RESUMO
BACKGROUND: While lymphadenectomy of metastatic lymph nodes (LNs) has been associated with improved outcome, the clinical utility of prophylactic lymphadenectomy in dogs with stage I cutaneous mast cell tumors (cMCTs) remains a controversial topic. To assess the therapeutic role of lymphadenectomy of uninvolved regional LNs, the long-term outcome of cMCT-bearing dogs with cytologically negative and surgically unresected regional LNs (observation only, OO) was compared with that of dogs with surgically resected and histologically negative regional LNs (prophylactic regional lymphadenectomy, PRL). RESULTS: A retrospective analysis of 64 dogs with a low-grade, completely resected stage I cMCT was performed: 35 (54.7%) dogs were subjected to OO and 29 (45.3%) underwent PRL. Dogs were monitored for a median of 813 and 763 days in the OO group and PRL group, respectively. The number of dogs undergoing MCT progression was significantly higher in the OO group (P = 0.028) and curve comparison revealed a tendency to a better time to progression in the PRL group (P = 0.058). No significant difference in survival time (P = 0.294) was observed between dogs in the OO and PRL groups. CONCLUSIONS: Our results showed that lack of immediate lymphadenectomy was associated with a higher risk for tumor progression. This preliminary judgement, reinforced by the findings that lymphadenectomy was well tolerated in all cases, and that histopathology provides the definitive assessment of the nodal pathological status, may suggest that prophylactic lymphadenectomy is indicated in the management of stage I MCTs. Larger prospective studies are warranted for generating clinical evidence of this latter hypothesis.
Assuntos
Doenças do Cão/patologia , Excisão de Linfonodo/veterinária , Mastocitoma/veterinária , Neoplasias Cutâneas/veterinária , Animais , Estudos de Casos e Controles , Doenças do Cão/cirurgia , Cães , Linfonodos/patologia , Metástase Linfática/patologia , Metástase Linfática/prevenção & controle , Mastocitoma/cirurgia , Estudos Retrospectivos , Neoplasias Cutâneas/cirurgiaRESUMO
Mast cell tumors in nondomestic felids are rarely reported and their biological characteristics are not well described. A retrospective review of the pathology records of 52 zoo-housed cheetahs (Acinonyx jubatus) identified five cases of mast cell tumor, involving four closely related individuals. The age at initial presentation varied from 14 mo to 6 yr. Four cases presented as solitary or multiple cutaneous masses that were mostly slow growing, up to 20 mm diameter, and predominantly nonulcerated. The diagnosis was made by fine needle aspiration cytology of a lesion in one case and by excisional biopsy in the others. Histopathologically, the lesions resembled low- to intermediate-grade canine mast cell tumors, with variations in the degree of anisocytosis and anisokaryosis. Surgical excision was incomplete for 80% of the cutaneous lesions, but local recurrence was not observed in any case. One animal with cutaneous lesions subsequently developed fatal visceral mastocytosis involving the spleen, liver, and adrenal gland. There was no evidence of lymph node invasion or paraneoplastic gastrointestinal signs in any of the cases.
Assuntos
Acinonyx , Mastocitoma/veterinária , Neoplasias Cutâneas/veterinária , Animais , Feminino , Masculino , Mastocitoma/patologia , Mastocitoma/cirurgia , Neoplasias Cutâneas/patologia , Neoplasias Cutâneas/cirurgiaRESUMO
Histopathologic surgical margin assessment in veterinary patients is an imprecise science with assessment limited to a small proportion of the surgical margin due to time and finances. Incomplete excision of canine mast cell tumours (MCTs) alters treatment recommendations and prognosis. Optical coherence tomography (OCT) is a novel imaging modality that has been reported in a single veterinary study for surgical margin assessment. Twenty-five dogs with 34 MCTs were enrolled in a prospective pilot-study to assess the imaging characteristics of canine MCTs with OCT and to evaluate the feasibility and utility of OCT-guided histopathology. All dogs underwent routine surgical excision of MCTs. OCT imaging was used to assess the entire surgical margin prior to placement in formalin. Either normal areas or areas suspected of incomplete MCT excision were inked. Standard histopathologic sectioning and tangential sectioning of inked areas were performed and compared to OCT results. OCT identified MCT near the surgical margin in 10 of 26 specimens (38.4%). Four specimens suspicious for incomplete margins on OCT had incomplete MCT excision that was missed on standard histopathologic sectioning. Six specimens had OCT-guided sections taken as suspicious, which did not show MCT on histopathology. OCT-guided pathology sections were able to detect incompletely excised MCT near the surgical margin with a sensitivity of 90% and specificity of 56.2% in this preliminary study. OCT imaging shows promise for guiding pathologists to areas of interest to improve the diagnostic accuracy of surgical margin assessment in excised canine MCTs.
