondroid and osseous metaplasia in a dog

A dog developed a cervical mass, and computed tomography verified a mass surrounding the trachea with some pulmonary masses. Histopathologically, the cervical mass was composed of malignant neoplastic cells showing follicular appearance which reacted positive for thyroglobulin on immunohistochemistry. A characteristic feature of the tumor was abundant and metaplastic stromal components. Anastomosed collagenous tissues connecting to capsule of the tumor were abundant in the stroma. In parts of the collagenous tissues, mature cartilages and bones were continuously formed. There was no cellular atypia or invasion in the components. We diagnosed this case as follicular thyroid carcinoma with metaplastic stroma. This is the first case report that characterizes stromal components with chondroid and osseous metaplasia in a canine thyroid carcinoma.

Carcinosarcoma in a white Rhinoceros (Ceratotherium simum simum)

In Rhinocerotidae, there are very few reports of tumors and no reports of a mixed tumor. This paper reports the case of a male 33-year-old southern white rhinoceros. Grossly, there were two masses in the coelomic cavity and solid nodules in the liver. Histologically, all tumors had a biphasic pattern that consisted of malignant epithelial cells (cytokeratin- and E-cadherin-positive) and non-epithelial cells (vimentin-positive) with cartilage. In this case, the prostate could not be identified, and instead, the largest tumor mass was present at that site. Furthermore, since structures regarded as the prostate duct remained in this tumor, we considered that this tumor was very likely to be of prostate gland origin. This case is the first report of carcinosarcoma in Rhinocerotidae.

Carcinosarcoma of the biliary system in a cat

A 12-year-old, mixed-breed domestic cat was diagnosed with a multicystic hepatic mass via ultrasonographic examination and computer tomography scan. The tumor associated with the left medial liver lobe, and connected by a thin stalk to the hilar region, was surgically removed. The mass was firm, encapsulated, mottled white to red black, multinodular, and cystic. Histologic diagnosis was carcinosarcoma supported by positive immunohistochemistry for cytokeratins and vimentin of atypical neoplastic cell populations. On the basis of morphology, the origin was considered to be in the biliary tract. Biliary carcinosarcoma is a rare neoplasm that occurs in people. The epidemiology and risk factors have not yet been determined, and the prognosis is poor except for cases in which curative resection is performed.

Thyroid carcino-sarcoma in a dog

An adult male greyhound was diagnosed with a thyroid carcino-sarcoma by means of histopathology and positive immuno-histochemistry staining for cytokeratin and vimentin. Surgery and radiotherapy of the area were successful in local tumour control. Adjuvant chemotherapy was recommended to treat and prevent further metastasis. The use of carboplatin, metronomic cyclophosphamide chemotherapy and toceranib failed to control the progression of distant metastasis. The survival time was seven months from the time of diagnosis. This is the eighth case of carcino-sarcoma of the thyroid documented in veterinary medicine and the first one treated with a multimodal approach based on surgery, radiotherapy and chemotherapy. As documented in human medicine, chemotherapy appeared to be ineffective to prevent or delay the progression of the metastatic disease in this case.

Intracardiac Ectopic Thyroid Carcinosarcoma in a Dog

A 13-year-old spayed female Labrador Retriever with a 1-year history of progressive exercise intolerance was diagnosed with an interventricular mass in the heart via echocardiogram. The animal's general condition progressively declined over the next 8 months, and it was euthanatized. The intracardiac mass, which protruded into the lumen of the right ventricle, was removed at necropsy and fixed in 10% buffered formalin. Histopathologic diagnosis was an ectopic thyroid carcinosarcoma based on the presence of 3 distinct neoplastic tissue types. Intermixed within the tumor were neoplastic thyroid follicles containing colloid and solid nests of thyroid follicular epithelial cells, vascular channels and clefts filled with blood and lined by neoplastic endothelium, and osteoid surrounded by spindle cells and often rimmed by large multinucleated cells. Immunohistochemical reaction for thyroglobulin was positive in the tumor cells forming the colloid-filled follicles and solid nests of epithelial cells. Neoplastic endothelium was positive for factor VIII-related antigen. The thyroid gland was located in its normal anatomic position and was histologically normal, ruling out the possibility that the intracardiac tumor was a metastatic lesion. To the authors' knowledge this is the first reported case of an intracardiac ectopic thyroid carcinosarcoma, and possibly the first ectopic thyroid carcinosarcoma in any location in any species.