In dogs, eyelid neoplasms are very common. They are not highly invasive and, as a rule, can be easily removed promptly, provided that the size of the neoplasm is insignificant. Neoplasms of the eyelids rarely give distant metastases, in this aspect they should be distinguished from neoplasms of the conjunctiva, which often recur and metastasize (Fig. 1). Eyelid neoplasms are found mainly in dogs over 6–8 years of age, regardless of gender. There is no particular breed predisposition. The most common are adenoma, papilloma, adenocarcinoma, melanoma, histiocytoma.
The most common neoplasms of the eyelids are neoplasms of the meibomian glands, usually adenomas or adenocarcinomas.
The meibomian gland is a modified sebaceous gland of the skin that secretes a fat-like secretion that is involved in the formation of the tear film necessary for the normal functioning of the cornea.
The meibomian glands are located in the thickness of the eyelid, in the region of the rib at a depth of about 3 mm from its edge. Their excretory ducts open directly at the edge of the eyelid.
Neoplasms of the meibomian glands arise in the gland itself, then the tumor tissue grows along the excretory duct of the gland and appears on the edge of the eyelid.
The source of the neoplasm is located in the thickness of the century - in the meibomian gland itself. The tissue that appears above the surface of the rib of the eyelid is a small part of the neoplasm. This tissue irritates the cornea, may bleed, ulcerate. Typical symptoms are blepharospasm, epiphora, conjunctival hyperemia. In severe cases, corneal vascularization and pigmentation are observed (Fig. 2).
Often the mistaken decision of the veterinarian is to remove the protruding part of the tumor - it is simply cut off with scissors, which leads only to a temporary cosmetic elimination of the problem.
The only correct tactic in the treatment of these neoplasms is their complete removal immediately after detection. Therefore, it is so important to pay special attention to small neoplasms and not wait for their tissue to grow.
The removal technique depends on the volume, nature of the neoplasm and its localization. When a neoplasm is damaged up to 30% of the eyelid length (Fig. 3), it is removed by means of a wedge-shaped resection of the eyelid section (V-plasty) and does not require additional manipulations. Removing 30% of the eyelid length does not affect its functionality. The cosmetic result is generally excellent or good (Fig. 4).
Removal is carried out either with scissors or with a scalpel. For precise, even cuts, it is convenient to use a special tool - the JAEGER insert (Fig. 5). After performing wedge resection, the wound is sutured in two stages. The suture material is used thin - 5-0, 6-0. Internal sutures are made with absorbable material. For skin sutures, it is advisable to use a monofilament suture material.
The lid rib is sutured using an intramarginal suture (Fig. 6). Such a suture minimizes the scar in the rib area and preserves its function, and the knot from this suture will not come into contact with the cornea and irritate it. Postoperative care does not require much effort: local and systemic antibiotic therapy and the use of a protective collar. The seams and protective collar are removed on the 10-14th day.
If the neoplasm of the eyelid is damaged by more than 50% of its length, after its removal, the formed defect must be compensated. For this, various options for reconstructive blepharoplasty are used. A similar case is shown in Figures 7, 8. The neoplasm was removed by means of wedge resection. As a result, an extensive defect was formed in the center of the upper eyelid and two areas with a normal edge of the eyelid appeared on the inner and outer sides of the palpebral fissure. A portion of the edge of the eyelid from the outside was transferred to the central part of the eyelid, and the defect in the area of the outer edge of the eyelid was replaced by skin from the temple. Thus, it was possible to preserve the normal structure and function of the eyelid in the central, most important area and to obtain a satisfactory cosmetic result (Fig. 9).
When removing the neoplasm, which is located in the medial angle of the palpebral fissure, a special technique is used (Fig. 10, 11). Removal of a large amount of tissue directly next to the rib requires additional reconstructive blepharoplasty. Otherwise, the defect creates significant tissue tension and deforms the eyelid, changing its normal position relative to the cornea. The most commonly used is the so-called H-plastic (Fig. 12). After removal of the neoplasm, the defect is compensated with the help of nearby tissues (Fig. 13, 14).
Inflammation of the sebaceous glands is not a very common skin disease; it is more commonly diagnosed in dogs. However, inflammation of the sebaceous glands has been reported in other animal species, including cats and rabbits. There are few reports of a similar condition in humans. The most important feature of this disease is infiltrative inflammation in combination with the destruction of the sebaceous glands.
