TANSITIONAL CELL CARCINOMA

Lina Marcela Ortiz Useche

Código: 503840
Viviana marin
Codigo:
 INTRODUTION
Also called invasive urothelial
 TANSITIONAL CELL CARCINOMA carcinoma of the bladder

It is the frequent form of“CANCER IN BLADDER” ORIGIN

¿WHAT IS transitional epithelial cells

 it is the most common neoplasm of the
IT? urinary bladder. (malignant cell formation)

 It is an infiltrative and invasive tumor

locally. (Spread beyond tissue layers and growth of
healthy tissues)
 partial or complete obstruction of the ureters
¿ WHAT CAUSED THE and urethra
TUMOR ?
METASTASIS IN 50% OF CASES
¿Where is metastasis caused?

  Lungs involve
 lymph nodes
 Kidneys
 Liver
 Prostate
Metastases are also reported:
 long bones
 skull
 eyes
 ETIOLOGY

The etiology of canine bladder cancer is probably multifactorial.

RISK FACTOR'S

SEX:

They are more frequent in females

Race:

Pastor de shetland
Teckel

Scottish Terriers
Bobtail
West Highland Beagle
White Terriers
 It occurs most frequently in elderly animals at an average of 9.5 to 12
AGE : years of age.

It is more common to occur in an overweight patient due to the

OBESITY deposition of herbicides and insecticides in adipose tissue.
 CLINICAL SIGNS

• Hematuria • Stranguria • Dysuria

• Polakiuria

• lameness • incontinence • polydipsia

 DIAGNOSIS

Laboratory

Diagnoses
Ultrasound
by image

Cytology Histology
CLINICAL CASE

TRANSITIONAL CELL CARCINOMA

SCIENTIFIC ARTICLE
 ANAMNESIS

REASON FOR CONSULTATION

The canine was presented for a hematuria evaluation

 REVIEW

Species Canine

Race caniche-pekinés

age 14 years

Color Brown

Sex Female
URINE ANALYSIS PHYSICAL EXAM

The urinalysis revealed:

 Dark brown cloudy urine The physical examination

revealed:
(Contains a large number
of red blood cells).
Dense abdomen on palpation
 6 to 9 transitional
Urinary bladder is very firm
epithelial cells with
clusters in each high-
powered field.

 No bacteria or crystals
were observed
ANTIMICROBIAL THERAPY IS PERFORMED PRESCRIPTION OF THE 2
ANTIBIOTIC CYCLE
was instituted with :
amoxicilina / ácido clavulánico 6.25 mg / kg, PO every 12
 enrofloxacin 5 mg / kg, PO, every 24 h for For 14 days
14 days.

 Ten days later: amoxicillina / acido DETERMINED

clavulanico, 6.25 mg / kg, PO, was
administered every 12 h for 24 days.
The owner was administering the
antibiotics incorrectly and that only half
ONE MONTH AFTER
the prescribed dose had been administered

the owner reported that the antibiotics had

resolved the hematuria in the canine patient.

had noticed urine stained red,

darker than before
 IT IS DONE : PRESCRIPTION OF 3 CYCLE OF ANTIBIOTICS

A side scan radiograph of

 amoxicilina/ácido clavulánico  6.25 mg / kg,
the abdomen : PO, every 12 hours for 14 days

 revealed no abnormalities.

 Radiopaque uroliths were not

detected 1 week after completing the Obvious
3rd course of the antibiotic hematuria

ONE WEEK AFTER

COMPLETE THE LAST CYCLE

the owner again reported

hematuria

requested more antibiotics

SECOND PHYSICAL EXAM
PRESCRIPTION OF 4 CYCLE OF ANTIBIOTICS

 amoxicilina / ácido clavulánico at a

 the abdomen was soft and
higher dose (8.3 mg / kg, PO, every
easily palpable.
12h for 14 days.
 without mass detection or
discomfort.

Auscultation of the heart:

revealed a bilaterally audible

grade 3-4 / 6 systolic cardiac
heart with the point of maximum
intensity on the left apex.
 OWNER REPORTS AFTER TWO WEEKS
he patient urinated more than normal
(urinary frequency)
I PERFORM 2 URINE ANALYSIS the owner reported that there was no change
in hematuria or urinary frequency

Urine was collected by CYSTOCENTESIS and

sent to a laboratory (IDEXX, Markham,
I only give half the prescribed dose of the antibiotic
Ontario) for analysis and culture.

