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Surgical treatment of transmissible venereal tumor (sticker sarcoma)
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Background: Sticker sarcoma, also called venereal sarcoma or venereal lymphosarcomatosis, is a tumor of the external genital organs in females and males. In male animals the penis and foreskin (prepuce) are affected, in the female, it happens in vagina (vagina) and labia (vulva). The diagnosis of sticker sarcoma is based on the chronic discharge, the typical locations and the characteristic appearance of the tumor. Methods: We have relied on the treatment method on the complete surgical removal of all cancer cells that we can access. Results: After surgery, we notice recurrent tumors about six months after surgical treatment, indicating the need for other treatments in addition to surgery. Conclusion: Although spontaneous regressions of sticker sarcoma are documented (with permanent immunity), chemotherapy is the treatment of choice today. Irradiation should also be effective. If the tumor is only removed surgically, there is a high rate of recurrence, and this is what happened with the case that we treated, as the tumor reappeared after less than six months.
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... In relation to gender, female dogs showed a higher occurrence (88.59%) than males (11.41%). This was in accordance with Florez et al. (2012), Hithem et al. (2020) and Priyadarshini et al. (2021). Honparkhe et al. (2010) reported higher occurrence in female dogs (56%) than male dogs (42%). ...
... Breed-wise occurrence of CTVT was reported to be highest in Labrador Retrievers (41.30%) followed by non-descript dogs (22.28%) ( Table 2). The CTVTs are commonly observed in stray dogs or freely roaming dogs or wild dogs with unrestricted sexual activity (Hithem et al., 2020). Bakhodirovich and Bobokulovich (2022) reported higher incidence of CTVT in mongrel dogs (21%) followed by German Shepherd dogs, Spaniels, Dobermann and Labrador Retriever dogs. ...
Canine transmissible venereal tumour (CTVT) is the most common neoplasm of the genital sites transmitted through allogenic transplantation of tumour cells during coitus or at extragenital sites like oral or nasal mucosa by licking, scratching or sniffing affected area. In this study the overall occurrence of CTVT and its occurrence was analysed based on breed, age, gender, parity, season, reproductive status and breeding history, collected from retrospective data of clinical records maintained at University Veterinary Hospitals. The overall occurrence of CTVT was 0.15 per cent among total presented cases, 0.88 per cent among total reproductive disorders, 21.42 per cent among total canine tumour cases and 4.74 per cent among cases with vaginal bleeding. Higher occurrence was recorded in female dogs (88.59%), dogs aged 2-5 years (73.91%), intact females (88.04%), pluriparous dogs (41.10%) and during south-west monsoon season (32.07%). Breed wise occurrence was higher in Labrador Retriever dogs (41.30%) followed by non-descript dogs (22.28%). Occurrence was higher in dogs with history of mating with stud dogs (81.60%) when compared to stray dogs (18.40%).
... Because rapid tumor growth and metastasis can be seen in dogs whose immune system is suppressed (Chikweto et al., 2013). It is primarily found in dogs with a weakened immune system in the southern regions, especially in the Mediterranean (Hithem et al., 2020). Compromised immune system plays a major role in acquiring and spreading of TVT (Das et al., 2020). ...
... Incidence is high in urban areas where mating of young and sexually active stray dogs is not controlled (Hayes et al., 1983;Rogers, 1997;Das and Das, 2000;Gurel et al., 2002). Stray dogs are at risk factor for contracting and transmitting this disease (Hithem et al., 2020). It occurs mostly in tropical and subtropical climates (Hayes et al., 1983;Rogers, 1997;Uçar, 2016). ...
