Pedal mass in a crossbred dog

Pedal mass in acrossbred dog

Author: David Grant

Editor: David Lloyd

$C:\Sonya's RVC Work\Derm cases\images\4_pedal mass_nov93\IMG0019_thumbnail_white_border.jpg$

$F:\-- Derm cases ESVD\images\new interface\titlebackground2.jpg$

$F:\-- Derm cases ESVD\images\new interface\buttonbackground3.jpg$

Click to reveal the text on this screen

Click the forward arrow to jump to the next screen

History - 1

$F:\-- Derm cases ESVD\images\section images\edited on dk blue\history.jpg$

•12-year-old entire female crossbred dog

•Weight 23 kg

•A lump had developed over a period of months onthe right fore foot

•The dog was presented when the lesion becameulcerated and began to bleed

History

$F:\-- Derm cases ESVD\images\new interface\titlebackground2.jpg$

$F:\-- Derm cases ESVD\images\new interface\buttonbackground3.jpg$

History - 2

$F:\-- Derm cases ESVD\images\section images\edited on dk blue\history.jpg$

•The dog was lame on the affected foot but otherwisein good health

History

$F:\-- Derm cases ESVD\images\new interface\titlebackground2.jpg$

$F:\-- Derm cases ESVD\images\new interface\buttonbackground3.jpg$

A mobile, ulcerated mass of 5cm diameter was presentover the third digit. It was notpainful on palpation. Therewere no other lesions; nolymphadenopathy.

Clinical signs - 1

$F:\-- Derm cases ESVD\images\section images\edited on dk blue\vetExamDogNarrow.jpg$

Signs

$C:\Sonya's RVC Work\Derm cases\images\4_pedal mass_nov93\IMG0019_250x250.jpg$

Lateral view of the mass

$F:\-- Derm cases ESVD\images\new interface\titlebackground2.jpg$

$F:\-- Derm cases ESVD\images\new interface\buttonbackground3.jpg$

How would youapproach this case?

$F:\-- Derm cases ESVD\images\section images\edited on dk blue\culture.jpg$

Signs

•What are the next steps you would take?

•Make a list of your principle differential diagnoses

•List any samples you would collect

•List any tests you would perform to assist in making adefinitive diagnosis

$F:\-- Derm cases ESVD\images\new interface\titlebackground2.jpg$

$F:\-- Derm cases ESVD\images\new interface\buttonbackground3.jpg$

Case investigation

$F:\-- Derm cases ESVD\images\section images\edited on dk blue\culture.jpg$

Differentials

•Principle differential diagnoses

•Neoplasia e.g. Schwannoma, haemangiopericytoma,fibroma, fibrosarcoma

•Bacterial pseudomycetoma

•Actinomycetosis, Nocardiosis, Eumyctic mycetoma

•Foreign body reaction

$F:\-- Derm cases ESVD\images\new interface\titlebackground2.jpg$

$F:\-- Derm cases ESVD\images\new interface\buttonbackground3.jpg$

Tests

$F:\-- Derm cases ESVD\images\section images\edited on dk blue\culture.jpg$

Tests

•Tests

•Surgical excision and histopathology were logicaldiagnostic and therapeutic steps

$F:\-- Derm cases ESVD\images\new interface\titlebackground2.jpg$

$F:\-- Derm cases ESVD\images\new interface\buttonbackground3.jpg$

Results

$F:\-- Derm cases ESVD\images\section images\edited on dk blue\culture.jpg$

Tests

$C:\Sonya's RVC Work\Derm cases\images\4_pedal mass_nov93\IMG0020_300x250.jpg$

Histopathology (Joan Rest)

Shows a mass of elongatedcells in onion-skin patternswith moderate quantities ofintervening collagen.

Some nuclei are pallisaded.Other areas are looser intexture. Characteristic of aschwannoma. Where an edgeis present there is a well-defined border.

$F:\-- Derm cases ESVD\images\new interface\titlebackground2.jpg$

$F:\-- Derm cases ESVD\images\new interface\buttonbackground3.jpg$

What is yourdiagnosis?

•Do the investigations permit a definitive diagnosis?

•Are there any additional investigations which you thinkmay need to be done?

Tests

$F:\-- Derm cases ESVD\images\section images\edited on dk blue\culture.jpg$

$F:\-- Derm cases ESVD\images\new interface\titlebackground2.jpg$

$F:\-- Derm cases ESVD\images\new interface\buttonbackground3.jpg$

Diagnosis

•Schwannoma

Tests

$F:\-- Derm cases ESVD\images\section images\edited on dk blue\culture.jpg$

$F:\-- Derm cases ESVD\images\new interface\titlebackground2.jpg$

$F:\-- Derm cases ESVD\images\new interface\buttonbackground3.jpg$

Prognosis

•Prognosis is quite good

•Tumour not attached to subjacent tissue

•No evidence of local spread

•Histology does not suggest malignancy

•But little skin available locally to facilitate removal

Tests

$F:\-- Derm cases ESVD\images\section images\edited on dk blue\culture.jpg$

$F:\-- Derm cases ESVD\images\new interface\titlebackground2.jpg$

$F:\-- Derm cases ESVD\images\new interface\buttonbackground3.jpg$

How would you dealwith this case?

$F:\-- Derm cases ESVD\images\section images\edited on dk blue\pred.jpg$

•Should preliminary cytology have been done?

•Is surgical excision wise as an initial procedure?

Therapy

$F:\-- Derm cases ESVD\images\new interface\titlebackground2.jpg$

$F:\-- Derm cases ESVD\images\new interface\buttonbackground3.jpg$

Therapy - 1

$F:\-- Derm cases ESVD\images\section images\edited on dk blue\pred.jpg$

Therapy

•Justification for immediate excision

•Lesion characteristic of neoplasm, clinically

•Dog in pain

•If an infection, surgery would still be necessary

•Good prognosis if complete removal possible

•Although schwannomas may recur after excision;they do not metastasize

•Warning: limb amputation could be necessaryultimately

$F:\-- Derm cases ESVD\images\new interface\titlebackground2.jpg$

$F:\-- Derm cases ESVD\images\new interface\buttonbackground3.jpg$

Response to surgery

Notes

$F:\-- Derm cases ESVD\images\section images\edited on dk blue\evaluating.jpg$

$C:\Sonya's RVC Work\Derm cases\images\4_pedal mass_nov93\IMG0021_300x300.jpg$

•Complete removal andcoaption was possible givinga good cosmetic result asseen here after 10 days

•No recurrence after 1 year

$F:\-- Derm cases ESVD\images\new interface\titlebackground2.jpg$

$F:\-- Derm cases ESVD\images\new interface\buttonbackground3.jpg$

Review

$F:\-- Derm cases ESVD\images\section images\edited on dk blue\evaluating.jpg$

Notes

•If you would like to review this case, please use thenavigation buttons below