Sebaceous glands are holocrine alveolar glandular formations, in mammals whose skin is covered with hair, connecting with hair follicles. These glands open up with a duct in the hair follicle funnel (funnel-oily junction). Their oily secretion (sebum) forms an emulsion with the secretion of the sweat glands on the surface of the epidermis and is distributed over the surface of the stratum corneum. The main function of this emulsion is to maintain the elasticity and softness of the skin, prevent the loss of moisture from the latter and, thereby, maintain an adequate level of skin hydration. Also, the emulsion performs the functions of a physical and chemical barrier, an obstaclepenetration into deeper tissues of the body of pathogenic microorganismsov. The chemical composition of the secretion of the sebaceous glands in different species of mammals is not the same. In dogs and cats, surface lipids prevail in it - especially free cholesterol, sterol esters and diesters of wax acids, while triglycerides and squalene are significantly less than in the secretion of the human sebaceous glands.
Etiology
Inflammation of the sebaceous glands in a narrow sense is a rare idiopathic skin disease. It often develops in the Akita Inu and the Standard Poodle. There is an assumption that in these dog breeds, the tendency to this disease is inherited in an autosomal recessive manner. In addition, inflammation of the sebaceous glands is common in the German Shepherd, Vizsla (Hungarian Short-haired Pointing Dog), Hovawart, in a number of other breeds and in crossbred dogs. The pathogenesis of the disease is still unknown. There have been suggestions that inflammation of the sebaceous glands occurs as a result of:
- primary structural defects of the sebaceous glands and their ducts, causing the leakage of secretions, to which the body, in turn, reacts as a foreign body;
- failure of lipid metabolism, which affect the formation of sebum;
- as well as violations of primary keratinization, leading to inflammation and atrophy of the sebaceous glands and their ducts.
Immunohistochemical studies of the sebaceous glands showed that mainly the cell population in the inflamed sebaceous glandsare dendritic cells of the main histocompatibility complex of class II, as well as CD4 + and CD8 + T-lymphocytes, which perform the functions of effector cells in cell-mediated autoimmune diseases. B-lymphocytes and autoantibodies to antigens of the sebaceous glands were not detected during their inflammation. The assumption that inflammation of the sebaceous glands is a cell-mediated autoimmune disease is supported by the fact that the concentration of T-lymphocytes and macrophages decreases during immunomodulatory therapy with cyclosporine.
Secondary destruction of the sebaceous glands, which is accompanied by clinical changes characteristic of hyperkeratosis, can develop in generalized demodicosis, leishmaniasis, severe histiocytic, granulomatous folliculitis and other diseases.
Clinical signs
Most often, adult dogs (young and middle-aged) get sick with inflammation of the sebaceous glands, regardless of sexual predisposition. Variations in clinical signs, degree of dissemination of lesions and inflammation of the sebaceous glands occur over a wide range of dogs of different breeds and different representatives of the same breed. This disease has a common characteristic clinical manifestation: silvery-white dandruff and skin scales attached to the hair (called follicular casts) appear on the skin of the animal. Most likely, such follicular secretions are the result of an insufficient amount of secretion of the sebaceous glands entering the funnel (in it in long-haired breeds of dogs keratinization of the outer shell of the hair root occurs) of the hair follicles. Inflammation of the sebaceous glands has been most studied in the Samoyed Laika, Akita Inu, and the Standard Poodle. The first sign of the disease in these breeds is the appearance of leaf-shaped keratinized emissions from the hair follicles and the enveloping of the hair shaft with a strong layer of keratinized tissue debris. Removing the hairline reveals follicular emissions surrounding the hair roots. The spread of inflammation in the standard poodle often begins in the dorsal part of the muzzle and temporal region, then the disease spreads to the dorsal part of the neck and chest. Dogs of the Hovawart and Akita Inu breeds have more intense symmetrical numerous foci of alopecia. A characteristic feature of the pathological process is the tarnishing and brittleness of the dog's coat.
Lesions appear on the head, ears, dorsal surface of the neck, tail, and then spread along the midline of the animal's body along its dorsal side. This stage is characterized by not very pronounced itching of the skin. As the disease progresses, it can take on a generalized nature with complications of secondary bacterial folliculitis, which contributes to increased pruritus. This stage of the pathological process is accompanied by the appearance of an unpleasant odor.
In the Hovawart and the Belgian Shepherd Dog, this disease is often accompanied by inflammation of the outer ear, in which dry, sticky skin scales accumulate in the ear canal. The duration of the clinically significant stage of the disease can vary. There is no seasonal dependence of inflammation of the sebaceous glands.
