11 year old castrated male Labrador Retriever
History Presented to NCSU Emergency Clinic on for blood dripping from penis Blood had been dripping from penis since Christmas 2006 Started on 3 week course of doxycycline for a presumed UTI, but clinical signs resumed shortly thereafter Another course of doxycycline was prescribed for 6-8 weeks When he presented here he was having dysuria/stranguria
Owner states that urine stream is always yellow but clots of blood will pass in the stream rDVM felt that the bulbourethral glands were enlarged and that there was a swelling caudal to the os penis No other relative history
Relative Findings Lungs auscult clearly with increased bronchvesicular sounds bilaterally Prostate palpates small and symmetrical on rectal palpation Extrusion of penis reveal no gross abnormalities except a blood clot on the urethral orifice Caudal to the os penis a plum sized firm mass seems adhered to underlying structures CBC – WNL, Chem panel – no significant findings, Urinalysis USG 1.019, ph 6, 2+ proteinuria, 0-5 WBC/hpf, 0-5 RBC/hpf, culture no growth
Right medial iliac lymph node Low cellularity – small lymphocytes Penile mass aspirate Neoplastic cells most consistent with carcinoma but a poorly differentiated sarcoma could not be ruled out
Thoracic radiographs Possible pulmonary nodule in left caudal lung lobe Abdominal radiographs Mineralized soft tissue mass associated with caudal os penis Flouroscopy Confirmed presence of pulmonary nodule CT Two soft tissue nodules in left caudal lung lobe Soft tissue mass at caudal os penis, potentially of urethral or os penis origin Enlarged medial iliac lymph node
Mass noted 10.5 cm from the distal end of the uretha and extended for 2 cm proximally Pinch biopsies taken Dysplastic transitional epithelium vs transitional cell carcinoma Bladder normal except for dilated urethral orifices
Scrotal urethrostomy Penis amputation Histopathology Hemangiosarcoma with clean margins Flash is going to have follow up with Oncology Services