prostatic carcinoma

Jakob, 8 yo MC Beagle

History Diagnosed with prostatic carcinoma 8/26/10 by

cytology from ultrasound guided prostatic aspirate done by an internist in Richmond. Originally presented to rDVM for abdominal/hind end pain.

Referred to NCSU Oncology for further evaluation & treatment on 8/30/10. Chest radiographs were clear. A focused ultrasound was done for baseline pre-treatment measurements and showed extension of the mass into the urethra.

Chemotherapy protocol of Mitoxantrone and Piroxicam was initiated at the initial visit.

Jakob has received regular recheck chest radiographs and abdominal/focused ultrasounds approximately every 1.5 mo to monitor his disease and response to treatment

Significant Clinical & Laboratory Findings

2/14/11: Physical Exam

TPR: WNLCVR: audible low 3rd heart sound (hx of mild

MR & TR, mild-mod AR/endocardiosis)ABD: Mild hepatomegalyRectal: Prostate firm and bliaterally enlarged

(R>>L), non-painful on palpation, anal sacs normal, normal stool

CBC: WNL

Focused Prostatic Ultrasound

Mineralization

Mineralization

Prostate Right Transverse

Prostate & Urethra

Prostate Tracing

Prostate Tracing

Thoracic Radiographs

Thoracic Radiographs

Assesment Prostate has increased in size <10% =

stable disease…..

EXCEPT……Thoracic radiographs showed new nodules

=progressive disease

1/10/11 2/14/11

X-sectional area sagittal (cm2)

12.78 13.2

X-sectional area transverse (cm2)

12.2 13.2

Length-sagittal (cm) 4.3 4.6

Length-transverse (cm) 3.3 3.5

Outcome

Jakob is doing well and is not currently exhibiting clinical signs of his disease (no straining to urinate/defecate)

He does progressive disease which means he has “failed” Mitoxantrone chemotherapy.

He was switched to Carboplatin at the 2/14/11 visit

Other Differential Diagnoses Alternative appearance of Prostatic

Carcinoma Benign Prostatic Hyperplasia Prostatitis

Prostatic carcinoma (again!)

Benign Prostatic Hyperplasia (BPH)

Prostatitis

Prostatitis

How do you differentiate? Signalment

BPH: Intact or recently neutered (within 1 year) Prostatitis: usually younger males, but can be any age Neoplasia: usually middle to older animals. High index of

suspicion with a large prostate in an older long ago neutered male

Get a sample Cytology/histopathology needed for a confirmed diagnosis

of neoplasia Prostatic wash with culture to rule in/out prostatitis

Neuter! If strongly suspect BPH or have ruled out other causes

neutering should reduce the size of the prostate in BPH but can take a while to see size reduction