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Ovarian Tumors 733

GEOGRAPHY AND SEASONALITY • Other endogenous estrogen source (e.g., Recommended Monitoring
Seasonality (spring) of estrous signs possible adrenal disease) Monitor for recurrence of clinical signs.
VetBooks.ir (4-12 months) in dogs Initial Database PROGNOSIS & OUTCOME Diseases and Disorders
in cats, and recurrence at typical cycle interval
• Vaginal cytology demonstrating cornified
ASSOCIATED DISORDERS
epithelial cells (p. 1183)
found and removed.
• As with intact females, ovarian tumors can • Negative serum luteinizing hormone Prognosis is good if remnant ovarian tissue is
occur. (LH) test: females with ovarian remnants,
• Stump pyometra and mammary neoplasia like intact females, have low/undetectable PEARLS & CONSIDERATIONS
may occur secondary to progesterone serum LH barring the preovulatory LH
exposure during the estrous cycle. surge, whereas LH concentrations should Comments
remain persistently elevated in OVE/OHE Positive LH test result indicates a spayed female
Clinical Presentation females (absence of inhibition from estrogen) or an intact female during the preovulatory LH
HISTORY, CHIEF COMPLAINT (p. 1361). surge. Confirm all positive results 1-2 weeks
Behavioral estrus, attracting males, licking vulva • Serum progesterone > 5 ng/mL (p. 1375) later because the normal LH surge has a short
excessively duration. Alternatively, use AMH test.
Advanced or Confirmatory Testing
PHYSICAL EXAM FINDINGS • Positive anti-mullerian hormone (AMH) test: Prevention
Swollen vulva, bloody or serosanguineous vulvar AMH is produced by the ovaries. A positive Complete removal of ovarian tissue at initial
discharge result indicates the presence of ovarian tissue OVE/OHE surgery prevents this condition.
(p. 1308). Consider laparoscopy for improved access to
Etiology and Pathophysiology • Vaginoscopy: to rule out other causes of ovaries in large or deep-chested breeds.
• Ovarian tissue remaining after OVE/OHE vulvar discharge (e.g., mass, foreign body)
becomes revascularized and hormonally • Ultrasound: occasionally useful, but ovarian Technician Tips
active. tissue is usually small and difficult to identify. • Some females may allow breeding to occur
• Ovarian tissue may remain in the abdomen • Histopathologic exam of tissue: to confirm and should be kept isolated from males.
due to improper placement of clamps, poor ovarian tissue removed surgically • When obtaining a vaginal cytology sample,
visualization of surgical field, tissue dropped use a large otoscope cone as a speculum to
during surgery, or ectopic/accessory tissue in TREATMENT avoid contamination from the vestibule.
the broad ligament (latter more common in
cats). Treatment Overview SUGGESTED READING
• It may take months to years after OVE/OHE Complete removal of ovarian tissue by explor- Ball RL, et al: Ovarian remnant syndrome in dogs
for ovarian remnant to become active (cause atory laparotomy and cats: 21 cases (2000-2007). J Am Vet Med
unknown). Assoc 236(5):548-553, 2010.
Acute and Chronic Treatment
DIAGNOSIS Surgery is best performed during estrus to AUTHOR: Kara A. Kolster, DVM, DACT
EDITOR: Michelle A. Kutzler, DVM, PhD, DACT
facilitate identification of ovarian tissue.
Diagnostic Overview
The diagnosis is suspected based on overt clini- Possible Complications
cal evidence of estrogen and/or progesterone Remnant ovarian tissue may be difficult to find
influence in a spayed female. Confirmation surgically. Careful exam of the ovarian pedicles
requires histopathologic evaluation of remnant and broad ligament is required with removal
ovarian tissue. of any suspicious tissue. If no obvious tissue is
found, both ovarian pedicles should be further
Differential Diagnosis resected and submitted for histopathologic
• Exogenous estrogen and/or progesterone evaluation.
source (e.g., owner’s hormone replacement
cream)

Ovarian Tumors Bonus Material Client Education
Sheet
Online
Epidemiology
BASIC INFORMATION • Germ cell tumors: median age of 6.4 years
SPECIES, AGE, SEX (dysgerminoma, 9 years; teratoma, 5 years;
Definition Canine, intact females: teratocarcinoma, 5 years)
Ovarian tumors are uncommon and are classi- • Epithelial tumors (40%-50% of all ovarian Feline, intact females:
fied by cell type origin as sex cord (granulosa tumors): median age of 9.6 years (adenomas, • Sex cord tumors (most common): median age
cell tumor, Sertoli-Leydig), epithelial (adeno- 10.5 years; adenocarcinomas, 9.3 years). of 9 years (granulosa cell tumor, 10 years).
carcinoma, adenoma, cyst adenocarcinoma), or Metastasis rate ≥ 60%. More than 50% are malignant.
germ cell (dysgerminoma, teratoma). • Sex cord tumors: median age of 8 years • Epithelial tumors: median age of 10 years
(granulosa cell tumor, 7 years; Sertoli, 5 (cystadenoma, 10 years)
Synonyms years; Sertoli-Leydig, 12 years). • Germ cell tumors: median age of 6 years
Ovarian neoplasia, ovarian cancer (dysgerminoma, 6 years; teratoma, 8 years)

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