References
Unilateral anal sacculectomy for anal sac apocrine gland adenocarcinoma with urethral involvement
Abstract
The patient presented to a veterinary hospital with a month-long history of ‘scooting’ and a right-sided anal gland mass. A diagnosis of a stage 2 anal sac apocrine gland adenocarcinoma was confirmed, and the patient underwent a right-sided anal sacculectomy. There was involvement of the urethra and adherence to the rectum and a subsequent urethral incision was necessary, which was surgically repaired at the time of surgery. The patient was hospitalised for several weeks postoperatively for urinary catheter care and further nursing interventions. The patient was discharged from hospital 3 weeks after surgery once the urethra had healed sufficiently enough to enable normal micturition and subsequently made a full recovery.
The patient was referred to the oncology department of a veterinary hospital with a history of faecal tenesmus and a palpable right-sided anal gland mass, confirmed as a stage 2 anal sac apocrine gland carcinoma after fine needle aspirates and abdominal ultrasonography at the referring veterinary surgery (RVS).
Species: Canine
Breed: Crossbreed
Age: 7 years 10 months
Sex: Male neutered
Weight: 19.8 kg
Canine anal sac gland carcinomas (also known as anal sac adenocarcinomas or apocrine gland carcinomas of the anal sacs) arise from the apocrine glands situated within the walls of the anal sacs, which secrete fluid into the glands themselves (Polton and Brearley, 2007). This type of tumour is thought to be relatively uncommon, however, correct and rapid diagnosis is vital because of its nature, as they are often invasive with a high rate of metastasis to regional lymph nodes. Approximately 36–96% of cases show metastasis to the lymph nodes at the time of presentation, with 50% of those cases showing metastases to the regional iliac and/or sub-lumbar lymph nodes (Bray, 2016). These tumours, which are usually unilateral, can present with a variety of clinical signs, including perianal swelling, faecal tenesmus or licking of the perianal area, but it is thought that up to 40% are detected incidentally during a routine examination (Bray, 2016). Clinical signs can also be attributed to increased ionised calcium levels as a result of paraneoplastic hypercalcaemia, and these cases may present with polyuria, polydipsia, weakness, weight loss or lethargy (Bray, 2016). Interestingly, there seems to be a higher prevalence of this type of tumour in specific breeds, with Polton and Brearley (2007) describing a particular disposition in English Cocker Spaniels. It is also reported that Labrador Retrievers, German Shepherds and English Springer Spaniels are at higher risk (Bray, 2016). Larger studies have shown no gender bias, but it was originally thought to affect largely older, female dogs; this now has been disproved (Bray, 2016).
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