Assuntos
Doenças do Cão , Margens de Excisão , Mastocitoma/veterinária , Tomografia de Coerência Óptica , Animais , Doenças do Cão/diagnóstico por imagem , Doenças do Cão/cirurgia , Cães , Estudos de Viabilidade , Mastocitoma/diagnóstico por imagem , Mastocitoma/cirurgia , Projetos Piloto , Estudos Prospectivos , Tomografia de Coerência Óptica/veterináriaRESUMO
The purpose of this study was to determine if clinical findings, histologic grade, or other histologic features were associated with clinical outcome in dogs with subcutaneous mast cell tumors (MCTs). Medical records of 43 client-owned dogs were retrospectively reviewed, and follow-up information was gathered via phone or follow-up examination. Progression-free survival (PFS), disease-free interval (DFI), and overall survival were calculated. Forty-two and twenty-two dogs, respectively, had grade 2 (Patnaik grading system) or low-grade tumors (two-tier grading system). Median PFS was 1474 days. Median DFI was not reached at >1968 days. Overall median survival time was not reached at >1968 days. In univariate analysis, argyrophilic nucleolar organizer regions (AgNORs), proliferating cell nuclear antigen, and mitotic index were negatively prognostic for PFS whereas Ki-67, proliferating cell nuclear antigen, and microvessel density were negatively prognostic for DFI. In multivariate analysis, AgNORs remained negatively prognostic for PFS. Results suggest that proliferation indices, especially AgNORs, may be useful in predicting the rare poor outcomes in dogs with subcutaneous MCTs. The vast majority of subcutaneous MCTs appear to be low or intermediate grade with excellent outcomes from good local tumor control.
Assuntos
Doenças do Cão/cirurgia , Mastocitoma/veterinária , Neoplasias de Tecidos Moles/veterinária , Animais , Antígenos Nucleares/metabolismo , Doenças do Cão/patologia , Cães , Feminino , Masculino , Mastocitoma/patologia , Mastocitoma/cirurgia , Antígeno Nuclear de Célula em Proliferação/metabolismo , Estudos Retrospectivos , Fatores de Risco , Neoplasias de Tecidos Moles/patologia , Neoplasias de Tecidos Moles/cirurgia , Resultado do TratamentoRESUMO
OBJECTIVE: Report clinical outcomes of dogs with surgically excised mast cell tumors (MCT) and soft tissue sarcomas (STS). STUDY DESIGN: Prospective clinical study. SAMPLE POPULATION: Fifty-three dogs with 52 MCT (50 low grade, 2 high grade) and 19 STS (12 grade I, 6 grade II, 1 grade III). METHODS: All dogs were examined at 3, 6, 12, 18, and 24 months postoperatively, with cytologic or histopathologic evaluation of suspected local recurrences. Dogs euthanized because of study tumor-related causes underwent necropsy. RESULTS: Median intraoperative margins were 20 mm and 30 mm wide for MCT and STS, respectively, with 1 fascial plane resected en bloc. The narrowest histologic tumor-free margins measured <1 mm in 21 of 52 (40%) MCT and 7 of 19 (37%) STS. All dogs were followed for 24 months. Two of 50 (4%) low-grade MCT were diagnosed, with local recurrence 181 and 265 days postoperatively. Two of 36 (6%) dogs with low-grade MCT developed visceral metastasis 181 and 730 days postoperatively. One of 2 dogs with high-grade MCT developed local recurrence 115 days postoperatively. No local recurrence or metastasis was diagnosed after excision of 19 STS. CONCLUSION: Local recurrence rates among predominantly low- to intermediate-grade MCT and STS were low, despite a high prevalence of histologic tumor-free margins <1 mm. Surgical recommendations for high-grade tumors cannot be extrapolated from this population. CLINICAL SIGNIFICANCE: Surgeons should seek to achieve microscopically complete excision for MCT and STS while minimizing patient morbidity and considering limitations of histopathology in predicting outcomes.
