An 11-year-old male American Bulldog was presented for hematuria and tenesmus. It had been treated for chronic bacterial prostatitis with abscessation two years earlier and underwent castration and a prostatic omentalization procedure. There was no histologic evidence of prostatic neoplasia at that time. On physical examination, an enlarged prostate was found by rectal palpation, and it was characterized with ultrasonography and computed tomography. Surgical biopsies were obtained, and histopathology identified prostatic adenocarcinoma. It received carprofen and mitoxantrone chemotherapy in addition to palliative radiation therapy; it was euthanized six weeks later due to a progression of clinical signs. Necropsy findings included marked localized expansion of the prostatic tumor and dissemination of prostatic carcinoma cells throughout the peritoneal cavity along the omental graft with infiltration onto the serosal surfaces of most abdominal viscera and fat. This case represents a previously unreported potential complication of the omentalization procedure wherein carcinoma cells from a prostatic tumor that independently arose after omentalization may have metastasized along the surgically created omental graft. 1. Introduction The surgical treatment of canine prostate abscesses was revolutionized by the application of an intracapsular prostatic omentalization technique first reported by White and Williams in 1995 [1]. In this procedure, an omental graft is tunneled through the parenchyma of the prostate after digitally breaking down any loculated abscesses and is sutured to the prostate. The omentum provides vascular and lymphatic drainage to cavitated sites of infection within the prostate gland. Along with systemic antibiotic therapy, prostatic omentalization has enabled the successful management of many refractory cases of prostatitis in dogs. No long-term complications have been reported with this technique. Prostatic carcinoma in dogs is generally an aggressive malignancy characterized by local invasiveness and early metastasis to regional lymph nodes, liver, lung, and bone [2–5]. Clinical signs are variable but typically include hematuria, stranguria, urinary incontinence, tenesmus, and pain, which may be localized if skeletal metastasis has occurred. The presence of an enlarged prostate in a neutered male dog may indicate malignancy; however, the prostate is not enlarged in all cases of prostatic carcinoma [4]. Radiography, ultrasonography, and computed tomography (CT) are useful imaging techniques to assess the prostate for the disease and to
References
[1]
R. A. White and J. M. Williams, “Intracapsular prostatic omentalization: a new technique for management of prostatic abscesses in dogs,” Veterinary Surgery, vol. 24, no. 5, pp. 390–395, 1995.
[2]
A. D. Weaver, “Fifteen cases of prostatic carcinoma in the dog,” Veterinary Record, vol. 109, no. 4, pp. 71–75, 1981.
[3]
A. M. Hargis and L. M. Miller, “Prostatic carcinoma in dogs,” Compendium on Continuing Education for the Practising Veterinarian, vol. 5, pp. 647–653, 1983.
[4]
F. W. Bell, J. S. Klausner, D. W. Hayden, D. A. Feeney, and S. D. Johnston, “Clinical and pathologic features of prostatic adenocarcinoma in sexually intact and castrated dogs: 31 cases (1970–1987),” Journal of the American Veterinary Medical Association, vol. 199, no. 11, pp. 1623–1630, 1991.
[5]
B. E. LeRoy and N. Northrup, “Prostate cancer in dogs: comparative and clinical aspects,” Veterinary Journal, vol. 180, no. 2, pp. 149–162, 2009.
[6]
G. K. Ogilvie and A. S. Moore, Managing the Canine Cancer Patient, Veterinary Learning Systems, Yardley, Pa, USA, 2006.
[7]
S. J. Withrow, D. M. Vail, and R. L. Page, Small Animal Oncology, WB Saunders, Philadelphia, Pa, USA, 5th edition, 2013.
[8]
C. J. Henry and M. L. Higginbotham, Cancer Management in Small Animal Practice, Saunders Elsevier, 2010.
[9]
T. Freitag, R. M. Jerram, A. M. Walker, and C. G. A. Warman, “Surgical management of common canine prostatic conditions,” Compendium: Continuing Education for Veterinarians, vol. 29, no. 11, pp. 656–672, 2007.
[10]
J. M. Turrel, “Intraoperative radiotherapy of carcinoma of the prostate gland in ten dogs,” Journal of the American Veterinary Medical Association, vol. 190, no. 1, pp. 48–52, 1987.
[11]
D. R. Proulx, D. M. Ruslander, M. L. Hauck, et al., “Canine prostatic neoplasia. A retrospective analysis of 10 dogs treated with external beam radiation (1989–2001),” in Proceedings of the 22nd Annual Conference of the Veterinary Cancer Society, p. 40, 2002.
[12]
C. R. Anderson, E. A. McNiel, E. L. Gillette, B. E. Powers, and S. M. LaRue, “Late complications of pelvic irradiation in 16 dogs,” Veterinary Radiology and Ultrasound, vol. 43, no. 2, pp. 187–192, 2002.
[13]
J. Obradovich, R. Walshaw, and E. Goullaud, “The influence of castration on the development of prostatic carcinoma in the dog. 43 cases (1978–1985),” Journal of Veterinary Internal Medicine, vol. 1, no. 4, pp. 183–187, 1987.