Transmissible venereal tumor (TVT) is a round cell type neoplasia that is transmitted by mating and physical transfer of tumor cells. It is one of the most common benign tumors in dogs that can be seen in both gender. The external genital area is the main location of the tumor. However, internal organ metastasis has been reported. The most common clinical signs are lobular masses which are seen in the caudal part of the penis, in the posterior region of the vagina and at the vestibulovaginal junction. Nodular lesions with rapid bleeding are the most pronounced clinical finding. Initially, the small tumor forms into a large ulcerated mass in the next periods. Simultaneously, the volume of the tumor increases and the lesions are seen multilobular, cauliflower-like, brittle, hyperemic, and hemorrhagic. The most practical diagnostic method of the tumor is vaginal cytology. Cytology findings are characterized by the round or oval cells which have, pale blue or colorless cytoplasm with cytoplasmic vacuoles and a prominent nucleus. Chemotheraphy is the most effective treatment method. The weekly intravenous administration of vincristine suplhate given for 3 weeks on average reveals that the treatment success rate is beyond 90%. In this review, etiology, clinical findings, diagnosis and treatment of TVT are presented .
... Pada kasus ini, massa tumor ditemukan pada caudal vagina hingga superficial vulva dengan diameter sekitar 6 cm disertai tetesan darah dan lama pertumbuhan tumor adalah delapan bulan (Gambar 1). Anjing liar merupakan faktor risiko tertular dan menularkan penyakit TVT (Hithem et al., 2020). Hubungan seksual dengan anjing penderita dianggap sebagai jalur penularan TVT utama (Hantrakul et al., 2014). ...
Transmissible Venereal Tumor (TVT)adalah tumor umum pada anjing yang ditularkan melalui perkawinan, jilatan, atau mengendus lesi tumor anjing penderita. Tujuan penulisan artikel ini adalah untuk mengungkapkan keberhasilan penanganan TVT pada anjing kacang melalui metode pembedahan dan kemoterapi. Anjing lokal/kacang betina berumur enam tahun dengan bobot badan 8,7 kg datang dengan keluhan adanya massa pada vagina disertai tetesan darah. Hasil pemeriksaan histopatologi menunjukkan adanya sel-sel tumor berupa sel-sel limfoblas homogen polyhedral tersusun dalam stroma dengan indeks mitosis tinggi yang teridentifikasi sebagai TVT. Penanganan dilakukan dengan eksisi massa tumor dan kemoterapi dengan vincristine sulfate 0,025 mg/kg bb secara intravena diberikan seminggu pascaoperasi sebanyak empat kali berturut-turut dengan interval waktu satu minggu. Pascaoperasi diberikan injeksi antibiotik cefotaxime 20 mg/kg bb, q12h intravena selama tiga hari, dilanjutkan dengan cefixime 10 mg/kg bb, q12h per oral selama lima hari. Analgesik asam tolfenamat 4 mg/kg bb, q24h diberikan selama tiga hari pascaoperasi. Tetesan darah berhenti setelah tiga hari dan luka insisi tertutup pada hari ke-7 pascaoperasi. Pada hari ke-35 terlihat luka mengering, ukuran kelamin kembali normal, tidak ada tetesan darah, serta nafsu makan dan minum baik, dengan ini disimpulkan bahwa penanganan kasus TVT dengan metode eksisi disertai kemoterapi memberikan hasil yang baik terhadap kesembuhan pasien.
Canine transmissible venereal tumor (CTVT) is a contagious neoplasm, mainly transmitted through coitus. This round cell mesenchymal tumor is common in Brazil, often located in the genitalia although extragenital presentations may also occur, such as cutaneous, oral, and nasal forms. The objective of this study was to perform an epidemiological analysis of CTVT from published data in the recent academic literature to systematically demonstrate the distribution of CTVT in Brazil, identify the frequency of this neoplasm and its main diagnostic tests, and characterize its main clinical manifestations in Brazil. For such purpose, it was analyzed the scientific publications with cases of CTVT in Brazil, in English or Portuguese, published between 2000−2020. The CTVT was identified in 19 Brazilian states plus the Federal District, totaling 3,622 cases across the national territory, with the largest number of cases recorded in the Southeast region. The cytological exam was the most used for the diagnosis of CTVT (89.2 %), followed by histopathological (37.8 %) and immunohistochemistry (13.5 %)¹. Predominant epidemiological aspects of CTVT identified in the study were: Mixed breed dogs (75.2 %), females (62.5 %), in adulthood (between 2 and 7 years) and dogs with free extra outdoor access (91.1 %). Genital presentation was the most frequent in the literature (86 %), followed by cutaneous (21.8 %), nasal (10 %), oral and lymph nodes presentations (10−5 %) and less frequent manifestations as ocular and anal/perianal (< 5 %). CTVT is a neoplasm widely distributed in Brazil, highly frequent and with several forms of clinical presentation, which can be underdiagnosed if there is no adequate knowledge of this tumor and its epidemiological characteristics. The extragenital manifestations of the neoplasm need further studies for its better characterization and more precise definition of its frequencies.
