Tuesday, August 10, 2010

154. Undescended testicular tumour

Aug 10,2010 report
REVIEW OF A CASE OF A TESTICULAR TUMOUR
DAY 3 AFTER NEUTER

Labrador Retriever, Male, 6 years, 17 kg.
A very thin gentle dog. Poor bodily condition and anaemic. High anaesthetic risk but surgery was necessary.

Complaint 2 days ago: Large lump in the left inguinal area
Noted: Preputial opening black and much swollen. Squatted and took over 1 minute to pee (suspect urethral obstruction, cystitis or prostrate enlargement/inflamation, tumour)

Blood test: Anaemia. Low haemoglobin, red blood cells and platelets. Kidneys and livers OK. No diabetes.

Urine analysis: Wait for lab results.
Urine dipstick by intern Ms Lai who collected urine today and wrote the following: No blood. Protein 1000 mg/dl, Glucose 100 mg/dl, pH 7.0 - 7.5, SG 1.015, leucocytes 500 WBC/ul

IV drip + Vit K1 in slow IV 2 hours
Isoflurane gas mask, neutered 2 days ago.
Prostate as large as a ping pong ball (digital rectal palpation while at the end of neuter anaesthesia) and dog reacted in pain.

Undescended testicular tumour, 4"X3" with multiple yellow nodules. Descended testicle appeared shrunkened and 1/3 normal size. Both sent to the laboratory for histopathology.

"Has the testicular tumour spread inside the body?" the father asked me. "It is hard to say without further tests, scans and X-rays." I replied. "Is it a testicular cancer? I had to wait for lab report.

Undescended testicle may develop into testicular tumour in man and dog. "Have you heard of Lance Armstrong who suffered the same condition as your Labrador?" I asked the father. "No," he said.

I am glad that this dog can now pee at one go. Will review tomorrow.

I gave him an anti-androgenic injection (Tardak). After 24 hours, at 5.30 pm today, Aug 10, 2010, he could just pee normally in one go in less than a few seconds.



Aug 10, 2010
HISTOPATHOLOGY RESULTS
A testicular tumour - sertoli cell tumour.
Comment from the histopathologist: A second interstitial (Leydig) cell tumour component cannot be excluded in this tumour. Most primary testicular neoplasm in the dog are benign. The rare malignant Seretoli cell tumour has no good cytological or histological markers of malignancy. The only way to determine malignancy is to identify metastases in lymphatics, spermatic cord, lymph node or distant sites. Pl correlate with clinical features.


Aug 10, 2010
URINE ANALYSIS
pH = 7.0, SG 1.027

Abnormal findings:
Prortein 2+, glucose+, blood 4+
White Blood cells >2250/uL, red blood cells 900/uL, epithelial cells 1053/uL, bacteria 3+

nephritis? + cystitis + prostatitis

Aug 10, 2010
BLOOD TEST
Total White cell count normal with neutrophils 82% (absolute 7.96), lymphocytes 12% (absolute 1.17), monocytes 5% (absolute 0.45), eosinophils 0.5% (absolute 0.05), basophil 0.4% (absolute 0.04)

but there is bone marrow depression as evident by:

Low platelets 90 (200-500)
Low haemoglobin
Low red cell count

Aug 17, 2010
Phoned owner to check on dog and post lab reports.
1. Yes, can take out the e-collar as it is one week.
2. "The dog no longer limps. We thought he had hip problems," the owner said. "It is the pain in the undescended testicular tumour as the cells are getting necrotic and dying.
3. "Does he attract other dogs to go near him when you took him out for walk?" I asked. "Many dogs would look at home or go near him," he said. "That is the result of excessive female hormone production - estrogen that caused him to be attracted by other dogs. Now, he should be getting less attention as he longer secretes the female sex hormones."

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