Inflammation of the sebaceous glands manifests itself differently in short-haired dogs. The formation of nodules with arched or merging patches of baldness is noted, which give the coat the appearance of being eaten by a moth. Localization of numerous scattered skin scales occurs mainly on the body of the animal. In addition, cyclical edema of the muzzle manifests itself, which gives veterinarians a reason to attribute this form of inflammation of the sebaceous glands to an independent disease.
Diagnostics
The diagnosis of "inflammation of the sebaceous glands" can be established on the basis of the results of the clinical examination of the animal and the data of the anamnesis. Differential diagnosis excludes seborrheic dermatitis, primary seborrhea, dermatitis as a result of the body's reaction to vitamin A, a generalized form of demodicosis, dermatomycosichthyosis. It should be noted that inflammation of the sebaceous glands can proceed in a nodular form (with the formation of nodules), as a result of the development of bacterial folliculitis and furunculosis. In order to establish the final diagnosis, a skin biopsy is performed with a histological examination of the material obtained. Pathohistological changes in the skin of dogs with inflammation of the sebaceous glands are of various nature and depend on the duration of the course of the disease. The early stage of inflammation of the sebaceous glands in the narrowed part of the hair follicles (isthmus) is characterized by the appearance of individual perifollicular cells of the inflammatory infiltrate. Then a granulomatous, pyogranulomatous or nodular inflammatory reaction develops around the sebaceous glands. Sebocytes (secretory cells of the sebaceous glands) are destroyed, as evidenced by histological sections of skin biopsies. The spread of the inflammatory process to the apocrine sweat glands is blocked due to blockage of the hair follicles. Inflammatory infiltrates are composed of lymphocytes, neutrophils, and histiocytes. The ducts of hair follicles of dogs of long-haired breeds with this disease are usually blocked, manifested by pronounced orthokeratosis hyperkeratosis. In short-haired dogs, hyperkeratotic changes are not so severe. The full development of the pathological process is characterized by the destruction of the sebaceous glands, and the foci of the inflammatory reaction of the skin becomes smaller. Telogenization or atrophy of hair follicles occurs. The presence of a secondary staphylococcal infection contributes to purulent folliculitis or furunculosis.
Treatment
Since inflammation of the sebaceous glands does not significantly affect the overall health of the animal, if there are no complications of secondary pyoderma, which can be avoided with appropriate therapy. When determining the methods of treatment and the choice of medicines, they strive to balance the recommendations of specialists, financial costs with safety, simplicity and ease of performing medical procedures. The purpose of the treatment of inflammation of the sebaceous glands is to restore the barrier function of the skin, for which they remove any excess exfoliated debris of skin tissue, take preventive measures of secondary bacterial infections that contribute to improving the quality of the coat and restoring hair growth. Since there are no effective means of treating inflammation of the sebaceous glands yet, long-term treatment is necessary to improve the clinical condition. In the literature, various treatment regimens for inflammation of the sebaceous glands are given.
An effective way to treat inflammation of the sebaceous glands in dogs is the use of shampoos with an antiseborrheic effect, followed by rubbing oils into the skin, as well as the use of additional skin treatment with moisturizing sprays between the above procedures. The scheme of such a local treatment for inflammation of the sebaceous glands provois as follows:
Stage 1:
- The dog's skin is treated with a combined shampoo with sulfur and salicylic acid;
- The foamed shampoo is left on the skin of the animal for at least 10 minutes;
- The skin of the animal is massaged for a specified period of time with a soft brush to remove excess skin scales;
- The shampoo is thoroughly rinsed off and the skin is wiped off with a towel.
Stage 2: A preparation is rubbed into the skin and coat of the dog, based on a light mineral oil (for example, baby skin oil). The animal remains in this form for several hours.
Stage 3: The oil is removed by briefly washing it off with an antibacterial shampoo with mild cleaning properties.
At the final stage of the therapeutic treatment, a conditioner or a mixture of propylene glycol and water (50-70% propylene glycol) is applied to moisturize. This mixture can be periodically applied to the skin of the animal, alternately intensively rubbing the oil into it.
Treatment according to this scheme at the beginning of the course is carried out once or twice a week, and after the onset of improvement in the dog's condition, the frequency of treatments is reduced to once every two weeks. Systemic therapy is necessary in order to stop the further development of the inflammatory response of the skin and to stimulate the differentiation of keratinocytes.