Assuntos
Doenças do Cão/cirurgia , Mastocitoma/veterinária , Recidiva Local de Neoplasia/veterinária , Sarcoma/veterinária , Neoplasias de Tecidos Moles/veterinária , Animais , Intervalo Livre de Doença , Doenças do Cão/mortalidade , Cães , Feminino , Estudos Longitudinais , Masculino , Margens de Excisão , Mastocitoma/mortalidade , Mastocitoma/cirurgia , Recidiva Local de Neoplasia/mortalidade , Recidiva Local de Neoplasia/cirurgia , Estudos Prospectivos , Sarcoma/mortalidade , Sarcoma/cirurgia , Neoplasias de Tecidos Moles/mortalidade , Neoplasias de Tecidos Moles/cirurgia , Cirurgia VeterináriaRESUMO
Cutaneous mast cell tumors (cMCTs) account for approximately 20% of skin neoplasms in cats. As there is no grading system for these tumors, prognosis is difficult to estimate. Although the typical presentation is a benign tumor that can be cured by surgical excision, a small but important proportion of feline cMCTs is biologically aggressive and can spread to local lymph nodes, precede the onset of disseminated cutaneous disease, or be associated with visceral involvement. A number of macroscopic and histologic features were retrospectively evaluated in cases of feline cMCTs treated with surgical excision with or without medical therapy. Cats were divided into 2 groups based on the clinical outcome. Group 1 included cats alive with no mast cell tumor-related disease at 1000 days from surgery; group 2 included cats developing histologically confirmed metastatic or cutaneous disseminated disease. The criteria allowing the best differentiation between the groups were used to develop a grading scheme. Groups 1 and 2 were composed by 48 (76%) and 15 (24%) cases, respectively. Tumors were classified as high grade if there were >5 mitotic figures in 10 fields (400×) and at least 2 of the following criteria: tumor diameter >1.5 cm, irregular nuclear shape, and nucleolar prominence/chromatin clusters. According to this scheme, the 15 (24%) high-grade cMCTs had significantly reduced survival time (median, 349 days; 95% CI, 0-739 days) as compared with the 48 low-grade tumors (median not reached; P < .001). Further studies are warranted to validate this grading system and test reproducibility on a larger case series.
Assuntos
Doenças do Gato/patologia , Mastocitoma/veterinária , Neoplasias Cutâneas/veterinária , Animais , Doenças do Gato/cirurgia , Gatos , Feminino , Masculino , Mastocitoma/patologia , Mastocitoma/cirurgia , Gradação de Tumores/veterinária , Neoplasias Cutâneas/patologia , Neoplasias Cutâneas/cirurgia , Resultado do TratamentoRESUMO
OBJECTIVE: Quantify changes in the circumferential lengths of surgical margins of resected canine mast cell tumors (MCT) and soft tissue sarcomas (STS) between the time of collection and histopathology. STUDY DESIGN: Prospective, hypothesis-driven, clinical study. SAMPLE POPULATION: Two hundred and thirty-seven margins from 69 excised tumors (50 MCT and 19 STS) in 51 client-owned dogs. METHODS: The lengths of surgical margins were recorded (eg, cranial, caudal, dorsal, and ventral) for each tumor at 5 time points: intraoperatively (in vivo), immediately after excision (ex vivo), after formalin fixation (postfixation), once mounted on glass slides (subgross), and as histologically tumor-free margins (HTFMs). RESULTS: Compared to in vivo dimensions, the length of surgical margins at each processing step (ie, ex vivo, postfixation, subgross, and HTFM) was reduced by a median of 3.0, 5.0, 6.0, and 8.8 mm for MCT; 2.5, 2.0, 5.0, and 5.0 mm for STS. All processing steps resulted in significant reductions among MCT samples (P < .0001), except between postfixation vs subgross, and for STS samples (P < .0001), except between ex vivo vs postfixation and subgross vs HTFM. The maximum reduction in the total length of margins (from in vivo to HTFM) was 29.6 and 24.2 mm for MCT and STS, respectively. CONCLUSION: Surgical margin length reductions occur due to a combination of physical factors (eg, tissue elasticity, myofibril contraction, and histologic processing) and biological factors (eg, microscopic tumor infiltration into the grossly normal surgical margin). CLINICAL SIGNIFICANCE: These data provide information relevant to evidence-based surgical planning and may influence patient morbidity in the most commonly encountered cutaneous malignancies of dogs.
