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FNA cytology - Sarcoma?

kmjx65
October 11th, 2010, 04:54 PM
Hi everyone, we recently received a fine need aspirate cytology result that indicates my 5 year old mini american eskimo, Ebie, likely has soft tissue sarcoma cells in a nodule I found a few weeks about on her front left paw. After getting the results I slowly felt everywhere on her body to see if I can feel anything else. I may have found another nodule just next to her rib. I can't tell really if it's a nodule or if I'm feeling something that's part of her body. I'm going to have the vet check it.

We have a surgical consultation set up for tomorrow. I'm not even sure if they are going to the surgery that day. I was wondering what advice you have on things I need to get done and questions that are appropriate to ask?

I spoke with someone at the vet's office who said I should expect to get chest radiographs done to see if she has any mets in her lungs. My sister who is graduating from med school this spring mentioned that a full body CT scan is usually needed to find mets in the body. Is this true or is a chest radiograph enough?

Also, we are probably getting a full blood panel done to see ensure she is able to withstand the surgery itself.

We'll have the surgeon feel her second lump I found to see if we need another FNA done on that one as well or do we just jump to get a biopsy of the second lump and the first lump? Does anyone know how accurate an FNA is?

Is the typical next step before getting surgery done is a biopsy? The nodule is on her paw they very likely won't be able to get enough clean margins, so if it is malignant, they will likely recommend amputation. I don't want her to be amputated, they do a pathology on the mass after the fact and find that it is NOT malignant and they could have just removed the mass only.

My sister says an FNA can be a little faulty and there are some benign masses that can be mistaken for sarcomas during cytology.

The only worry I have with doing a biopsy is that is it quite invasive and the second lump is pretty deep under her skin. Also, if you get a biopsy done, could it possible cause the cells to metastasize?

Has anyone else who has been through this situation? any advice?

At this point so far we have an appointment set up with the oncologist for November in addition to the surgery consultation.

Thanks all.

kathryn
October 11th, 2010, 09:54 PM
Hmm.. well I work in a shelter and basically, we have a surgery table and an anesthesia machine to work with and that's about it :o What we generally do is just take the lumps off and if the people want them biopsied we send them out to a lab and get the results back. I've seen a FNA done once, and that was not for a client or anything it was another shelters puppy that had a lump on it's leg that just turned out to be some sort of allergy thing. :shrug: I think people tend to over think things too much, but then again I have no idea what the protocols are where you live. I can tell you I wouldn't have a bleepin' clue where the heck to send an animal to for a CT scan?? :confused: Probably University of Penn would do one for a few grand.

So yeah, basically if this were my pet I would just end up taking her to the shelter with me and just take the lumps off and send them out. FNA are not 100% that is correct. But weighing the options I would absolutely opt to have a tumor removed and find out it was benign than to sit around and then later on it turned out to be cancerous. Todays anesthesia techniques for animals (atleast where I am) are extremely safe. I mean we really have nothing to work with at my shelter and we have taken off massive tumors, amputated limbs, done open chest surgeries, etc on top of 10,000 spay/neuters a year of cats, dogs and other assorted animals of various ages and I think in an average year we have lost maybe.. 5-10 animals? IF that. I can't count the one vet we had for a bit because frankly he had bad luck, but I mean within the last 4 or 5 months I can think of 2 cats that died from anesthesia... both of which were strays of unknown origin and the necropsy on the one showed some major organ issues.

We took a tumor off a dogs "privates" recently and it was about the size of a golfball. We sent it out for a biopsy and it came back as a mast cell tumor. Our vet ended up putting him back under and removed a large portion of tissue around the area and did some reconstructive surgery. The dog is fine now and doing great in his new home.


So yeah, my advice is don't worry on it too much, do your homework, talk to more than one vet... but I mean what you are describing would easily be a surgery we would do at the shelter in 20 minutes tops and your dog would be going home the same day. Do a basic blood panel, get a decent x-ray...Hope that helps ease your mind a bit :fingerscr