It has been noted that the use of corticosteroid drugs in doses that provide them with an anti-inflammatory effect and immunosuppressive action in the treatment of some short-haired dog breeds provides a positive therapeutic effect in only a few cases.
Synthetic retinoids have anti-inflammatory properties, accelerate the differentiation of keratinocytes and suppress the secretory function of the sebaceous glands. The effective positive effect of these drugs in the treatment of inflammation of the sebaceous glands in dogs of the Vizsla breed, in contrast to other breeds, has been noted. Synthetic retinoids are prescribed to dogs by mouth at a dose of 1 mg per 1 kg of body weight 1-2 times a day. In most cases, an improvement in the patient's clinical condition is noted within 6 weeks of treatment, after which the frequency of taking synthetic retinoids is reduced.
In one of the experiments, dogs suffering from inflammation of the sebaceous glands were given vitamin A orally in doses ranging from 1 0 000 to 3 0 000 international units twice a day. An improvement in the clinical condition of patients was noted within three months. During long-term use of corticosteroids and retinoids, clinicians have noted side effects in dogs. That is why, in case of inflammation of the sebaceous glands, these drugs should not be chosen as therapeutic drugs if they do not provide complete recovery.
Administration of high doses of fish oil by mouth to dogs reduces the severity of clinical signs of sebaceous gland inflammation.
Cyclosporine is highly effective at a dose of 5 mg per 1 kg of animal body weight once a day. Among the advantages of cyclosporine egAbout safety and good tolerance, it effectively reduces the intensity of the perifollicular inflammatory infiltration process, which contributes to the destruction of the sebaceous glands, and increases the relative number of hair follicles with the sebaceous glands. Experience shows that treatment with this drug has the greatest effect at an early stage of the disease, during the intensive development of the inflammatory reaction. In cases of a chronic course of the disease, with atrophy and disappearance of all sebaceous glands, and the cessation of the inflammatory reaction, such treatment is less effective. This suggests that only those sebaceous glands that have not been completely destroyed have the ability to regenerate.
In the first four months of this treatment, in combination with additional local treatments, there is a decrease in the intensity of the formation of skin scales and a decrease in alopecia, at which time the general clinical condition of the dog and the quality of the coat are significantly improved. You may not be able to continue using cyclosporine as often. This drug also has the property of inducing hair growth, so it can also promote healing. Preliminary results from an experiment (not yet published) have shown that topical agents accelerate clinical improvement in dogs with inflamed sebaceous glands. Interestingly, intensive topical treatment (eg, as described above) appears to be clinically as effective as systemic cyclosporine. Realizing that an animal with this pathology has to be treated for life, it is important for the doctor to know himself and convince the owner of the sick dog that the treatment of inflammation of the sebaceous glands with the use of local therapy does not require such an investment of time, effort and expense as the treatment of possible complications ... In cases of long-term use of glucocorticoid drugs in high doses, severe side effects often develop.
In the perianal area of domestic animals, many types of tumors are likely to develop, such as lymphoma, squamous cell carcinoma, soft tissue sarcoma, melanoma, mastocytoma, melanoma and some others. But, in the overwhelming majority of cases, tumors develop either from the hepatoid glands ( adenoma and adenocarcinoma of the hepatoid glands), or from the apocrine glands of anal sacs ( adenocarcinoma of the apocrine glands of the anal sacs).
Hepatoid (perianal, circumanal) glands are located in the thickness of the skin around the anus, and are also scattered on the hairless areas of the skin of the prepuce, pelvic limbs and on the caudal surface of the tail root. The name "hepatoid glands" comes from the fact that the morphological structure of these glands resembles the structure hepatocytes, and these are regarded as nonsecreting sebaceous glands in adult dogs.
The apocrine glands of the anal sacs are located in the connective tissue surrounding the sacs, and secrete a secret into the cavity of the sacs. Anal sacs are paired blind cutaneous diverticula located on the side of the anus.
In cats, unlike dogs, there are no analogs to the hepatoid glands of dogs, therefore, adenoma and adenocarcinoma are not recorded in them. The only type of tumor in cats is adenocarcinoma of the apocrine glands of the anal sacs, which is extremely rare.
