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Renal tumours in the dog and cat

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Category: Schede
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  • Disciplina: Oncologia
  • Specie: Cane e Gatto

Renal tumours are an uncommon finding in dogs, accounting for less than 2% of all tumours, and are rare in cats. Primary renal tumours are prevalently of epithelial origin (mostly carcinomas), although it should not be forgotten that some are lymphomas (more common in the cat) and around 10% are nephroblastomas. It is important to remember that the frequency of secondary renal tumours is higher than the frequency of primary tumours. Benign renal tumours are an uncommon finding1-5.

 

AETIOLOGY AND PATHOGENESIS

The aetiology and pathogenesis of primary renal tumours is largely unknown. One study on renal tubular carcinoma in the dog showed that the epidemiology and biological behaviour of these tumours overlap with those in humans; however, the study did not allow verification of the involvement of the von Hippel-Lindau6 gene in the tumorigenesis of this malignancy. There are reports of concomitant renal cystoadenocarcinomas with multiple dermal nodules and multiple uterine leyomyomas in German Shepherd dogs with the canine Birt-Hogg-Dube (BHD) gene mutation.

 

EPIDEMIOLOGY

Primary renal tumours do not seem to occur more frequently in any particular breed, although in German Shepherd dogs a genetic predisposition to the development of multicentric dermal nodules has been found in subjects with renal cystoadenocarcinoma. The average age of onset is 7.1-8.8 years for carcinomas and 8.8-8.0 years for sarcomas and nephroblastomas. The male:female ratio varies from 1.8:1 to 1.6:1, which is close to what has been reported in humans. Subjects affected by renal lymphomas and renal cystoadenocarcinomas may have bilateral neoplasms 3-5.

 

SIGNS AND SYMPTOMS

The clinical signs and symptoms of renal tumours are non-specific, although occasionally pain on palpation of the vertebral column or abdomen has been reported. Dysorexia/anorexia, an altered sensorium, weight loss and occasionally abdominal distension have also been described. A common finding is haematuria5. The presence of multiple cutaneous nodules in a German Shepherd dog may raise the suspicion of a concomitant renal neoplasm. It has also been reported that hypertrophic osteopathy may occur in dogs and cats affected by, respectively, carcinoma of renal transitional cells and by renal adenoma9-11.

 

DIAGNOSTIC EXAMINATIONS

Laboratory tests do not show any specific alterations in reference values, with the exception of an increase of azotaemia and marked neutrophilia, which has been frequently associated with renal carcinomas. Furthermore, given the possible haematuria (especially microscopic), a mild regenerative anaemia may be recorded, while polycythaemia secondary to the excessive production of erythropoietin has been found in the presence of renal tumours12-14. From a diagnostic point of view ultrasonograpy is an excellent method for visualising the kidneys and the entire abdomen (Fig.1). Furthermore, ultrasonography can be used for ultrasound-guided cytology and, under general anaesthesia, for biopsies for histological studies15. It has recently been proposed that the use of ultrasound contrast media could improve the visualisation of renal lesions16.For accurate staging of the tumour it is necessary to determine the presence or absence of  thoracic involvement by means of both direct radiography and X-ray computed tomography. This latter diagnostic imaging technique also allows accurate staging of renal neoplasms by revealing any direct or indirect involvement of surrounding structures, such as the vena cava.

 

DIFFERENTIAL DIAGNOSIS

  • primary renal neoplasm
  • secondary renal neoplasm
  • renal haematoma
  • renal abscess

 

TREATMENT

The treatment of choice for non-lymphomatous, unilateral renal tumours is surgery, provided that secondary tumours have been excluded. Correct staging is always essential in the case of a renal lymphoma, as it is for all lymphoproliferative disorders. The suggested treatment for renal lymphoma is polychemotherapy, incorporating drugs capable of crossing the blood-brain barrier, in view of the possible involvement of the central nervous system.

The mean survival of dogs with renal tumours has been reported to be 16 months for renal carcinoma (range, 0-59 months), 9 months for renal sarcomas (range, 0-70 months) and 6 months for nephroblastoma (range, 0-6 months)5.  Surgery can be considered curative in cases of benign renal tumours.

 

References

  1. Frimberger AE, Moore AS, Schelling SH. Treatment of nephroblastoma in a juvenile dog. J Am Vet Med Assoc 207:596–598, 1995.
  2. Rudd RG, Whitehair JG, Leipold HW. Spindle cell sarcoma in the kidney of a dog. J Am Vet Med Assoc;198:1023–1024, 1991.
  3. Lucke VM, Kelly DF. Renal carcinoma in the dog. Vet Pathol 13:264–276, 1976.
  4. Klein MK, Campbell GC, Harris CK, et al. Canine primary renal neoplasms: A retrospective review of 54 cases. J Am Anim Hosp Assoc 24:443–452, 1987.
  5. Bryan JN, Henry CJ, Turnquist SE, et al. Primary renal neoplasiaof dogs. J Vet Intern Med;20:1155–1160, 2006.
  6. Pressler BM, Williams LE, Ramos-Vara JA, et al. Sequencing of the von Hippel-Lindau gene in canine renal carcinoma.Vet Intern Med. 23(3):592-7, 2009.
  7. Lium B, Moe L. Hereditary multifocal  renal cystadenocarcinomas and nodular dermatofibrosis in german shepherd: macroscopic and histopathologic changes. Vet Pathol 22: 447-455, 1985.
  8. Lingaas F, Comstock KE, Kirkness EF, et al. A mutation in the canine BHD gene is associated with ereditary multifocal  renal cystadenocarcinoma and nodular dermatofibrosis in the german shepherd dog. Hum Mol Genet 12: 3043-3053, 2003.
  9. Gorse MJ. Polycytemia associated with renal fibrosarcoma in a dog. J Am Vet Med Assoc, 192: 793-794, 1988.
  10. Johnson RL, Lenz SD. Hypertrophic osteopathy associated with a renal adenoma in a cat. J Vet Diagn Invest, 23(1):171-5, 2011
  11. Peeters D, Clercx C, Thiry A, et al. Resolution of paraneoplastic leukocytosis and hypertrophic osteopathy after resection of a renal transitional cell carcinoma producinggranulocyte-macrophage colony-stimulating factor in a young Bull Terrier.J Vet Intern Med,15(4):407-11, 2001.
  12. Peterson ME, Zanjani ED. Inappropriate erythropoietin production from a renal  carcinoma in a dog with polycythemia. J Am Vet Med Assoc, 179: 995-996, 1981.
  13. Durno AS, Webb JA, Gauthier MJ, et al. Polycythemia and inappropriate erythropoietin concentrations in two dogs with renal T-cell lymphoma.J Am Anim Hosp Assoc, 47(2):122-8, 2011.
  14. Waters DJ, Prueter JC. Secondary polycytemia associated with renal disease in the dog: two cases and review  of literature. J Am Anim Hosp Assoc, 24:109-114, 1998.
  15. Vignoli M, Barberet V, Chiers K, et al .Evaluation of a manual biopsy device, the 'Spirotome', on fresh canine organs: liver, spleen, and kidneys, and first clinical experiences in animals. Eur J Cancer Prev, 20(2):140-5, 2011.
  16. Haers H, Vignoli M, Paes G, et al. Contrast harmonic ultrasonographic appearance of focal space-occupying renal lesions. Vet Radiol Ultrasound, 51(5):516-22, 2010.