Assuntos
Doenças do Cão/cirurgia , Margens de Excisão , Mastocitoma/veterinária , Sarcoma/veterinária , Animais , Cães , Feminino , Masculino , Mastocitoma/cirurgia , Recidiva Local de Neoplasia/veterinária , Estudos Prospectivos , Sarcoma/cirurgia , Neoplasias Cutâneas/cirurgia , CrânioRESUMO
OBJECTIVE: To determine the feasibility and agreement of margin assessment by imprint cytology, shaved margin histopathology, and radial section histopathology in canine cutaneous and subcutaneous mast cell tumors (MCT) and soft tissue sarcomas (STS). STUDY DESIGN: Prospective clinical study. SAMPLE POPULATION: Three hundred and forty margins from 72 excised tumors (52 MCT and 20 STS) in 54 client-owned dogs. METHODS: Imprint cytology samples were acquired by pressing glass slides to the cut surgical margin of the freshly excised surgical specimen. Shaved margin samples were obtained from the patient wound bed using a scalpel immediately prior to closure. Radial section histopathology was performed as part of routine histopathologic processing. All margins were assessed as either positive or negative for presence of tumor cells at the surgical margin. Agreement among methods was calculated using Fleiss Kappa coefficients and an association of method, margin direction, and tumor type with positive margin status was evaluated using a general linear mixed model. RESULTS: Positive margin detection rates differed for MCT (imprint cytology 21%, radial section histopathology 9%, and shaved margin histopathology 3%; P < .0001) but not for STS. Intermethod agreement was poor (Fleiss Kappa = 0.051 and 0.176 for MCT and STS, respectively). Margin direction did not influence margin status for either tumor type. CONCLUSION: Imprint cytology and shaved margin histopathology are feasible, but their results are frequently disparate from routine radial section histopathology. Future studies are needed to evaluate the correlation of each method with local recurrence rates.
Assuntos
Citodiagnóstico/veterinária , Doenças do Cão/cirurgia , Mastocitoma/veterinária , Sarcoma/veterinária , Cirurgia Veterinária/métodos , Animais , Citodiagnóstico/métodos , Cães , Feminino , Masculino , Mastocitoma/cirurgia , Estudos Prospectivos , Sarcoma/cirurgiaRESUMO
OBJECTIVE: To assess the ability of a novel imaging system designed for intraoperative detection of residual cancer in tumor beds to distinguish neoplastic from normal tissue in dogs undergoing resection of soft tissue sarcoma (STS) and mast cell tumor (MCT). STUDY DESIGN: Non-randomized prospective clinical trial. ANIMALS: 12 dogs with STS and 7 dogs with MCT. METHODS: A fluorescent imaging agent that is activated by proteases in vivo was administered to the dogs 4-6 or 24-26 hours before tumor resection. During surgery, a handheld imaging device was used to measure fluorescence intensity within the cancerous portion of the resected specimen and determine an intensity threshold for subsequent identification of cancer. Selected areas within the resected specimen and tumor bed were then imaged, and biopsies (n=101) were obtained from areas that did or did not have a fluorescence intensity exceeding the threshold. Results of intraoperative fluorescence and histology were compared. RESULTS: The imaging system correctly distinguished cancer from normal tissue in 93/101 biopsies (92%). Using histology as the reference, the sensitivity and specificity of the imaging system for identification of cancer in biopsies were 92% and 92%, respectively. There were 10/19 (53%) dogs which exhibited transient facial erythema soon after injection of the imaging agent which responded to but was not consistently prevented by intravenous diphenhydramine. CONCLUSION: A fluorescence-based imaging system designed for intraoperative use can distinguish canine soft tissue sarcoma (STS) and mast cell tumor (MCT) tissue from normal tissue with a high degree of accuracy. The system has potential to assist surgeons in assessing the adequacy of tumor resections during surgery, potentially reducing the risk of local tumor recurrence. Although responsive to antihistamines, the risk of hypersensitivity needs to be considered in light of the potential benefits of this imaging system in dogs.