Table. Perianal tumors of dogs
|
Perianal glands |
Anal sacs |
||
|
Benign |
Malignant |
Malignant |
|
|
Cell type |
Apocrine |
||
|
Tumor type |
Perianal adenoma |
Perianal adenocarcinoma |
Adenocarcinoma of the anal sacs |
|
Often in intact males, very rarely in females. |
Low incidence |
||
|
Hormonal factors |
Males: Usually in intact dogs, testosterone-dependent |
||
|
Localization and appearance |
Hairless areas of the perianal region; single, multiple, or diffuse: may be localized on the prepuce and head of the tail. |
Usually single; may be invasive; often ulcerated. |
Subcutaneous at 4 and 8 o'clock, firm and fixed; primary tumors can be small in size with nodular metastases. |
|
Paraneoplastic syndrome |
No, (occasionally hypercalcemia). |
25% -50% - hypercalcemia. |
|
|
Metastasis pattern |
First - regional nodes, then to remote areas; the frequency of metastasis is up to 50%, especially with multiple local relapses. |
Usually to regional lymph nodes, then to distant sites. |
|
|
Special examination |
Not; in cytology, it is difficult to distinguish between benign and malignant formations. |
Abdominal imaging (radiography and / or ultrasound) focusing on the caudal abdomen chest radiography. |
Abdominal imaging (radiography and / or ultrasound): chest radiography; serum calcium levels and kidney function tests. |
|
Castration, conservative surgical removal ** |
Wide excision of the primary tumor and removal of the lymph node (if involved); postoperative radiation for residual microscopic lesions: radiation or chemotherapy if the lesions are inoperable; castration is of little use. |
Wide excision of the primary tumor and removal of the lymph node (if involved); postoperative radiation for the primary focus and regional lymph nodes, as well as chemotherapy. |
|
|
Forecasts |
Excellent, less than 10% relapse after castration. |
Excellent or good (for tumors<5 см в диаметре); характерны рецидивы, но они могут формируются через несколько месяцев и могут быть повторно прооперированы. |
Excellent; good in some cases (depending on stage and treatment). |
* If multiple, recurrent, or large (like in males), consider adrenal secretion of testosterone; signs of Cushing's disease are likely.
** Estrogens are capable of causing tumor regression, well, they carry the risk of bone marrow suppression. Adenoma may respond well to radiation, but surgery is cheaper, faster, and safer. The application of cryosurgery and electrochemotherapy is described.
A source. Withrow and MacEwen "s Small Animal Clinical Oncology - 5th edition
Morbidity and risk factors
Perianal adenoma is a benign tumor that develops from the circumanal (hepatoid) glands, accounting for 58% -96% of all perianal tumors in dogs; it is not recorded in cats due to the absence of hepatoid glands. The development of the tumor is hormone-dependent, the growth of neoplasms is stimulated by androgens, while estrogens, on the contrary, inhibit. The average age of the development of the disease is 10 years, in the overwhelming majority of cases it is observed in intact males, it is likely to develop in castrated females, due to the reduced level of estrogen in the body. Rarely, the production of testosterone by the adrenal glands can cause tumor growth. Probably a breed predisposition in the Cocker Spaniel, Bulldog and Samoyed.
Perianal adenocarcinoma is a malignant tumor of the hepatoid glands, accounting for 3% to 21% of all perianal tumors. The average age at development of the disease is 11 years. Unlike adenoma of the hepatoid glands, with adenocarcinoma there is no dependence on the influence of androgens, and this type of tumor is recorded with the same frequency in both males and bitches. A predisposition is likely in giant breed dogs.
Adenocarcinoma of the apocrine glands of the anal sacs is an aggressive tumor originating from the aforementioned glands. It makes up about 17% of all neoplasms of the perianal region of dogs; not numerous cases of adenocarcinoma have been described in cats (about 0.5% of all neoplasms of the skin and subcutaneous tissue). The average age of development of the disease in dogs is 9-11 years, in cats - 12 years. Probable breed predisposition in English Cocker Spaniel and Siamese cats. The disease can manifest itself at 5 years of age in dogs and 6 years of age in cats.
Pathology and behavior
Perianal adenoma is a benign tumor with appropriate behavior, is characterized by slow growth, can reach considerable size and ulcerate, but does not metastasize. Perianal adenocarcinoma metastasizes quite rarely; at the time of diagnosis, metastases are found in 15% of cases. Presumably, metastases in adenocarcinoma form later, when the primary tumor becomes larger and more invasive. Adenocarcinoma often metastases to the regional sub-lumbar and pelvic lymph nodes, distant metastases are rare and can affect the lungs, kidneys and bones. The histological distinction between these two tumors (adenoma and adenocarcinoma) is not always defined.
