Ileocolic Intussusception Associated with a Multicentric Round Cell Tumor in a Red-Tailed Boa (Boa constrictor constrictor)
A 5-yr-old, female red-tailed boa constrictor (Boa constrictor constrictor) was presented with hyporexia, regurgitation, and progressive focal distention of the caudal coelom for 2 months. During physical examination a firm, well-demarcated and movable intracoelomic mass was detected halfway down the caudal coelom, but no other abnormalities were noticed. Ultrasonographic examination showed the mass to consist of an intestinal intussusception. A complete blood cell count and serum biochemistry results revealed mild anemia and leukocytosis as well as hyperuricemia and hyperphosphatemia with inversion of the calcium/phosphorus ratio. Explorative celiotomy was performed and revealed anterograde invagination of the ileum into the colon through the ileocolic junction. Although the intussusception was surgically repositioned, the snake died 3 wk postoperatively, despite showing a good general condition and defecation following assisted feeding. During necropsy, a thickened wall of the caudal segment of the ileum that was previously involved in the intussusception was observed as well as the presence of multifocal, white nodules throughout the parenchyma of the liver, spleen, and kidneys. Histopathological examination demonstrated a malignant round cell tumor of the ileum with infiltration of neoplastic round cells in the liver, spleen and kidneys. Immunohistochemical staining (CD3, CD20, MAC387, S100, and NSE) could not confirm the cell origin of the round cell tumor. The present case highlights the need to include round cell tumors as a differential diagnosis in the development of ileocolic intussusception in red-tailed boa constrictors.Abstract
Ultrasonographic images of an iliocoloc intussusception in a 5-yr-old, female red-tailed boa constrictor (Boa constrictor constrictor) showing a heterogenic echoic texture with a concentric ring appearance (arrowheads) on the short axis view (A). On the long axis view (B), accumulation of feces (asterisk) is noted in the distended ileal lumen cranial to the intussusception. The ileal lumen gradually decreases to eventually become partially obstructed at the level of the intussusception (arrowheads).
Intraoperative view of an ileocolonic intussusception in a 5-yr-old, female red-tailed boa constrictor (Boa constrictor constrictor). (A) Anterograde invagination of the caudal segment of the ileum (asterisk) through the ileocolic junction into the colon (arrow) resulting in a distended colon. The left ovary is also exteriorized (arrowhead). (B) The invaginated ileum (asterisk) is approached by performing a colotomy (arrowheads). The invaginated ileum and the distal colon (arrow) contain fecal content. Note the fibrinous material between ileum (intussusceptum) and colon (intussuscipiens).
Postmortem findings in a 5-yr-old, female red-tailed boa constrictor (Boa constrictor constrictor) with a multicentric round cell tumor. (A) Liver. Multifocal white, nodular poorly demarcated to coalescing lesions (1–5 mm; arrowheads) are seen on the liver surface. The nodules rarely protrude from the liver surface; the liver capsule remains intact. (B) Cross-section view of the liver confirmed the lesions (arrowheads) dispersed throughout the liver parenchyma, replacing normal liver tissue. (C) Renomegaly with a white-glazing surface caused by the infiltrative nature of the round cell tumor affecting the whole kidney. (D) Cross-section view of the same kidney revealing replacement of normal kidney tissue by neoplastic lesions (arrowheads). (E) Circumferential mural thickening of the ileum (arrowheads).
Histological images of a multicentric round cell tumor in a 5-yr-old, female red-tailed boa constrictor (Boa constrictor constrictor; hematoxylin and eosin stain). (A) Marked infiltration of round cells in the submucosa (SM) of the ileum. The mucosa (M) is eroded (100×). (B) The neoplastic round cells (arrowheads) are characterized by a round excentric nucleus with basophilic cytoplasma and perinuclear halo (400×).
