Case Study

Transitional cell carcinoma of the trigone and prostate is suspected in a 9 year old MN Shetland Sheepdog with hematuria

A 9-year-old neutered male Shetland Sheep dog was presented for evaluation of urine dribbling urine and hematuria.

A 9-year-old neutered male Shetland Sheep dog was presented for evaluation of urine dribbling urine and hematuria.

Sonographic Differential Diagnosis

The mineralizing prostatic mass enters into the urethra, which is suggestive of transitional cell carcinoma or prostatic carcinoma. Ultrasound-guided FNA of the prostate or ultrasound-guided traumatic catheterization would be recommended. Eventual urethral stent placement can also be considered, which would allow for interventional radiology and chemotherapy (via fluoroscopy at an interventional radiology facility).

Image Interpretation

The urinary bladder in this patient was normal cranial to the cystourethral junction. However, a mass was noted in the proximal urethra, which is consistent with transitional cell carcinoma. The mass also involved the prostate and measured 3.25 x 2.76 cm. It was difficult to ascertain whether the mass is deriving from the prostate or urethra. Power Doppler flow signals were significant in this patient, which is suggestive of increased vascularity of the mass.

DX

Prostatic mass and urethra, mineralizing. Prostatic carcinoma vs transitional cell carcinoma

Outcome

The patient was euthanized.

Clinical Differential Diagnosis

Bladder disease – neoplasia, uroliths, cystitis. Prostatic disease – neoplasia, abscess. Urethral disease – neoplasia, uroliths, granulomatous reaction.

Sampling

None. However, ultrasound-guided traumatic catheterization or FNA would be warranted for a tissue diagnosis. (In my experience, no overt tissue seeding of neoplastic cells has occurred with this procedure.)