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Tag: tumour

  • Don’t remove a mass without knowing what it is

    I came across a paper that advised we should know exactly what a mass is before surgery. The rationale being as follows (Ettinger, 2015):

    “Do something: aspirate or biopsy, and treat appropriately.

    Needle biopsy
    Vet performing a needle biopsy on a cocker spaniel. Image ©iStock.com/Paolo_Toffanin

    “Why diagnose early? Obtaining a definitive diagnosis with cytology or biopsy early and before excision will lead to improved patient outcomes for superficial masses. Surgery is likely curative for the majority of superficial tumours when detected early, when they are small – especially benign lesions and locally invasive tumours with a low probability of metastasis. If tumours are removed with complete surgical margins, the prognosis is often good with no additional treatments needed.

    “Pet owners need to be aware of the ‘pea’ size requirement to have masses evaluated, and veterinarians must measure and document the size of the mass to compare growth.

    “If more than 1cm (or the size of large pea) and present for a month, the mass should be aspirated or biopsied.

    “Knowing the tumour type prior to the first surgery will increase success of a curative-intent surgery.”

    In all honesty, I rarely do this for masses booked in for surgery and I suspect as lipomatosus, and for masses that visually appear consistent for histiocytoma – but there are tips here I will follow in the future.

    Reference
    Ettinger S (2015). Top Ten Oncology Mistakes and How to Avoid Them, North American Veterinary Conference: Small Animal & Exotics Proceedings, Gainsville, Florida.

  • When is a lipoma not a lipoma?

    Fine-needle aspiration (FNA).
    Fine-needle aspiration (FNA) of a mass. Image source: BSAVA ’09 Congress Times.

    We recently had a case where a freely mobile, soft mass on the ventral abdomen, which had been present for a number of years, had started to get larger.

    We carried out a fine-needle aspiration (FNA) biopsy, and I fully expected this to confirm the presence of a lipoma (a benign fatty tumour common in dogs).

    However, I was really surprised when the cytology revealed the presence of a mast cell tumour, with a surgical procedure to follow.

    My tip would be that it is definitely worthwhile checking out those seemingly innocuous “lipomas” with FNAs.

  • Neuro-exams can be very helpful

    Prolapsed gland of the third eyelid, or Cherry eye as it is sometimes known. Image by Joel Mills (CC BY-SA 3.0) via Wikipedia.
    Prolapsed gland of the third eyelid, or cherry eye as it is sometimes known. Image by Joel Mills (CC BY-SA 3.0) via Wikipedia.

    A nice six-year-old Labrador with a history of possible trauma, complete forelimb muscle atrophy and proprioceptive deficits was brought to see me.

    Radial paralysis was high up on the list of differentials, but the poor chap had not shown any response to conservative management.

    I noticed it had mild anisocoria, slight ptosis and third eyelid prolapse, indicating the less obvious Horner’s syndrome. A bell rang in my mind of a case I recalled seeing as a student – it revealed itself to be indicative of a brachial plexus injury/tumour.

    Sadly, an MRI scan at Davies Veterinary Specialists confirmed the presence of a tumour.

    Very sad.