Paraneoplastic hypercalcemia in a dog with benign renal angiomyxoma

Journal of Veterinary Diagnostic Investigation http://vdi.sagepub.com/

Paraneoplastic Hypercalcemia in a Dog with Benign Renal Angiomyxoma Isuru Gajanayake, Simon L. Priestnall, Livia Benigni, Kate English, Brian A. Summers and Oliver A. Garden J VET Diagn Invest 2010 22: 775 DOI: 10.1177/104063871002200523 The online version of this article can be found at: http://vdi.sagepub.com/content/22/5/775

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Case Reports

775

J Vet Diagn Invest 22:775–780 (2010)

Paraneoplastic hypercalcemia in a dog with benign renal angiomyxoma Isuru Gajanayake,1 Simon L. Priestnall, Livia Benigni, Kate English, Brian A. Summers, Oliver A. Garden Abstract. An 11-year-old, male, neutered crossbred Collie dog was presented for a history of polydipsia and polyuria. Diagnostic investigations revealed total and ionized hypercalcemia and an increased concentration of parathyroid hormone–related peptide. Abdominal ultrasonography and contrast-enhanced computed tomography of the abdomen revealed a right-sided, cystic-appearing renal mass. Cytological examination of ultrasound-guided aspirates of the mass revealed high numbers of spindle cells. The mass was removed en bloc via an ureteronephrectomy. Histopathological examination of the mass revealed neoplastic spindle cells in loosely packed and interlacing streams within a myxomatous stroma. Immunohistochemical examination with vimentin, von Willebrand Factor, and a-smooth muscle actin confirmed the mass to be a renal angiomyxoma. A minority of the neoplastic spindle cells showed positive cytoplasmic parathyroid hormone–related peptide immunostaining. The hypercalcemia resolved following surgery, and the parathyroid hormone–related peptide concentration returned to within the reference interval. The dog was no longer polydipsic or polyuric 1 year following surgery. The present report describes a previously unreported renal neoplasm causing paraneoplastic hypercalcemia and highlights the possibility of paraneoplastic hypercalcemia being caused by a benign neoplasm. Key words:

Computed tomography; dogs; kidney; paraneoplastic; parathyroid hormone–related peptide.