Assuntos
Doenças do Cão/diagnóstico por imagem , Mastocitoma/veterinária , Neoplasia Residual , Sarcoma/veterinária , Animais , Biópsia , Doenças do Cão/cirurgia , Cães , Feminino , Mastocitoma/diagnóstico por imagem , Mastocitoma/cirurgia , Recidiva Local de Neoplasia/prevenção & controle , Recidiva Local de Neoplasia/veterinária , Estudos Prospectivos , Sarcoma/diagnóstico por imagem , Sarcoma/patologia , Sarcoma/cirurgiaRESUMO
This retrospective case series evaluates survival outcome of 94 dogs with high metastatic risk mast cell tumours (MCT). Patients were treated with a cytotoxic chemotherapy protocol or the tyrosine kinase inhibitor masitinib, in the presence of gross disease or as an adjunct to surgical resection of the primary tumour. In patients presenting with metastatic disease, surgical resection of the primary tumour with adjunctive therapy with any chemotherapy incurred a significant survival advantage [median survival time (MST): 278 days] compared to patients receiving chemotherapy without surgical excision of the primary tumour (MST: 91 days, P < 0.0001). Patients with a surgically excised Patnaik grade II tumour and high Ki-67 in the absence of metastatic disease treated with vinblastine and prednisolone showed a significantly longer survival (MST: 1946 days) than those treated with masitinib (MST: 369 days, P = 0.0037). Further prospective case-controlled clinical trials of high-risk MCTs are required to make precise evidence-based treatment decisions for individual patients.
Assuntos
Antineoplásicos/uso terapêutico , Doenças do Cão/tratamento farmacológico , Mastocitoma/veterinária , Animais , Benzamidas , Quimioterapia Adjuvante/veterinária , Doenças do Cão/mortalidade , Doenças do Cão/cirurgia , Cães , Mastocitoma/tratamento farmacológico , Mastocitoma/mortalidade , Mastocitoma/cirurgia , Gradação de Tumores , Piperidinas , Inibidores de Proteínas Quinases/uso terapêutico , Piridinas , Estudos Retrospectivos , Fatores de Risco , Análise de Sobrevida , Tiazóis/uso terapêutico , Resultado do TratamentoRESUMO
This was a multi-institutional retrospective study evaluating the outcome and clinical parameters associated with the postoperative prognosis of 36 cats with splenic mast cell tumors treated with splenectomy. Clinical parameters reviewed included signalment, clinical history, results of staging tests, surgical variables, administration of blood products, presence of metastasis, postoperative complications, administration of chemotherapy postoperatively, chemotherapy protocol, and response to chemotherapy. Overall median survival time was 390 days (range, 2-1737 days). Administration of a blood product (P < .0001), metastasis to a regional lymph node (P = .022), and evidence of either concurrent or historical neoplasia (P = .037) were negatively associated with survival. Response to chemotherapy (P = .0008) was associated with an improved median survival time. Larger-scale prospective studies evaluating different chemotherapy protocols are required to elucidate the discrepancy between lack of survival benefit with administration of chemotherapy and improvement in survival time with positive response to chemotherapy.