[14]
K. U. Sorenmo, M. Goldschmidt, F. Shofer, C. Goldkamp, and J. Ferracone, “Immunohistochemical characterization of canine prostatic carcinoma and correlation with castration status and castration time,” Veterinary and Comparative Oncology, vol. 1, no. 1, pp. 48–56, 2003.
[15]
K. K. Cornell, D. G. Bostwick, D. M. Cooley et al., “Clinical and pathologic aspects of spontaneous canine prostate carcinoma: a retrospective analysis of 76 cases,” Prostate, vol. 45, no. 2, pp. 173–183, 2000.
[16]
B. E. LeRoy, M. V. P. Nadella, R. E. Toribio, I. Leav, and T. J. Rosol, “Canine prostate carcinomas express markers of urothelial and prostatic differentiation,” Veterinary Pathology, vol. 41, no. 2, pp. 131–140, 2004.
[17]
W. G. Nelson, A. M. de Marzo, T. L. DeWeese et al., “The role of inflammation in the pathogenesis of prostate cancer,” Journal of Urology, vol. 172, no. 5, pp. S6–S12, 2004.
[18]
C. A. Bradbury, J. L. Westropp, and R. E. Pollard, “Relationship between prostatomegaly, prostatic mineralization, and cytologic diagnosis,” Veterinary Radiology and Ultrasound, vol. 50, no. 2, pp. 167–171, 2009.
[19]
H. F. L'Eplattenier, S. A. van Nimwegen, F. J. van Sluijs, and J. Kirpensteijn, “Partial prostatectomy using Nd:YAG laser for management of canine prostate carcinoma,” Veterinary Surgery, vol. 35, no. 4, pp. 406–411, 2006.
[20]
J. M. Liptak, S. P. Brutscher, E. Monnet et al., “Transurethral resection in the management of urethral and prostatic neoplasia in 6 dogs,” Veterinary Surgery, vol. 33, no. 5, pp. 505–516, 2004.
[21]
C. Weisse, A. Berent, K. Todd, C. Clifford, and J. Solomon, “Evaluation of palliative stenting for management of malignant urethral obstructions in dogs,” Journal of the American Veterinary Medical Association, vol. 229, no. 2, pp. 226–234, 2006.
[22]
V. J. Poirier, L. J. Forrest, W. M. Adams, and D. M. Vail, “Piroxicam, mitoxantrone, and coarse fraction radiotherapy for the treatment of transitional cell carcinoma of the bladder in 10 dogs: a pilot study,” Journal of the American Animal Hospital Association, vol. 40, no. 2, pp. 131–136, 2004.
[23]
J. A. Lawrence and L. J. Forrest, “Intensity-modulated radiation therapy and helical tomotherapy: its origin, benefits, and potential applications in veterinary medicine,” Veterinary Clinics of North America—Small Animal Practice, vol. 37, no. 6, pp. 1151–1165, 2007.
[24]
C. J. Henry, D. L. McCaw, S. E. Turnquist et al., “Clinical evaluation of mitoxantrone and piroxicam in a canine model of human invasive urinary bladder carcinoma,” Clinical Cancer Research, vol. 9, no. 2, pp. 906–911, 2003.
[25]
K. U. Sorenmo, M. H. Goldschmidt, F. S. Shofer, C. Goldcamp, and J. Ferracone, “Evaluation of cydooxygenase-1 and cyclooxygenase-2 expression and the effect of cydooxygenase inhibitors in canine prostatic carcinoma,” Kleintierpraxis, vol. 52, no. 1, p. 36, 2007.
[26]
G. S. Palapattu, S. Sutcliffe, P. J. Bastian et al., “Prostate carcinogenesis and inflammation: emerging insights,” Carcinogenesis, vol. 26, no. 7, pp. 1170–1181, 2005.
[27]
A. M. de Marzo, E. A. Platz, S. Sutcliffe et al., “Inflammation in prostate carcinogenesis,” Nature Reviews Cancer, vol. 7, no. 4, pp. 256–269, 2007.
[28]
E. O. Kehinde, S. M. Abdeen, A. Al-Hunayan, and Y. Ali, “Prostate cancer metastatic to the omentum,” Scandinavian Journal of Urology and Nephrology, vol. 36, no. 3, pp. 225–227, 2002.
[29]
F. Zagouri, M. Papaefthimiou, A. N. Chalazonitis, N. Antoniou, M. A. Dimopoulos, and A. Bamias, “Prostate cancer with metastasis to the omentum and massive ascites: a rare manifestation of a common disease,” Onkologie, vol. 32, no. 12, pp. 758–761, 2009.
[30]
T. G. Nyland, S. T. Wallack, and E. R. Wisner, “Needle-tract implantation following US-guided fine-needle aspiration biopsy of transitional cell carcinoma of the bladder, urethra, and prostate,” Veterinary Radiology and Ultrasound, vol. 43, no. 1, pp. 50–53, 2002.