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Traitement multimodal d’un carcinome mammaire inflammatoire : chirurgie, chimiothérapie et AINS COX-2 sélectif

Simeon, C., Pepin-Richard, C., Fine, M.
Pratique médicale & chirurgicale de l'animal de compagnie 2013 v.48 no.3 pp. 79-86
bladder, anti-inflammatory activity, colic, drug therapy, mammary glands, cytotoxicity, carcinoma, mammary neoplasms (animal), mesentery, Bull Terrier, metastasis, surgery, necropsy, lungs, bitches, fever, X-radiation
A non-sterilised 11-year-old American Staffordshire terrier bitch was presented in consultation for sudden listlessness, hyperthermia, cutaneous seepage associated with the sudden swelling of the two right and left inguinal mammary glands, suggesting an inflammatory mammary carcinoma. Cytological analysis revealed a mammary carcinoma, and the thoracic X-ray was normal. Surgical ablation of the two mammary half chains (M4 and M5 right and M4 and M5 left) was performed respectively at D18 and D65. The histological study revealed moderately differentiated comedocarcinoma, with invasion of dermal lymphatic vessels by neoplastic emboli. The dog then underwent five sessions of doxorubicine (30mg/m2) 3 weeks apart without any notable incident, and firocoxib was administered daily. At D252, the thoracic X-ray showed multiple pulmonary metastases, and the dog presented numerous small inguinal cutaneous nodules, compatible with cutaneous metastases. At D328, the cutaneous and pulmonary metastases had progressed substantially, but the dog continued to be in good overall condition. However, at D337, i.e., 11 months after diagnosis, the dog was put down because of a sudden decline in her condition. The autopsy revealed a metastatic invasion of lungs, bladder, colic mesentery, and the whole thickness of the abdominal wall, from skin to peritoneum. This case is interesting, because it shows that long survival (11 months) is sometimes possible in case of inflammatory mammary carcinoma when the overall therapy includes surgery, chemotherapy and selective COX-2 anti-inflammatory whose action on certain cancers (including inflammatory mammary carcinomas) and the development of metastases is known.