Assuntos
Doenças do Gato/cirurgia , Mastocitoma/veterinária , Esplenectomia/veterinária , Neoplasias Esplênicas/veterinária , Animais , Antineoplásicos/uso terapêutico , Doenças do Gato/tratamento farmacológico , Doenças do Gato/mortalidade , Gatos , Feminino , Masculino , Mastocitoma/tratamento farmacológico , Mastocitoma/mortalidade , Mastocitoma/cirurgia , Assistência Perioperatória/veterinária , Prognóstico , Estudos Retrospectivos , Esplenectomia/mortalidade , Neoplasias Esplênicas/tratamento farmacológico , Neoplasias Esplênicas/mortalidade , Neoplasias Esplênicas/cirurgiaRESUMO
Completeness of mast cell tumour (MCT) excision is determined by assessment of histologically tumour-free margins (HTFM). The HTFM width necessary to prevent local recurrence (LR), recognized as histologic safety margin (HSM) in human oncology, has not been defined. We hypothesized that HTFM width would correlate with risk for LR and high-grade tumours would require wider HTFM than low-grade tumours. Records of dogs with completely excised MCTs were included. Signalment, two-tier tumour grade, tumour size, HTFM width, recurrence and therapy data was collected. High-grade (n = 39) tumours were more likely to recur than low-grade (n = 51) tumours (35.9% versus 3.9%), P < 0.0001, with no association between HTFM width and LR. Twenty-nine percent of low-grade tumours had HTFM less than 3 mm; none recurred. Narrow (≤3 mm) histologic margins are likely adequate to prevent LR of low-grade tumours. High-grade tumours have significant risk of LR regardless of HTFM width.
Assuntos
Doenças do Cão/cirurgia , Mastocitoma/veterinária , Gradação de Tumores , Recidiva Local de Neoplasia/veterinária , Animais , Doenças do Cão/classificação , Cães , Mastocitoma/classificação , Mastocitoma/cirurgia , Estudos RetrospectivosAssuntos
Anestesia com Circuito Fechado/veterinária , Anestesia Geral/veterinária , Doenças do Cão/cirurgia , Falha de Equipamento/veterinária , Mastocitoma/veterinária , Ventiladores Mecânicos/veterinária , Anestesia com Circuito Fechado/instrumentação , Anestesia Geral/instrumentação , Animais , Cães , Masculino , Mastocitoma/cirurgiaRESUMO
La mastocitosis consiste en una proliferación anormal de mastocitos en los tejidos, y el mastocitoma solitario es una de las formas más frecuentes. La evolución tiende a la curación espontánea, si bien un mínimo porcentaje de mastocitomas solitarios requieren extirpación quirúrgica (AU)
Mastocytosis is abnormal proliferation of tissue mast cells, being solitary mastocytoma the most common. Evolution tends to spontaneous healing, although a small percentage of solitary mastocytoma require surgical removal (AU)
Assuntos
Humanos , Masculino , Lactente , Mastocitoma/diagnóstico , Mastocitoma/cirurgia , Conduta Expectante/organização & administração , Conduta Expectante/normas , Mastócitos/patologia , Diagnóstico Diferencial , Mastocitoma/fisiopatologia , Eritema/complicações , Eritema/diagnóstico , Edema/complicações , Mastocitose Cutânea/complicações , Mastocitose Cutânea/diagnóstico , Mastocitose Cutânea/tratamento farmacológicoRESUMO
OBJECTIVE: To compare survival and local recurrence outcomes in dogs with mast cell tumors with incomplete or close margins treated with primary re-excision or radiation therapy of the primary site versus no additional local therapy. STUDY DESIGN: Retrospective case series. ANIMALS: Dogs (n = 64). METHODS: Outcomes of canine mast cell tumor cases that had incomplete or close surgical resection and presented to the Ontario Veterinary College Health Sciences Centre (2001-2010) were evaluated after additional local therapy (primary re-excision or radiation therapy) or no additional local therapy (comparison). Follow-up was performed through evaluation of medical records and telephone contact with referring veterinarians and owners. RESULTS: Tumors (n = 70) in 64 dogs were studied. Median survival times for the primary re-excision (2930 days) and radiation therapy (2194 days) groups were significantly longer than for the comparison (710 days) group. Local recurrence occurred in 13% of the re-excision group, 8% of the radiation therapy group, and 38% of the comparison group. Although local recurrence rate was not statistically significant for the re-excision group, time to local recurrence was statistically longer for both the re-excision and radiation groups. Adjunctive chemotherapy was not associated with improved survival or local control. CONCLUSION/CLINICAL RELEVANCE: There is significant improvement in survival and duration of local control when additional local therapy is performed after incomplete or close resection of mast cell tumors. These follow-up therapies should be recommended to owners when mast cell tumors are incompletely or closely resected.