Adenocarcinoma of the apocrine glands is characterized by aggressive behavior and differs significantly from adenocarcinoma of the hepatoid glands both clinically and histologically. At the time of diagnosis, metastases are formed in 46% 96% of cases. Lesions are often one-sided, in rare cases they can be bilateral. The characteristic sites for the development of metastases are regional lymph nodes (sub-lumbar and pelvic), while the size of the primary tumor can be less than 0.5-1 cm in diameter, while metastases in the lymph nodes can reach significant sizes. Distant metastases are more often formed in the lungs, liver, spleen, bones, less often in the heart, adrenal glands, pancreas, kidneys and mediastinum. An increase in calcium levels as a variant of paraneoplastic syndrome is noted in 27% of cases.
Due to the rare incidence of apocrine gland adenocarcinoma of anal sacs in cats, biology and behavior are not clearly defined.
Clinical signs
The history of the disease with adenoma of the hepatoid glands is characterized by slow growth (from months to years), single or multiple formations, solid, 5-3 cm in diameter. The characteristic localization is around the anus, but can also develop at the root of the tail, prepuce, scrotum and groin. The lesions can become infected and appear, but invasion into the underlying tissues is not typical.
In perianal adenocarcinoma, the symptoms are similar to those in adenoma, but there is more rapid tumor growth and invasion of the surrounding tissues and underlying structures. With a significant size of primary mass formations or metastases of regional lymph nodes, a history of defecation disorders (constipation, pain, dyschezia) is likely.
Signs of adenocarcinoma of anal sacs can be associated with a primary tumor (tenderness in the perianal region, swelling, bleeding, licking), with obstruction of the pelvic canal with tumor metastases (tenesmus, constipation), or hypercalcemia (polydipsia / polyuria, anorexia, lethargy, vomiting). Also, a sign of disruption of the musculoskeletal system is likely, with the formation of metastases in the bones. In cats with adenocarcinoma of the anal sacs, the main features are more often associated with the primary tumor.
Diagnostics
The history of the disease and the characteristic appearance of adenoma and adenocarcinoma of the hepatoid glands allow a presumptive diagnosis of a high degree of probability. Due to the fact that it is not always possible to distinguish between these types of tumors histologically, much attention is paid to the history of the disease, for example: the development of neoplasms in non-castrated males is more characteristic of adenoma, and the development of a tumor in a castrated male and non-neutered bitches is more characteristic of adenocarcinoma. If adenocarcinoma is suspected, work is carried out to determine the probable metastasis - rectal examination of the pelvic and sub-lumbar lymph nodes, visual examination (radiography ± ultrasound) of the thoracic and abdominal cavities. Cytological examination reveals typical hepatoid cells.
In adenocarcinoma of the apocrine glands of the anal sacs, the primary complaints may not be associated with perianal disease (eg polyuria / polydipsia due to hypercalcemia), the examination of the animal requires a thorough rectal examination, visual examination of the abdominal and thoracic cavities, as well as a biochemical blood test. When identifying metastases in the lymph nodes and abdominal organs, ultrasound has some advantages over radiographic examination. CT and MRI can provide more complete data on the presence and nature of metastases. A presumptive diagnosis of a high degree of probability is made on the basis of the detection of solid discrete masses in the area of \ u200b \ u200bthe anal sacs, together with suitable clinical signs. The final diagnosis is based on the pathomorphological and / or cytological examination of the samples.
Adenocarcinoma of anal sacs in cats is diagnosed similarly to those of canine neoplasms.
Differential diagnosis
Other benign and malignant formations of the perianal region (lymphoma, squamous cell carcinoma, soft tissue sarcoma, melanoma, transmissible venereal sarcoma, mastocytoma, melanoma, lipoma, fibroma, trichoepithelioma and some others).
Perianal fistula.
Perianal abscess.
Diseases of the anal sacs (with adenocarcinoma of the anal sacs).
Treatment
With adenoma of the hepatoid glands, it is the method of choice, due to androgenic dependence perianal adenoma, the vast majority of tumors regress. Surgical excision may be recommended in males with progressive growth and ulceration of the neoplasm, in recurrent tumors, and in females. In addition to conventional surgical excision techniques, cryosurgery and laser ablation can be used for local lesions less than 2 cm in size. Irradiation and hyperthermia are quite effective for adenoma of the hepatoid glands, but they are rarely used due to the high cost and the likelihood of various complications.
