Surgical Resection of an Interrenal Cell Adenocarcinoma in a Woma Python (Aspidites ramsayi) with 18 Month Follow-up
An 8-yr-old intact male woma python (Aspidites ramsayi) presented for a caudal coelomic mass effect of 3 wk duration. Ultrasound and fine needle aspiration with cytology failed to identify the source of the mass. Exploratory surgery found a 10-cm diameter, lobulated, cystic mass closely associated with the left kidney. Tumor resection with left adrenalectomy and left nephrectomy was performed. Histopathologic examination identified an adrenal interrenal cell (cortical) adenocarcinoma with adjacent renal fibrosis. The snake recovered from surgery uneventfully and was clinically healthy over an 18 month follow-up period. Eleven months postsurgery a contrast-enhanced coelomic computed tomography scan was performed to evaluate the snake for metastatic disease or local recurrence. No metastases were identified, but local recurrence was not definitively ruled out and continued monitoring of the surgery site was recommended. Eighteen months postsurgery an ultrasound examination of the snake revealed significant tumor regrowth. Because of the recurrence of disease, no further treatment was pursued.Abstract
Caudal coelomic mass surgically resected from a woma python. The ductus deferens is visible on the lateral aspect (white arrows) and kidney is visible dorsally (black arrow).
Low magnification (x 20) histopathologic view of the coelomic mass. The neoplasm is composed of neoplastic epithelial cells separated by expanses of hemorrhage and fibrin (1) that surround cystic cavities (2). A band of fibrous connective tissue (3) surrounds the neoplasm. Hematoxylin and eosin. Scale bar = 1 mm.
High magnification (x 400) of the neoplasm, highlighting columnar to polygonal neoplastic cells arranged in cords, nests, and packets and separated by a fine fibrovascular stroma. Neoplastic cells contain variable amounts of vacuolated, eosinophilic cytoplasm with round, basally placed nuclei with finely stippled chromatin. Hematoxylin and eosin. Scale bar = 50 μm.
Contrast-enhanced coronal computed tomography of a woma python 11 months following resection of an interrenal cell adenocarcinoma. (A) Coronal view of cranial coelom, lung window, including (1) heart, (2) liver, and (3) right lung. No evidence of metastatic disease is present. (B) Coronal view of caudal coelom, soft tissue window, including right kidney (block arrow) and a focal, mildly contrast-enhancing, soft tissue and fat attenuating lesion at the surgery site (line arrow) that is possibly an early local tumor recurrence.
