Case Study

CT – Prostatic adenocarcinoma or transitional cell carcinoma (TCC) with metastases in a 14 year old MN Jack Russell Terrier

This 14 year old Jack Russell Terrier has a history of abdomninal mass in the caudal pelvic region causing possible urethral obstruction.

PE: Corneal changes right eye; painful caudal abdomen, uncomfortable on rectal, prostatic urethra palpates thickened.

Chem: mildlh elevated BUN and ALKP

This 14 year old Jack Russell Terrier has a history of abdomninal mass in the caudal pelvic region causing possible urethral obstruction.

PE: Corneal changes right eye; painful caudal abdomen, uncomfortable on rectal, prostatic urethra palpates thickened.

Chem: mildlh elevated BUN and ALKP

Image Interpretation

CT of the abdomen and thorax –

Abdomen:

The prostatic gland presents marked irregular enlargement at 3 x 3.2 x 2.6 cm, the organ surface is ill-defined, multifocal parenchymal mineralization is noted as well as moderate non-uniform contrast enhancement. The enlarged prostate exerts a mass effect on the descending colon that is displaced dorsally. The normal fat in-between the prostatic gland and the urinary bladder is lost. The prostatic mass lesion cannot be delineated from the urinary bladder neck. The wall of the urinary bladder presents severe irregular focal thickening at the urinary bladder neck blending into the region of the vesical trigone as well as moderate generalized thickening with irregular luminal surface. Moderate bilateral pyelectasia is noted as well as moderate proximal and mild distal ureteral dilation. Both kidneys present mild generalized enlargement.The renal cortex of both kidneys reveals multiple small cystic lesions without contrast enhancement. In the gallbladder irregular mineral attenuating gravity dependent roundish concrement that is visible on the ventral wall, approximately 6mm in diameter.

Thorax:

Multifocal interstitial pulmonary nodules of varying size are noted throughout all lung lobes.

DX

The findings are consistent with a prostatic adenocarcinoma or transitional cell carcinoma of the prostatic gland with infiltrative growth into the urinary bladder wall and bilateral partial ureteral obstruction as well as metastatic spread into the lung

Outcome

If final confirmation of the diagnosis is warranted ultrasound guided prostatic wash or traumatic catheterization may be considered. However, the computed tomographic changes noted here are known to be pathognomonic. The prognosis for the dog is poor. Further ureteral obstruction and development of hydronephrosis has to be expected. The dog may benefit from palliative treatment with meloxicam to decelerate tumor growth. The ability of active micturition needs to be
ensured.