Surgical Management of Neurofibroma with Cystic Endometrial Hyperplasia in a Labrador Female Dog

Abstract

Canine genital tumours are rare, accounting for 3.0-4.0% of all tumours, and primarily affect intact females, with most occurring in the vagina and vulva rather than the uterus (8:1 ratio) (Thacher and Bradley, 1983). Most vaginal tumours (73-94%) are benign and reported occasionally (Salomon et al., 2004; Balamurugan and Sivasudharsan, 2021). Typical clinical signs include a visible protruding mass, vulvar discharge, dysuria, and tenesmus (Withrow and Susaneck, 1986). Some vaginal tumor may be treated with aglepristone or vincristine sulphate, and surgical approaches include episiotomy and excision of the tumorous mass, or more aggressive procedures such as vaginectomy, urethroplasty, and ventral pelvic osteotomy (Salomon et al., 2004; Rollon et al., 2008; Verma et al., 2019). Ovariohysterectomy may be performed to prevent recurrence of the tumourous mass, which may be due to hormonal imbalance.

The cystic endometrial hyperplasia/pyometra complex is a severe, poly-systemic diestrual disorder of intact bitches, characterized by endometrial hyperplasia and inflammatory cell infiltration (Veiga et al., 2017). The pathogenesis is multifactorial, involving abnormal uterine responses to progesterone and estrogen (De Bosschere et al., 2001), IGF-1-stimulated endometrial growth, matrix metalloproteinase-mediated remodelling and Escherichia coli colonization via specific endometrial receptors (Schlafer and Gifford, 2008). While CEH and pyometra can present as distinct disorders (Hagman et al., 2009), hyperplastic secretory activity frequently results in sterile fluid accumulation (mucometra/hydrometra) or bacterial pyometra. Affected bitches commonly present with inappetence, vomiting, polyuria/polydipsia, and abdominal distension (Smith, 2006). Ultrasonography confirms the diagnosis, and total ovariohysterectomy (OHE) is the treatment of choice; medical management with prostaglandin F2α carries a risk of uterine rupture or recurrence (Gobello et al., 2003; Gumber et al., 2010). Local surgical excision via episiotomy, coupled with ovariohysterectomy (OHE), is curative for benign genital tumours and prevents recurrence. The present document reports case of a bitch with a neurofibroma along with CEH that was successfully managed surgically.