Assuntos
Doenças do Cão/cirurgia , Mastocitoma/veterinária , Recidiva Local de Neoplasia/veterinária , Animais , Doenças do Cão/radioterapia , Cães , Feminino , Masculino , Mastocitoma/radioterapia , Mastocitoma/cirurgia , Recidiva Local de Neoplasia/radioterapia , Recidiva Local de Neoplasia/cirurgia , Estudos Retrospectivos , Análise de SobrevidaRESUMO
CASE DESCRIPTION: A 10-year-old spayed female Jack Russell Terrier and a 7-year-old neutered male mixed-breed dog were evaluated because of acute, progressive, unilateral forelimb lameness associated with signs of pain and turgid antebrachial swelling. CLINICAL FINDINGS: For either dog, there were no salient pathological or diagnostic imaging abnormalities. A diagnosis of compartment syndrome was confirmed on the basis of high caudal antebrachial compartmental pressure in the affected forelimb. TREATMENT AND OUTCOME: Both dogs underwent surgical exploration of the affected forelimb. In each case, an intramuscular tumor (mast cell tumor in the Jack Russell Terrier and suspected sarcoma in the mixed-breed dog) was detected and presumed to be the cause of the high compartmental pressure. At 6 months following tumor excision, the dog with the mast cell tumor did not have any clinical signs of disease. The dog with a suspected sarcoma underwent tumor excision and forelimb amputation at the proximal portion of the humerus followed by chemotherapy; the dog was euthanized approximately 1 year following treatment because of pulmonary metastasis. CLINICAL RELEVANCE: Compartment syndrome is a serious but rarely reported condition in dogs and is typically ascribed to intracompartmental hemorrhage. These 2 cases illustrate the potential for expansile intramuscular antebrachial tumors to cause compartment syndrome in dogs.
Assuntos
Síndromes Compartimentais/veterinária , Doenças do Cão/etiologia , Mastocitoma/veterinária , Sarcoma/veterinária , Animais , Síndromes Compartimentais/etiologia , Síndromes Compartimentais/cirurgia , Doenças do Cão/patologia , Cães , Feminino , Masculino , Mastocitoma/complicações , Mastocitoma/cirurgia , Sarcoma/complicações , Sarcoma/cirurgiaRESUMO
A 3-year-old Marwari mare was presented for evaluation of an irregular, reddish mass protruding from behind the right third eyelid. The mass appeared to arise at the ventral limbal area, involved the perilimbal bulbar conjunctiva and widely extended into corneal tissue. No other ocular or systemic abnormalities were detected at the time of presentation. The mass was surgically removed by lamellar keratectomy, with defocused CO(2) laser used as adjunctive therapy to treat the surgical exposed area and its surroundings. Histopathologic evaluation showed sheets of densely packed, well-differentiated neoplastic mast cells separated by fibrovascular connective tissue. Nuclear staining for Ki-67 was performed, and an average of 370 cells were positive per 1000 counted cells. Two months postoperatively, the surgical site was filled with flat fibrovascular and pigmented tissue, while the surrounding cornea was transparent with no superficial vascularization around the fibrotic scar. Thirty-two months after treatment, no recurrence of the neoplasia was reported.
Assuntos
Neoplasias Oculares/veterinária , Doenças dos Cavalos/patologia , Mastocitoma/veterinária , Animais , Neoplasias Oculares/patologia , Neoplasias Oculares/cirurgia , Doenças dos Cavalos/cirurgia , Cavalos , Mastocitoma/patologia , Mastocitoma/cirurgiaRESUMO
Upper-lip reconstruction after mast-cell tumor-resection in a French bulldog was achieved by using a transposition flap from the nasal-skin-fold and an oral mucosal flap. The new technique is an alternative for reconstruction of extensive upper-lip defects in brachycephalic dogs and achieves satisfactory functional and cosmetic results.
