Page 2043 - Cote clinical veterinary advisor dogs and cats 4th

1022 Uterine Neoplasia

Prevention Client Education uterine tubes. In Johnston SD, editor: Canine and
OHE • Failure of an animal to continue to progress feline theriogenology, Philadelphia, 2001, Saunders,
pp 206-463.
VetBooks.ir Technician Tips • Bloody discharge or abdominal pain during AUTHOR: Cheryl Lopate, MS, DVM, DACT
through labor should instigate a veterinary
exam.
Carefully monitor patients under anesthesia.
EDITOR: Michelle A. Kutzler, DVM, PhD, DACT
Marked drop in blood pressure may occur from
reperfusion injury. To avoid this, administer or after delivery is abnormal.
fluid bolus with crystalloid or colloid solutions SUGGESTED READING
and do not premedicate with hypotensive drugs Johnston SD, et al: Disorders of the canine uterus and
(e.g., acepromazine, dexmedetomidine). uterine tubes, and disorders of the feline uterus and

Uterine Neoplasia Client Education
Sheet

BASIC INFORMATION • Constipation • Cytologic exam of vulvar discharge may
• Chronic low-grade fever: uncommon demonstrate neoplastic cells.
Definition • Radiographs may reveal an enlarged caudal
Benign or malignant cellular proliferations PHYSICAL EXAM FINDINGS abdominal viscus.
involving the uterus are uncommon in dogs • Bloody vulvar discharge • Abdominal ultrasound exam reveals a mass
and cats. • Abdominal distention with palpable mid- in the uterine, cervical, or vaginal lumen:
caudal abdominal mass ○ If mass appears solid (homogeneous, mini-
Synonyms • Weight loss mally vascularized), fine-needle aspiration
Uterine mass, nodule, or polyp • Depression for cytologic exam is appropriate.
• Lymph node enlargement (especially ingui- • Thoracic radiographs for evidence of
Epidemiology nal): uncommon metastasis
SPECIES, AGE, SEX
• Most common in bitches > 10 years of age Etiology and Pathophysiology Advanced or Confirmatory Testing
and queens between 5 and 10 years of age • Uterine tumors may be of endometrial, • Hysteroscopy may reveal a luminal or mural
• Accounts for 1%-19% of all reproductive myometrial, serosal origin; may be primary mass.
tumors in dogs and 1%-2% of all reproduc- or metastatic • Biopsy may be taken by transcervical
tive tumors in cats • Leiomyoma is the most common tumor and endoscopic collection technique (TECT).
may be found incidentally or concurrent with • MRI may better delineate the mass and
GENETICS, BREED PREDISPOSITION pregnancy. provide further evidence of metastasis (rarely
Boxers may be overrepresented. necessary).
DIAGNOSIS • Laparoscopy may be useful for visualization
RISK FACTORS and biopsy.
Older age, intact reproductive tract Diagnostic Overview
Tumor is typically suspected with a history of TREATMENT
CONTAGION AND ZOONOSIS bloody vulvar discharge with supportive cytologic
Transmissible venereal tumor (TVT); uterine findings and/or ultrasound evidence of a uterine Treatment Overview
metastases can result in TVT dysgerminoma mass. Histopathologic exam of a specimen from Ovariohysterectomy (OHE): partial or complete
the mass is the confirmatory test of choice.
ASSOCIATED DISORDERS Acute General Treatment
Uterine torsion and/or rupture Differential Diagnosis • Typically, complete OHE is recommended
• Pyometra to ensure that any small masses not palpable
Clinical Presentation • Segmental endometrial hyperplasia or visible are removed at the time of initial
DISEASE FORMS/SUBTYPES • Uterine lithiasis surgery.
May involve the endometrium (polyp); myo- • Pregnancy • Abdominal inguinal lymph nodes may be
metrium (leiomyoma, fibroma, fibroleiomyoma, • Mummified fetus submitted for assessment of metastasis.
fibroadenoma, adenoma, leiomyosarcoma, ade- • Subinvolution of placental sites (SIPS) • For a long-standing tumor, necrosis of the
nocarcinoma, adenoacanthoma, fibrocarcinoma); • Adenomyosis uterine wall is possible, or adhesions to other
lipoma; or metastatic disease (lymphoma; TVT • Granuloma abdominal tissues may require resection.
dysgerminoma) • Mural abscess
• Decidual reaction Chronic Treatment
HISTORY, CHIEF COMPLAINT • Remnant of the mesonephric duct Depending on tumor type and degree of
• Bloody, mucoid, mucopurulent, or muco- • Serosal inclusion cysts metastasis, chemotherapy, immune modulators,
hemorrhagic vulvar discharge or radiation therapy may be appropriate. Con-
• Abdominal distention Initial Database sultation with an oncologist is recommended.
• Ascites • CBC, serum biochemistry profile, urinalysis
• Depression or lethargy (avoid unguided cystocentesis): results may be Possible Complications
• Vomiting normal with benign tumors to abnormal with If malignancy is present, complications associ-
• Anorexia metastatic disease, depending on metastatic ated with tumor metastasis in other locations
• Dysuria location. may occur.

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