Complications post-MCT removal

Re: Complications post-MCT removal

David Mills — Thu, 07 Jun 2012 22:54:09 GMT

[quote user="Matt Hilary"]

Thank you both for your input.

To clarify, from where on the dog am I taking the FNA? The swelling/oedema encompasses a part of the flank on the RHS and the right forelimb. Representative samples from three different regions? Would mast cells really be present in oedema?

[/quote]

Don't expect a lot of cellularity but this sounds like a response to surgery rather than MCT 'spread'. An FNA will give you an indication of the inflammatory cells present, but if there are MCs present then its a more complex situation; it will also help identify cellulitis.

[quote user="Matt Hilary"]

If I can take a sample and identify mast cells, what's the plan regarding treatment? Is there any role for steroids to treat mast cell reactivity?

[/quote]

Yes to corticosteroids. Some people advocate pre-surgical shrinkage of MCTs in difficult areas with c/s with 70% responding and diameter reduction being around 45% - significant in certain areas:

http://www.ncbi.nlm.nih.gov/pubmed/18167109

In any case if this is a reactive, inflammatory process and not infection then c/s will likely reduce to swelling significantly, and likely resolve it altogether.

Re: Complications post-MCT removal

Matt Hilary — Thu, 07 Jun 2012 19:52:06 GMT

Thank you both for your input.

If I can take a sample and identify mast cells, what's the plan regarding treatment? Is there any role for steroids to treat mast cell reactivity?

Re: Complications post-MCT removal

Bob Russell — Wed, 06 Jun 2012 13:32:31 GMT

I had a not dissimilar case where I thought I was removing a simple cyst.

http://www.vetsurgeon.org/forums/t/9954.aspx

It all went pear-shaped, was referred and still there was no final answer! It did not turn out to be neoplastic, developed post-op infection following referral!

It did settle. I would second the FNA - mast cells are easy to identify. If you don't like cytology may I suggest you follow the link to Decra's CPD and do a quick refresher. Good hints on sample collections and staining so we all learned something!

Re: Complications post-MCT removal

Stephen Courtney — Sun, 03 Jun 2012 22:09:55 GMT

Do your own fine needle aspirate and see what you get - mast cells are easy to spot, so are neutrophils and bacteria - so long as your diff quick is clean and relatively fresh (ie not full of crystalline chunks and debris) and you haven't let dermatologists contaminate it with hair and scrapings!

You either have a cellulitis or an acute flare of inflammation due to some other cause - such as a possible recrudescence of the mast cell tumour or something unexpected.

It seems a little late to be getting a post op infection at this stage - I'd expect such problems to surface soon after the original surgery

Re: Complications post-MCT removal

Matt Hilary — Sun, 03 Jun 2012 21:25:18 GMT

Summary:

Removed intermediate MCT + mass necrotic fat from 8yo MN Labrador
3.5w post-op develops profuse swelling cranial to incision site (MCT site appears unaffected)
Demeanour partially improved on ABs + pain relief but limited progress on swelling
Post-op infection or MCT reactivity?
Further treatment options?