Soft tissue sarcoma

Re: Soft tissue sarcoma

Bob Russell — Wed, 25 Jun 2014 10:20:09 GMT

I have said broadly similar things to the owner of a 10yr old lurcher. I removed a mass on its foreleg, considering its behaviour to be pretty benign. It has turned out to be a 'soft tissue' sarcoma with incomplete margins.

The husband was all for me lopping off the leg but I have suggested a wait and see approach. Hopefully it will be fine (I went to a day CPD that Gerry did!) but if necessary I will lop the leg off!

Re: Soft tissue sarcoma

Tim Charlesworth — Wed, 25 Jun 2014 09:51:53 GMT

I'd echo Gerry's comments. There is a difference between intentional/planned local resection of these and simple shelling out and some of the papers looking at recurrence rates were restricted to older dogs (which may play a part in why they didn't recur) but I think that leaving be and monitoring the site would be reasonable. The other options would be to resect your wound to extend the margin, depending on the size of the wound you create, you can often leave them open (bandaged in short term) to heal by 2nd intention (this does take a bit of confidence), close them locally or even graft (full graft or punch grafts depending on experience) or send the dog for radioTx/consider chemo as per GP.

If you send me a photo of the wound (size + location) + the histo report I can tell you what I would do if that would be useful,

definitely no panic though. All of the above are valid options and not mutually exclusive,

Tim

Re: Soft tissue sarcoma

Gerry Polton — Wed, 25 Jun 2014 08:16:18 GMT

Before you get too alarmed, direct yourself to the November 2009 issue of JSAP. A rather elegant paper demonstrated that marginal excision of low grade spindle cell sarcomas resulted in lasting remission (up to seven years) in over 70% of cases. Multiple subsequent workers have demonstrated the same thing. Before advising an expensive intervention, consider no action at all as a perfectly valid option. Your owner may not be comfortable with a 30% or so risk of relapse. But in actual fact, they may be very comfortable with it indeed.

I have made an assumption that this is a low grade spindle cell sarcoma. Feel free to e-mail the report to me if you are in any doubt and you would appreciate me taking a look. The alternative treatments suggested of radiotherapy and metronomic chemotherapy are reasonable suggestions. I would prefer revision surgery to those two if push came to shove but all are perfectly rational in appropriate cases.

Taking advice from the Hitchhikers Guide to the Galaxy, DON'T PANIC.

Gerry

Re: Soft tissue sarcoma

Claire Fisher — Tue, 24 Jun 2014 23:02:39 GMT

Is referral for radiotherapy possible? or consider metronomic chemotherapy.

Otherwise wait and see - I have had similar histo reports where the mass never recurred.