Eccrine adenocarcinoma in a cat's paw

Abstract

A geriatric, male castrate, American Domestic Shorthair cat was presented to Cornell University Hospital for Animals (CUHA) for evaluation of an eccrine adenocarcinoma involving the right metacarpal pad. Bleeding associated with the right front paw was first noticed by the owners in August of 2003. The cat presented to the referring veterinarian on August 26th 2003, at which time an ulcerated mass was noted on the right metacarpal pad. An incisional biopsy was obtained, and histopathologic assessment was consistent with an eccrine adenocarcinoma. Two-view thoracic radiographs were unremarkable. A complete blood count, chemistry panel, and urinalysis were performed. The chemistry panel revealed renal parameters at the upper end of normal [creatinine = 2.0 mg/dL (0.7-2.1mg/dL), BUN = 33.1mg/dL (17-35mg/dL), phosphate = 13.3mg/dL (3.0-6.6mg/dL)]. Urine specific gravity was >1.045, and occasional cocci were seen in urinary sediment. The cat was treated with enrofloxacin for the urinary tract infection. On presentation to the Oncology Service at the CUHA, the cat was quiet but alert and responsive. Physical examination confirmed an ulcerated mass associated with the right metacarpal pad that measured 1.0 x 1.0 x 0.5cm. The mass was not painful on palpation, and the cat showed no signs of lameness. Thoracic auscultation was unremarkable. Abdominal palpation revealed no abnormalities. All peripheral lymph nodes palpated normal in size and consistency. The remainder of the physical exam was unremarkable. A complete blood count, chemistry panel, and urinalysis were performed. Results showed no significant abnormalities. The two lateral thoracic referral radiographs were reviewed, a third dorsoventral view was obtained, and an abdominal ultrasound was performed. No evidence of metastatic diseases was identified in either imaging modality. Slides from the initial metacarpal biopsy were reviewed by the CUHA Surgical Biopsy Service, and confirmed a sweat gland carcinoma. The described diagnostic evaluation generated a problem list that consisted of a mildly overconditioned, mildly stressed, geriatric, male castrated feline, with an ulcerated right metacarpal sweat gland carcinoma. Forelimb amputation was recommended by the CUHA Oncology Service as the primary treatment to provide local control and the best long-term prognosis. Locally aggressive resection combined with radiation therapy was suggested as an alternative treatment, but was declined by the owners due to uncertain efficacy.