Leiomyosarcoma in a 7 year old Flat Coat

RE: Leiomyosarcoma in a 7 year old Flat Coat

Neil Wheadon — Mon, 11 Sep 2017 17:14:55 GMT

As an update

IDEXX expert called me back and he was very helpful

1) Thanks for the initial tip. Many will not respond to surgery

2) A few will respond to removing the ovaries, but you can look for oestrogen receptors on the submitted material and this can be done for about £100. This is from human oncology

3) Removal is fraught. Ideally advanced imaging required and a vaginectomy required. Something beyond me as a locum, especially as I won't be about for follow up and where does that urethra go?

In consultation with the owner, path of least harm, so have left alone.

Thanks for the 2 replies, especially Lou, who stopped me in my tracks, appreciated

Neil

RE: Leiomyosarcoma in a 7 year old Flat Coat

Beats — Mon, 04 Sep 2017 21:07:56 GMT

Hi Neil,

Not sure what you mean re dorsally.

I think removing the ovaries can make some sense, but I think removing the lump is the more important consideration.

I tend to put a pair of mayos in and open up skin and vagina in a one cut up the level of anus if required and then cut and stitch (I'd use diathermy if I had it...). If it's quite deep into horizontal canal can often pull forwards and just remember to stitch a bit of mucosa BEFORE you cut the whole lump off as it will ping back never to be seen again otherwise. There's quite often a few lumps - I remove the main culprit and then make a call on whether worth cutting more or not. Put a foley catheter in the urethra once you've opened up the vagina and leave it in for a few days if in doubt and you're cutting right up to the urethral opening (It's hard to stick back in again if not urinating post-surgery due to inflammation/infection etc).

I think even the malignant ones can be slow-growing, so I'd probably excise, but don't quote me on that!

RE: Leiomyosarcoma in a 7 year old Flat Coat

Lou Dawson — Mon, 04 Sep 2017 14:11:15 GMT

Benign leiomyomas are hormonally responsive but I don't think sarcomas are. Metastasis is uncommon so I'd guess that debulking might be palliative. I don't think OVH would have too much of an effect on this tumour in my experience (happy to be corrected by someone with more clinical/repro/oncology experience though) but may help reduce risk of any additional lesions developing?