In adenocarcinoma of the hepatoid glands, aggressive surgical excision is used with adequate capture of the surrounding tissue. With the involvement of the sphincter, removal of half of it or a little more leads only to temporary and passing problems of defecation. Due to the tendency for adenocarcinoma to recur locally, multiple palliative resections may be required over several years. After surgery, radiation or chemotherapy may be given, but the effectiveness of these methods has not been definitively determined. Surgical excision of the lymph nodes can be used as a palliative measure.
In adenocarcinoma of the apocrine glands of the anal sacs, the method of choice is aggressive surgical excision of the tumor together with the regional lymph node (with involvement and operability). Radiation and / or chemotherapy is used both postoperatively and as the only treatment, but the effectiveness of these methods has not been precisely determined.
Forecasts
With adenoma of the hepatoid glands, most dogs respond well to castration ± local surgical excision.
With adenocarcinoma, the prognosis largely depends on the stage of the disease, complete excision of small lesions can lead to complete recovery, but this type of tumor is prone to local recurrence and repeated excisions of the formations are likely to be carried out over several months or years.
With complete excision of adenocarcinoma of the anal sacs and the absence of metastases, the prognosis is from favorable to cautious. When identifying metastases, long-term prognosis is poor. Hypercalcemia is resolved with complete removal of the tumor, a recurrence of hyperalcemia is indicative of either tumor recurrence or the formation of metastases.
Photo1.12 year old male labrador retriever, formation near anus, presumably perianal adenoma. Castration was chosen as a method of treatment.
Photo 2. 13 year old male crossbreed, the owners turned to the veterinary clinic for an ulcer below the anus, a close examination revealed several formations. Castration is proposed as a method of treatment.
Valery Shubin, veterinarian, Balakovo
Text of the article and photos 1-5 from the manual SMALL ANIMAL DERMATOLOGY A COLOR ATLAS AND THERAPEUTIC GUIDE 2017
Translation from English: veterinarian Vasiliev AB
Peculiarities
Tumors of the perianal glands in dogs are usually benign tumors arising from the hepatoid glands, possibly due to androgenic stimulation. Perianal adenomas commonly occur in older, non-castrated male dogs and are uncommon in female and neutered male dogs. Perianal adenocarcinomas are rare and equally common in older male and female dogs, regardless of castration status.
Adenomas are single or multiple, slowly growing, hard, round or lobular cutaneous nodules of variable size that may ulcerate. Tumors usually occur near the anus, but may also occur on the tail, perineal or prepuce, or may appear as a diffuse raised ring of tissue around the anus. Perianal adenocarcinoma looks similar to adenoma but tends to grow and ulcerate more rapidly.
Diagnosis
1 Cytology: Clusters of large, round or polyhedral hepatoid epithelial cells that contain abundant pale blue cytoplasm, round or oval nuclei, and one or two nucleoli. A second population of smaller epithelial "reserve" cells is also often present. Adenocarcinomas cannot be reliably differentiated cytologically from adenomas.
2 Dermatohistopathology: lobules of polygonal cells resembling hepatocytes, with abundant eosinophilic cytoplasm with small vacuoles and a central rounded nucleus. Each lobule is surrounded by a ring of reserve cells. Squamous metaplasia may occur. In adenomas, mitotic figures are rarely observed. Adenocarcinomas look similar to adenomas, but have increased anisocytosis / anisocaryosis and frequent mitotic figures.
Treatment and prognosis
1 In non-castrated male dogs, neutering and removal of tumors is the treatment of choice for most perianal adenomas.
2 For large or diffuse benign lesions, initial castration and waiting for several months for tumor shrinkage are indicated in order to remove the tumor more easily and safely.
3 Surgical removal is also indicated for adenomas in female or neutered male dogs.
4 Cryotherapy or laser ablation may be helpful for adenomas smaller than 1–2 cm in diameter.
5 Estrogen therapy can reduce tumor size but can cause fatal bone marrow suppression and is therefore not recommended.
6 Perianal adenocarcinomas will not regress after castration and complete removal of the tumor by surgery is the treatment of choice. Radiation therapy or chemotherapy can slow the progression of the disease if tumors are not completely removed.
7 Recurrence of adenomas after castration or resection requires exclusion of possibly underlying hyperadrenocorticism.
8 The prognosis for perianal adenomas is good because tumors are benign and usually do not recur after castration. The prognosis for perianal adenocarcinomas is cautious to questionable, since recurrence with local invasion after surgery or metastasis may occur, most often in regional (peri-lumbar or pelvic) lymph nodes, liver and lungs. Dogs with adenocarcinomas larger than 5 cm and dogs with metastases have a poorer prognosis at the time of diagnosis and may only live for a few months.