RESULTS PREANESTHETIC BLOOD ANALYSIS

ADVISED
Yellow and cloudy urine (contained a
significant number of red blood cells).
1 to 5 transitional epithelial cells 1 to 5 cholesterol of 11.68 mmol / L (RI: 2.84 to 8.27
squamous epithelial cells the pH was mmol / L) 11.1 mmol / L urea (RI: 2.5 to 9.6
mmol / L) 6.4 mmol / L potassium (RI: 3.5 to 5.8
6.5 protein was 2+ No bacteria or
mmol / L)       A complete blood count: revealed a
crystals were observed. There was no
moderate elevation of platelets but no other
growth in urine culture, suggesting
abnormal findings.
non-radiopaque uroliths or malignancy.
IT IS ADVISED TO PERFORM AN
ECHOGRAPHY OF THE URINARY BLADDER

The ultrasound image revealed a knotted

hyperechoic mass.
LOCATION: Area of ​the trigone leading to a
patent urethra

 The body and base of the bladder wall

appeared normal.

 A diagnosis of transitional cell carcinoma

was made.

 a biopsy of the tumor was recommended

using a urethral catheter to confirm the
diagnosis
This finding is consistent with transitional cell
carcinoma.
 RESULTS WERE DISCUSSED WITH
THE OWNER SIX WEEKS AFTER

Options were presented for human

euthanasia or palliative treatment with a the dog was presented to assess: decreased
non-steroidal anti-inflammatory drug responsiveness the inability to stand up.
(NSAID).
TREATMENT
OWNER REPORTS
0.125 mg / kg PO was prescribed every 24 h
frequent monitoring of liver and kidney
function (every 4 weeks) was recommended the dog was less receptive Less energetic
 inappetent,  had an occasional cough I had
DAY AFTER vomited that morning. No blood was
detected in the urine for the past 3 weeks.

the owner reported dark urine and weakness, and a

physical examination was recommended
 PHYSICAL EXAM POST-MORTEN EXAM

 the dog was calm

 less responsive than on previous visits. COLLECTED :

 The complete urinary bladder and
 Lost a weight loss of 0.4 kg in 1.5 sections of kidney and liver.
months  They were sent to the (Animal Health
Laboratory, University of Guelph) for
 dehydration from 5% to 7%. histopathology.

 Auscultation: heart sounds were HISTOPATHOLOGY :

muffled a plaque in the mucosa of the urinary
bladder made up of compact neoplastic
 Palpation: the abdomen was tense and cells that infiltrated the submucosa.
distended, the bladder was enlarged
but not firm. This confirms an invasive transitional cell
carcinoma of the urinary bladder..

DEATH
 DISCUSIÓN
Because bacteria were not cultured from urine in
This case highlights the importance of patient this case, the wrong dosage is unlikely to have
monitoring and communication with the client
serious implications.
to ensure that the appropriate dose of
medication is administered to the patient

Urine culture on presentation may have led to a faster

diagnosis of malignancy by ruling out a bacterial
infection

Treatment options, such as

chemotherapeutic drugs or the use of the This case also showed the value of ultrasound
NSAID piroxicam, may have prolonged examination to make a tentative diagnosis of CBT
the survival time of this dog.
Due to the progressive nature of this Surgical removal of most tumors is difficult
due to their location and proximity to the
disease, most treatment is palliative.
ureters.

VARIOUS SURGICAL TECHNIQUES HAVE BEEN

DESCRIBED AND OTHER TREATMENT OPTIONS A median post-surgical survival
INCLUDE CHEMOTHERAPY time of 125 days was reported in 23
dogs after surgical reduction of the
primary tumor.
a technique in which circumferential
and did not cause urinary incontinence or
excision of the bladder neck and proximal
necrosis of the bladder wall
urethra was performed while successfully
preserving the neurovascular pedicles

One study reported average survival

A median survival time of 180 days was times of 259 days in 11 dogs with the
reported in 62 dogs with the use of pyroxican. use of doxorubicin along with
cyclophosphamide.

Piroxicam is also commonly combined Carbon dioxide laser ablation has also
with chemotherapeutic agents, such as been used in combination with
mitoxantrone. treatment with mitoxantrone and
piroxicam
CHEMOTHERAPY PROTOCOL
Gracias