To evaluate recurrence rate and disease-free interval (DFI) of dogs with low-grade soft tissue spindle cell sarcoma of the extremities treated by marginal excision.
Retrospective study.
Dogs (n=35) with soft tissue low-grade spindle cell sarcoma.
Medical records were reviewed and dogs that had marginal surgical resection of low-grade soft tissue spindle cell sarcoma at or distal to elbow and stifle were included.
Histopathologic margins were dirty (12 dogs), clean but close (12), and clean (11). Follow-up after surgery occurred from 210 to 2202 days (minimum, 180 days). Local recurrence and metastatic rates were 10.8% and 0%, respectively. Median DFI and survival time were not reached, because <50% of dogs died of disease-related events. Mean DFI and mean survival time were 697.8 days (95% CI: 559.7-836 days) and 703.5 days (95% CI: 566.6-840.5 days), respectively. There were no significant differences among survival functions stratified by histologic margins.
Marginal surgical excision without adjuvant treatment of low-grade soft tissue spindle cell sarcoma of the extremities results in a low local recurrence rate.
Low-grade spindle cell sarcomas located at or distal to the elbow and stifle joints can be excised without need for wide or radical surgery.
One hundred eighty seven dogs from which fibrous connective tissue sarcomas had been excised were studied until death or for at least 3 years after surgery. Dogs with a skin fibrosarcoma had a median survival time of 80 weeks, compared with 140 weeks for animals with haemangiopericytoma in similar sites, this difference being statistically significant. However, the difference in survival time between the two histologic types disappeared when tumours with a similar mitotic index were compared. Dogs with a tumour of mitotic index 9 or more had a median survival time of 49 weeks, compared with 118 weeks for those with a tumour of mitotic index less than 9, regardless of tumour morphology. Tumour recurrence rates of 62% and 25% respectively for the two groups were also significantly different.
To evaluate efficacy of radiation for treatment of incompletely resected soft-tissue sarcomas in dogs.
Prospective serial study.
48 dogs with soft-tissue sarcomas.
Tumors were resected to < 3 cm3 prior to radiation. Tumors were treated on alternate days (three 3-Gy fractions/wk) until 21 fractions had been administered. Cobalt 60 radiation was used for all treatments.
Five-year survival rate was 76%, and survival rate was not different among tumor types or locations. Four (8%) dogs developed metastases. Eight (17%) dogs had tumor recurrence after radiation. Development of metastases and local recurrence were significantly associated with reduced survival rate. Median survival time in dogs that developed metastases was 250 days. Median disease-free interval for all dogs was 1,082 days. Median time to recurrence was 700 days. Dogs that developed recurrence after a prolonged period responded well to a second surgery. Acute radiation toxicosis was minimal; osteosarcoma developed at the radiation site in 1 dog.
An excellent long-term survival rate may be achieved by treating soft-tissue sarcomas in dogs with resection followed by radiation. Amputation is not necessary for long-term control of soft-tissue sarcomas in limbs. Development of metastases and recurrence of local tumors after radiation treatment are associated with decreased survival rate. Acute and delayed radiation toxicosis was minimal with the protocol used in this study.
