Chapter 28 - Tumors of the Male Reproductive System Flashcards
What is the most common location for tumors in the male reproductive system? What percentage of reproductive tumors do they comprise? Overall prevalence?
Testicles
90%
7% prevalence
What are the three most common testicular tumors and from what testicular subsets do they arise?
Sertoli cell tumor - sustentacular cells at seminiferous
Interstitial cell tumor - interstitial cells of Leydig between seminiferous tubules
Seminoma - spermatic germinal epithelium of seminiferous tubules
For which tumor is a cryptorchid testicle a risk factor?
Is there a difference between inguinal and abdominal cryptorchidism?
Which testicle is most commonly associated with cryptorchidism?
Sertoli cell tumors and seminomas
Crytporchidism is a risk factor overall, risk is higher with inguinal vs abdominal
Right testicle
Up to what percentage of dogs with testicular tumors have more than one type of testicular tumor?
4-20%
With what frequency do the different types of testicular tumors occur in dogs within the USA?
Equal frequency
In Norway, what breeds are at increased risk for developing testicular tumors? Which ones?
Shelties and Collies have a 5x increased
Shelties - majority (80%) are Sertoli
Collies - majority (70%) mixed Sertoli/seminoma
Norweigan elkhounds - 2x increased risk of seminoma
What hormones are produced by the different testicular tumors?
Sertoli - 50% produce estrogen and signs of feminization; 17% if scrotal
Interstitial - rarely testosterone and estrogen
Seminoma - rarely estrogen
What tumor is most likely to cause feminization signs?
How can estrogen be measured?
What are the clinical signs?
Sertoli (>50% if cryptorchid and 15% if scrotal)
Estraidol 17-B - usually higher when compared to normal dogs; not all dogs have elevated estraidol
Testosterone/estraidol ratio - usually lower; feminization signs occur secondary to disruptions in this ratio, may be a better
CS: bilateral symmetric alopecia, cutaneous hyperpigmentation, thinning of skin, galactorrhea, gynecomastia, atrophy of prepuce, atrophy of contralateral testicle, squamous prostatic metaplasia, bone marrow suppression
What is the metastatic rate of the different types of testicular tumors?
Sertoli - <15%
Interstitial - rare
Seminoma - <15%
What is the gross appearance of the different testicular tumors?
Sertoli - firm, lobulated, white or grey, greasy
Seminoma - homogeneous, soft, occasionally lobulated, ivory
Interstitial - soft, expansive, yellow to orange, often contain cysts with serous or serosanguinous fluid
Which testicular tumor can sometimes be associated with perianal gland hyperplasia?
Interstitial cell tumor
What are early vs late effects of estrogen in BM?
Transient increase in granulopoiesis with peripheral neutrophilia followed by progressive neutropenia, thrombocytopenia, and nonregenerative anemia, resulting in aplastic anemia and pancytopenia
What % of dogs with a testicular tumor have a contralateral testicular tumor or a primary tumor elsewhere?
50%
Therefore, COMPLETE STAGING is recommended
What is the treatment of choice for testicular tumors?
Bilateral orichectomy and scrotal abalation
After castration in dogs with Sertoli cell tumor, when do signs fo feminization resolve?
Prognosis if bone marrow hypoplasia or aplastic anemia present?
1 to 3 months after, unless metastasis is present
BM hypoplasia - guarded
Aplastic anemia - poor
How common are feline testicular tumors?
Rare; Sertoli, seminoma, interstitial cell tumor, and teratoma reported
What is the prevalence of prostatic tumors in dogs?
<1%
What is the most common prostatic tumor found in intact dogs?
Prostatic adenocarcinoma - usually urothelial or ductular in origin, rather than acinar, since they are androgen-independent
Where does TCC arise from within the prostate?
Prostatic ducts
What is an identified risk factors for prostatic carcinoma development in dogs?
Castration; OR 2.3:4.3
What % of dogs with prostatic carcinoma have metastasis at the time of diagnosis and at the time of death?
Which px may be at increased risk for metastasis?
40% at diagnosis; SLLN most commonly
80% at death
Younger dogs
What % of canine prostatic carcinoma develops metastatic disease to bone? Most common site?
22 to 42%
Lumbar vertebrae
What % of dogs with prostatic carcinoma have COX-2 expression?
75-88% express COX-2 (vs 0% normal prostate tissue)
Predilection for bone in prostatic carcinoma may be mediated by what 3 things?
TGF-B, PTH-rP, endothelin
Mets from prostatic carcinoma to bone have what action on bone? Osteoproductive or osteolytic?
More commonly osteoproductive, but can also be osteolytic
Skeletal metastasis most commonly OSTEOBLASTIC in nature
MST of dogs with prostatic carcinoma treated with NSAIDs vs no treatment?
NSAID MST 7m (6.9m); another 2018 study said 1.7m
<1m (0.7m or 21d)
What % of dogs with prostatic carcinoma have a BRAF mutation?
85%
What is the benefit of systemic chemo for prostatic carcinomas?
Unclear
What tumors usually affect the soft tissues of the penis, prepuce, and scrotum in dogs? What are the most common neoplasm of the canine penis?
TVT, SCC (most common ones), sebaceous gland adenoma, mesothelioma, papilloma, lymphoma, plasma cell tumor, mast cell tumor, hemangioma, melanoma, fibrosarcomaTVT and SCC
What bone tumors can arise from the os penis?
Ossifying fibroma, benign mesenchymoma, multilobular osteochondrosarcoma, osteosarcoma
OSA behaves similar to axial OSA
What is the tx of choice for penile tumors?
Perineal urethrostomy and penile amputation
Tx for TVT?
Chemotherapy with vinc, not sx, also responsive to RT
Mineralization in the canine prostate can be due to what?
In intact dogs - prostatitis, BPH, cysts
In neutered dogs - 100% PPV for neoplasia
What should the size of the prostate be in a neutered dog?
Small; a normal sized prostate in a neutered dog is abnormal
What % of dogs with prostatic carcinoma have a concurrent UTI?
33-36%
Prostatectomy should be considered in which dogs?
Dogs with early stage dz and no capsular involvement
What % of dogs undergoing total prostatectomy develop major complications, transient incontinence, and permanent incontinence?
Major complications - 16%: dehiscence, uroabdomen, prepubic herniation
60% transient - resolved within 4 weeks
35% permanent incontinence
In the VSSO study where dogs were treated with prostatectomy, did the addition of chemotherapy prolong ST?
No
What is the DFI and MST in dogs with prostatic carcinoma when treated with prostatectomy, NSAIDs, and chemo?
Negative PI in the VSSO study?
DFI 2.7m
MST 7.7m
1-yr SR 32% and 2-yr SR 12%
Histologic extracapsular extension MST 4.6m
Overall clinical response rate and MST of dogs with TCC and prostate involvement when treated with chemo and an NSAID?
Clinical response 33%
MST 3.5m
Negative PI in dogs with prostatic carcinoma when treated with chemo + NSAID?
Intact male status - shorter MST
Presence of CS - shorter MST
Metastasis to sites other than lungs - shorter MST
Tx with NSAIDs alone
Survival time of dogs with prostatic lymphoma? How does it usually present? LN involvement and multicentric dz? Most common phenotype?
Mean ST 2m; 2 dogs tx with chemo survived for 1 and 10m
56% had LN involvement and all appeared to have multicentric intra-abdominal dz
High grade T cell lymphoma
Absence of mineralization on AUS
Prostatic tumors in cats? Most common one? Survival time?
Rare
Adenocarcinoma
Most die within 3m
