4.4 Article

Cutaneous seeding of transitional cell carcinoma of the urinary bladder after placement of a subcutaneous ureteral bypass device in a dog with bilateral ureteral obstruction

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AMER VETERINARY MEDICAL ASSOC
DOI: 10.2460/javma.258.8.877

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A 12-year-old female Jack Russell Terrier diagnosed with transitional cell carcinoma of the urinary bladder trigone and urethra developed complications leading to euthanasia. Caution should be exercised in the treatment of renal diseases in dogs to prevent similar complications.
CASE DESCRIPTION A 12-year-old spayed female Jack Russell Terrier was presented with pol-lakiuria and stranguria. CLINICAL FINDINGS Transitional cell carcinoma (TCC) of the urinary bladder trigone and urethra was diagnosed via CT, cystoscopic, and histologic examinations. Azotemia developed 2 weeks following diagnosis, secondary to bilateral ureteral obstruction. TREATMENT AND OUTCOME Percutaneous antegrade ureteral stenting was unsuccessful; therefore, a subcutaneous ureteral bypass (SUB) device with 2 nephrostomy and 1 cystostomy catheters was surgically placed. Two months following placement of the SUB device, the dog developed a firm, multilobulated cutaneous mass at the site of the subcutaneous access port of the SUB device. Results of cytologic examination of cells aspirated from the mass were consistent with TCC. Within 1 month of confirmation of TCC of the cutaneous mass, the mass was ulcerated and infected, and the dog was euthanized because of signs of pain and perceived poor quality of life. CLINICAL RELEVANCE Seeding of neoplastic cells is a known complication of needle aspiration or biopsy or surgery in people and dogs with carcinomas. The occurrence of TCC at the SUB port site suggested caution with the placement of a SUB device in dogs with obstructive TCC.

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