Case of the week 6.1.21
Publication Date: 2021-06-01
History
15 year old mixed breed dog. Male castrated.
4 images
Findings
Opposite lateral and VD radiographs of the abdomen are available for interpretation
The serosal detail is normal. The liver is mildly enlarged with rounded caudal margins. The prostate is moderately enlarged with multifocal regions of mineralization. The urinary bladder is moderately enlarged with smooth margins.
The spleen, kidneys and gastrointestinal tract are normal. There is mild periarticular new bone formation of the coxofemoral joints.
Diagnosis
Mineralized prostatomegaly is consistent with prostatic carcinoma.
Hepatomegaly remains nonspecific but likely represents a benign, rather than malignant, process.
Discussion
https://pubmed.ncbi.nlm.nih.gov/19400462/
Canine prostatic disease is commonly evaluated with abdominal ultrasound and radiographs. Mineralization of the prostate is often reported, but the clinical relevance of this finding is currently not known. The-purpose of this study was to characterize the relationship between ultrasonographic and radiographic prostate mineralization and the final diagnosis. Medical records of 55 dogs with evidence of prostatomegaly or prostatic mineralization and a cytologic diagnosis were evaluated. Radiographs and ultrasound images were assessed for caudal retroperitoneal lymphadenopathy, vertebral lesions, or other signs of metastasis, and mineralization was assessed semiquantitatively. Twenty-two of 55 (40%) dogs had prostatic neoplasia. Regarding neoplasia, mineralization in neutered dogs had a positive predictive value (PPV) of 100%, a negative predictive value (NPV) of 50%, and a sensitivity and specificity of 84% and 100%, respectively. Mineralization in intact dogs had a PPV of 22%, an NPV of 96%, and a sensitivity and specificity of 67% and 77%, respectively. All neutered dogs with prostatomegaly but not prostatic neoplasia had bacterial prostatitis and were castrated within the previous 3 months. Intact dogs with prostatomegaly and mineralization but not neoplasia had paraprostatic cysts (n = 3), benign prostatic hyperplasia (n = 2) or prostatitis (n = 2). Mineralization score was not indicative of neoplasia. In conclusion, neutered dogs with prostatic mineralization were very likely to have prostatic neoplasia. Intact dogs were unlikely to have prostatic neoplasia if no mineralization was found on radiographs or ultrasound.
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