What is your diagnosis? Cryptorchidism and Sertoli cell tumor

Computed tomographic findings in dogs with ovarian tumors: A tortuous ovarian artery consistently identifies ovarian origin in complex abdominal masses

The aim of this retrospective multicentric case series is to describe the CT findings of ovarian neoplasia in dogs. Twenty dogs with pre- and postcontrast CT exams and cytological/histological diagnosis of ovarian neoplasia were included. Five dogs presented with bilateral tumors, for a total of 25 neoplasms: 15 carcinomas (4 bilateral), 4 granulosa cell tumors, 2 poorly differentiated malignant neoplasia (bilateral), 2 luteomas, 1 teratoma, 1 dysgerminoma. In two dogs, the tumor developed from an ovarian remnant. Ovarian tumors showed variable size, lobulated shape, and precontrast heterogenous appearance. Mineral foci and/or fat components were rare, observed in teratoma, granulosa cell tumors (2), and ovarian carcinoma. Tumor type was not found to be associated with any CT features. Larger masses were more likely located in the central abdomen ventral to the ipsilateral kidney, demonstrated signs of tumor rupture, and were associated with abdominal or sternal lymphadenopathy and peritoneal effusion. A tortuous ovarian artery was constantly detectable, associated with an enlarged gonadal vein (12 cases). Related cavitary changes were peritoneal effusion (14 dogs) and sternal lymphadenopathy (7 dogs). Presumed or confirmed metastasis was reported in 9 of 20 cases, with CT evidence of transcoelomic (serosal thickening, peritoneal nodules, omental cake, implant lesions to the liver, spleen, and diaphragm), lymphatic and hematogenous spread (lungs, liver, bone, muscles, and spleen). In conclusion, the present study reports the CT features of different canine ovarian neoplasia. A tortuous ovarian artery may be useful to consistently recognize the ovarian origin of a large abdominal mass.

Laparoscopic gonadectomy in a dog with 78,XX/78,XY chimerism and underdeveloped reproductive organs

CASE DESCRIPTION

A 1-year-old externally sexually intact female Great Dane was referred for further evaluation of abnormal and underdeveloped internal reproductive organs.

CLINICAL FINDINGS

Physical examination findings included a cranioventrally displaced vulva and a grade 2/6 left apical systolic heart murmur. No uterus or ovaries were identified during abdominal ultrasonography. Computed tomography with retrograde vaginourethrography revealed an underdeveloped uterus and possible left intra-abdominal gonad. Karyotyping revealed mixed sex chromosomes (70% XY and 30% XX). Analysis of a serum sample yielded positive results for anti-Müllerian hormone; other findings included mid range estradiol concentration (48.2 pg/mL [within reference intervals for sexually intact and neutered males and females]), low progesterone concentration (< 0.2 ng/mL [within reference intervals for anestrous females]), and low testosterone concentration (< 20 ng/dL [similar to the expected concentration in neutered males]). Overall, the results of the sex hormone analyses were consistent with findings for either a sexually intact female or a neutered male dog. The dog's cardiac structure and function were echocardiographically normal.

TREATMENT AND OUTCOME

The dog was anesthetized and underwent laparoscopic gonadectomy. The gonads, although abnormal and underdeveloped, were readily identified intraoperatively and successfully removed. On the basis of histologic findings, the removed gonads were confirmed to be rudimentary testicles. The dog recovered from anesthesia and surgery without complications.

CLINICAL RELEVANCE

Laparoscopic surgery was effective for visualization of abnormal and hypoplastic reproductive organs when abdominal ultrasonography and CT were of limited diagnostic usefulness, and laparoscopic surgery allowed straightforward gonadectomy in a 78,XX/78,XY chimeric dog.

Computed Tomographic Features in a Case of Bilateral Neoplastic Cryptorchidism with Suspected Torsion in a Dog

An 11-year-old male German Shepherd dog presented for inappetence and weight loss. Physical examination and initial bloodwork revealed palpable abdominal masses, mild non-regenerative anemia, and thrombocytopenia. Survey radiography and abdominal ultrasonography confirmed the presence of bilateral abdominal masses and lymphadenopathy. Contrast-enhanced computed tomography (CT) was performed in order to further investigate the origin of the intraabdominal masses, confirming two enlarged cryptorchid testes, one of which had an associated CT “whirl sign.” Histopathology of the testes and lymph nodes revealed bilateral malignant Sertoli cell tumors and seminomas with lymph node metastasis of both neoplasms. The purpose of this case report is to discuss the benefits of CT in the diagnosis of cryptorchid testes and describe an additional organ that may display CT “whirl sign.”