Soft-tissue sarcomas develop from a variety of mesenchymal tissues, but they are often considered collectively, due to similarity in clinical behavior and histologic features. These tumors are locally invasive, with poorly defined histologic margins and neoplastic cells that often infiltrate through fascial planes. In general, local recurrence is common following conservative excision. Pretreatment biopsy provides information on tumor type and grade, which will allow the clinician to properly plan for an aggressive first surgery. Adopted from human medicine, the canine histopathologic grading system is predictive. Specifically, mitotic rate is predictive for metastasis, and necrosis and mitotic rate are predictive for survival. Diagnostic imaging is useful to determine the extent of disease and for treatment planning. The most effective treatment for soft-tissue sarcomas is surgical excision. Surgery with curative intent requires preoperative biopsy, planning, and a wide first excision. Increasingly, surgery is being replaced by a combined-modality approach. Radiation therapy plays an important role in the management of soft-tissue sarcomas, but it has little role as a single treatment modality. Radiation therapy is appropriate for incompletely excised tumors or for preoperative treatment. Chemotherapy's role is most appropriate in the adjunct setting, and is mainly used to treat incompletely resected tumors, high-grade tumors, and metastatic disease.
Soft-tissue sarcomas are a heterogeneous group of tumors with similar biological behaviors. Wide surgical excision remains the cornerstone of treatment for these tumors. Local recurrence is common following conservative resection, and recurrent tumors are more difficult to treat. Radiation therapy or re-excision with wider margins is indicated if excision is microscopically incomplete. Chemotherapy is often recommended as an adjunctive treatment for high-grade soft-tissue sarcomas because of their higher metastasis rates when compared to low-or intermediate-grade soft-tissue sarcomas. Knowledge of extent of disease and histological grade is helpful in guiding treatment choices.
For this review of surgery in soft tissue sarcoma, we reviewed literature and added our personal experience. In front of a soft tissue tumour, the major objective is to think it could be a sarcoma. Diagnosis actually is made by core needle biopsies, but sometimes a surgical biopsy is needed. Surgical resection is better defined since ten years and distinguishes resection R0 (in sano), R1 (microscopic residual disease) and R2 (macroscopic residual disease). Quality of resection is determined collegially by confrontation of surgical and pathological reports according recommendations of the French Sarcoma Group (FSG). The risk of local recurrence depends on resection-type and tumour grade. With the help of the surgical classification from FSG, local prognosis is better understood and treatment can be adapted to individual tumours. In experienced hands, local recurrence can be pushed down to near 10 against 20% formerly. Severe complications after sarcoma surgery occur in 14% of cases. Functional outcome studies have benefited from new scoring systems, which complete each other. Isolated limb perfusion is a method that could save limbs in some desperate situations. Conclusion: Due to rarity and treatment specifications, soft tissue sarcoma should be treated in specialised centres.
To determine the efficacy of primary re-excision alone for treatment of soft tissue sarcomas after recent incomplete resection, the frequency and clinical importance of detecting residual tumor in resected scars, and prognostic factors associated with the procedure.
Retrospective case series.
41 dogs.
Medical records of dogs that had undergone recent incomplete excision of a soft tissue sarcoma at a referring veterinary practice and subsequent re-excision of the scar at the Colorado State University Veterinary Medical Center were reviewed. Owners and referring veterinarians were contacted for follow-up information. Slides from re-excised specimens were reviewed. Dogs that underwent radiation therapy after the re-excision procedure were excluded.
41 dogs met the inclusion criteria, and long-term follow-up information was available for 39 dogs. Median follow-up time was 816 days. Local recurrence of tumor developed in 6 of 39 (15%) dogs, and distant metastasis occurred in 4 of 39 (10%) dogs. Healthy tissue margins of 0.5 to 3.5 cm were achieved at re-excision. Residual tumor was identified in 9 of 41 (22%) resected scars. No tumor-, patient-, or treatment-related variables were associated with local recurrence except for the presence of liposarcoma or fibrosarcoma or whether fine-needle aspiration had been performed prior to surgery.
After incomplete resection of soft tissue sarcomas, resection of local tissue should be performed, even if excisable tissue margins appear narrow. A long-term favorable prognosis is achievable without radiation therapy or amputation. The presence of residual tumor in resected scar tissue should not be used to predict local recurrence.
- J Bangl
Bangl. J. Vet. Med. (2020). 18 (1): 25-29
ISSN: 1729-7893 (Print), 2308-0922 (Online)
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