Lambeau de transposition provenant du repli cutané nasal pour une reconstruction de la lèvre supérieure chez un Bouledogue français. Une reconstruction de la lèvre supérieure après une résection d'une tumeur à mastocytes chez un Bouledogue français a été réalisée en utilisant un lambeau de transposition provenant du repli cutané nasal et un lambeau oral des muqueuses. La nouvelle technique représente une option pour la reconstruction de défauts importants de la lèvre supérieure chez les chiens brachycéphaliques et donne des résultats fonctionnels et esthétiques satisfaisants.(Traduit par Isabelle Vallières).
Assuntos
Doenças do Cão/cirurgia , Lábio , Procedimentos de Cirurgia Plástica/veterinária , Retalhos Cirúrgicos/veterinária , Animais , Antineoplásicos/uso terapêutico , Cães , Feminino , Mastocitoma/tratamento farmacológico , Mastocitoma/cirurgia , Mastocitoma/veterinária , Procedimentos de Cirurgia Plástica/métodosRESUMO
A six-year-old Labrador Retriever was presented for management of a 2 x 2 cm cutaneous mass over the dorsal aspect of the carpus. A fine needle aspirate performed by the referring veterinarian was consistent with a mast cell tumour. The ipsilateral prescapular lymph node was enlarged. Preoperative staging did not reveal any evidence of metastasis. Wide excision of the mass and prescapular lymphadenectomy were performed. The large carpal wound was reconstructed using a combination of Z-plasty and phalangeal fillet using the first digit (dewclaw); about 20% of the original defect was allowed to heal by second intention. Histopathology was consistent with a grade II mast cell tumour with metastatic spread to the lymph node. Vinblastine and prednisolone adjuvant chemotherapy was instituted. Functional and cosmetic outcome were good; only a small 1cm area of alopecia persisted. The dog was disease-free 53 months after surgery. A combination of Z-plasty and a phalangeal fillet using the first digit was a successful treatment to reconstruct a large wound over the dorsal aspect of the carpus in this case.
Assuntos
Doenças do Cão/cirurgia , Mastocitoma/veterinária , Procedimentos de Cirurgia Plástica/veterinária , Neoplasias Cutâneas/veterinária , Animais , Cães , Masculino , Mastocitoma/cirurgia , Neoplasias Cutâneas/cirurgia , Retalhos Cirúrgicos/veterináriaRESUMO
OBJECTIVE: To identify the blood supply to the vulval fold and adjacent skin, and evaluate it as a transposition flap for closing perineal wounds in dogs. STUDY DESIGN: Prospective study. ANIMALS OR SAMPLE POPULATION: Five female canine cadavers and 2 cases referred for excision of mast cell tumors adjacent to the vulva. METHODS: Dissection was performed to identify the vascular supply to the vulval fold in two cadavers following arterial injection of red latex and methylene blue, respectively. In three cadavers, barium sulfate mixed 1:1 with water was injected into the terminal aorta. The vulval fold and surrounding perineal skin was excised and radiographed. Transposition flaps using the vulval fold and adjacent skin were used to close skin defects in two dogs presented for wide excision of mast cell tumors situated ventro-lateral and dorso-lateral to the vulva, respectively. RESULTS: The vulval fold and adjacent skin was perfused bilaterally by branches of the ventral perineal and external pudendal arteries, which entered dorsally and ventrally, respectively. As incisions used to create a transposition flaps from the skin surrounding the vulval fold transect these vessels, the flap is dependent on the sub-dermal plexus for survival. There was 100% survival of transposition flaps in the 2 clinical cases and healing proceeded uneventfully with acceptable cosmetic and functional results. CONCLUSIONS: The vulval fold and surrounding skin can be used as a subdermal plexus flap to close large perineal defects in dogs. CLINICAL RELEVANCE: Availability of a defined local skin flap will improve treatment of diseases resulting in large perineal skin defects in female dogs.