Photo 1. Tumors of the perianal glands in dogs... Elongated, pedunculated tumor in the perianal region in an elderly Cocker Spaniel.
Photo 2. Tumors of the perianal glands in dogs... Ulcerated node in the perianal region in an elderly Cocker Spaniel.
Text of the article and photo from the book
SMALL ANIMAL DERMATOLOGY
A COLOR ATLAS AND THERAPEUTIC GUIDE
KEITH A. HNILICA, DVM, MS, DACVD, MBA 2011
Translation from English. veterinarian Vasiliev AB
Peculiarities
Nodular hyperplasia of the sebaceous glands, epithelioma of the sebaceous glands and adenoma of the sebaceous glands are benign tumors of the secretory cells of the sebaceous glands. They are common in older dogs, with the highest prevalence in poodles, cocker spaniels, pygmy schnauzers and terriers (sebaceous adenoma / hyperplasia) and in Shih Tzu, Lhasa apso, Siberian huskies and Irish terriers (sebaceous epithelioma). Benign tumors of the sebaceous glands are uncommon in older cats, with a possible predisposition in Persian cats. Sebaceous adenocarcinomas are rare cancers in older dogs and cats. Among dogs, Cocker Spaniels are predisposed.
Benign tumors of the sebaceous glands of dogs and cats are usually solitary, hard, raised, cauliflower-like or warty-looking and range from a few millimeters to several centimeters in diameter. Lesions may be yellowish or pigmented, hairless, oily, or ulcerated. Nodules with hyperplasia of the sebaceous glands can be multiple. Sebaceous adenocarcinomas tend to appear as solitary, hairless, ulcerated, or erythematous intradermal nodules, less than 4 cm in diameter, that invade the subcutaneous tissue. Tumors of the sebaceous glands of dogs and cats are most common on the trunk, paws, head and eyelids in dogs and on the head in cats.
Diagnosis
1 Distinct wart or cauliflower growth
2 Cytology:
Sebaceous hyperplasia / adenoma: Cells slough off in clusters and look similar to normal sebaceous gland cells with a foamy, pale blue cytoplasm and small dark nucleoli.
Sebaceous epithelioma: small, homogeneous, sometimes melanotic epithelial cells with few sebaceous gland cells.
Carcinoma of the sebaceous glands: extremely basophilic basal cell type with nuclear and cellular pleiomorphism.
3 Dermatohistopathology:
Sebaceous gland hyperplasia: multiple enlarged mature lobules of the sebaceous glands with one peripheral layer of basaloid germ cells and a central duct. Mitotic figures are not observed.
Sebaceous adenoma: Similar to hyperplasia, but with increased numbers of basaloid germ cells and immature sebaceous gland cells. Low mitotic activity and loss of organization are visualized around the central duct.
Sebaceous epithelioma: multiple lobules of basaloid epithelial cells interspersed with reactive collagenous tissue and secondary inflammation. Early high mitotic activity is observed. There may be scattered areas of differentiation of sebaceous gland cells, squamous metaplasia or melanization.
Adenocarcinoma of the sebaceous glands: poorly defined lobules of large epithelial cells with varying degrees of differentiation and cytoplasmic vacuolization. The nucleoli are large and the mitotic activity is moderately high.
Treatment and prognosis
1 For benign tumors of the sebaceous glands of dogs and cats, observation without treatment is advisable
2 Surgical removal (laser ablation or cryosurgery) of benign sebaceous gland tumors is usually indicated and sufficient for cosmetically unacceptable tumors or tumors
That bother the animal.
4 The forecast is good. Benign tumors of the sebaceous glands of dogs and cats do not invade locally, do not metastasize, and rarely recur after surgical removal. Sebaceous adenocarcinomas locally infiltrate surrounding tissues and sometimes involve regional lymph nodes, but distant metastasis is rare.
Photo 1 Tumors of the sebaceous glands of dogs and cats... This adenoma of the sebaceous glands on the nose shows the characteristic appearance of "cauliflower"
Photo 2 Tumors of the sebaceous glands of dogs and cats... This adenoma of the sebaceous glands persisted for several years with poor progression.
Photo 3 Tumors of the sebaceous glands of dogs and cats... This adenoma of the sebaceous glands on the auricle demonstrates the characteristic size and shape of these tumors.
Loading ...