Mast Cell margins - Pinnectomy or no Pinnectomy?

Re: Mast Cell margins - Pinnectomy or no Pinnectomy?

Elisabeth Knappett — Tue, 05 Nov 2013 14:21:18 GMT

Thanks for the update - good news there then!

Re: Mast Cell margins - Pinnectomy or no Pinnectomy?

Anthony Dennison — Tue, 05 Nov 2013 09:29:08 GMT

Sorry, yes the report came back at the end of last week. It was a grade I MCT, full margins achieved, including deep margins.

Re: Mast Cell margins - Pinnectomy or no Pinnectomy?

Elisabeth Knappett — Mon, 04 Nov 2013 23:27:48 GMT

Any histo report yet? Interested in the outcome of this case, a colleague has something similar brewing at the moment......

Re: Mast Cell margins - Pinnectomy or no Pinnectomy?

Anthony Dennison — Mon, 28 Oct 2013 08:51:57 GMT

Sorry for the delay on this;

I removed the mass last week, and it had shrunk, almost to just a thickened area of skin. So it will be interesting to see what the histo report says

Re: Mast Cell margins - Pinnectomy or no Pinnectomy?

Christopher Saul — Sat, 26 Oct 2013 14:36:05 GMT

I don't think we can decide if this case requires systemic chemotherapy until we have histology; you cannot grade MCTs reliably on cytology alone so you don't even know for sure what margins you need to achieve.

MCTs are in the first instance surgical diseases so if you can remove it fairly easily then I would do so. If not, I guess there is no harm in shrinking it with some neo-adjucntive steroids to facilitate surgery.

I would suggest explaining to the owners that the surgery is an excisional biopsy rather than a definative procedure at this stage. If histo suggests the MCT is aggressive and the margins from your initial excisional biopsy are inadequate then a second surgery, or referral for RT, are options. If the histo returns a low grade tumour (or intermediate with good margins) then it's a bonus!!

Re: Mast Cell margins - Pinnectomy or no Pinnectomy?

Elisabeth Knappett — Mon, 21 Oct 2013 00:25:10 GMT

How old is the dog? Just that I've had a mass diagnosed as MCT on cytology return as histiocytoma on histology, think they can look similar in certain stages? May explain why its disappeared...

I second trying to shrink first with masivet/antihistamines first, possibly speak with a local oncologist?

Re: Mast Cell margins - Pinnectomy or no Pinnectomy?

Hanna Bennett — Sun, 20 Oct 2013 18:34:55 GMT

also - the only issue I've had with pre treating with steroids (which I certainly do) is occasionally the mass shrinks so much you can't find it to remove it!

Re: Mast Cell margins - Pinnectomy or no Pinnectomy?

Hanna Bennett — Sun, 20 Oct 2013 18:32:58 GMT

they certainly no longer recommend 3 cm margins, the last specific advice I had was margins should be the same size as your mass. having said that, I will excise closely in awkward areas, having discussed the possibility of further surgery with owners beforehand. if it is grade 3 then all the surgery in the world won't fix it. so I now wait for grading before making any complicated decisions.

Re: Mast Cell margins - Pinnectomy or no Pinnectomy?

Anthony Dennison — Sun, 20 Oct 2013 09:30:46 GMT

I spoke to the owner on Friday, who says the mass has disappeared since I sampled it (?!). Seeing the dog again on Tuesday (I'm off tomorrow) to have a feel and then discuss options.

After my last MCT, Liverpool Oncology department said that margins only need to be >5mm, is that right?

Re: Mast Cell margins - Pinnectomy or no Pinnectomy?

Hanna Bennett — Sat, 19 Oct 2013 21:38:35 GMT

I would always do local resection first - it could be grade 1 (fixed) or grade 2 (95% fixed). but then i'm a medic not a surgeon.

Re: Mast Cell margins - Pinnectomy or no Pinnectomy?

Sammy82 — Sat, 19 Oct 2013 10:44:36 GMT

Or you could try Masivet if finances are not too restricted.

Re: Mast Cell margins - Pinnectomy or no Pinnectomy?

Matt Hilary — Fri, 18 Oct 2013 11:42:27 GMT

Not sure about your question re margins but if trying to reduce size of the mass may be worth trying anti-histamines as well/instead of steroids.