Oral plasma cell tumour

RE: Oral plasma cell tumour

David Mills — Mon, 14 Sep 2020 10:13:20 GMT

Update on this case, a month down the line and no evidence or recurrence as yet. Removed the vicryl sutures today as some reaction to them. Pic below.

RE: Oral plasma cell tumour

Ex Member — Wed, 19 Aug 2020 21:46:43 GMT

Finger crossed for him!

RE: Oral plasma cell tumour

Evelyn Barbour-Hill — Wed, 19 Aug 2020 17:10:58 GMT

[quote userid="8991" url="~/001/veterinary-clinical/small-animal/oncology/f/discussions/29284/oral-plasma-cell-tumour/224978#224978"]Owner does not wish to pursue further treatment if/when regrows (partly due to financial considerations), so benign neglect for now and hope there is a decent tumour-free period of time.[/quote]

Yes, fair enough.

RE: Oral plasma cell tumour

David Mills — Wed, 19 Aug 2020 09:24:11 GMT

Thanks, I was quite pleased with the result.

Elected not to send for histo - although an en bloc resection it did disintegrate when removed, which does make me suspicious of some spread especially to bony margins. Owner does not wish to pursue further treatment if/when regrows (partly due to financial considerations), so benign neglect for now and hope there is a decent tumour-free period of time. They sure do grow quick these things.

RE: Oral plasma cell tumour

Ex Member — Tue, 18 Aug 2020 14:14:06 GMT

Dear David, yes of course histology is a must because if histological margins are incomplete that would be an indication for adjuvant therapy or, even if owner cannot afford either electrochemo, radio or chemo, you would know that there is increased risk of recurrence. Let us know if you need further advice.

Regards and stay safe, Chiara

RE: Oral plasma cell tumour

Evelyn Barbour-Hill — Tue, 18 Aug 2020 12:32:28 GMT

[quote userid="8991" url="~/001/veterinary-clinical/small-animal/oncology/f/discussions/29284/oral-plasma-cell-tumour/224965#224965"] Performed a partial caudal maxillectomy yesterday, before and after pics below.[/quote]

Thanks for the update, lovely pictures!

Are you getting histology done with regard to margins, or is there no point?

RE: Oral plasma cell tumour

David Mills — Tue, 18 Aug 2020 08:17:27 GMT

Thanks for all the replies, very helpful and pragmatic. Performed a partial caudal maxillectomy yesterday, before and after pics below. Aimed for gross 1cm margins, suspicion of some bone involvement lingual aspect. Will see how things progress from here. Thank you again.

RE: Oral plasma cell tumour

Ex Member — Fri, 14 Aug 2020 23:42:27 GMT

Dear David that sounds a good plan. Electrochemotherapy is the application of electrical pulses after administration of chemo to open the cancer cell (process called electroporation) so the chemo can concentrate inside the cancer cell by increasing significantly its effectively. It can be used in almost any tumour type after incomplete surgical resection or as palliative in unresectable tumours. Only a couple of treatments is usually needed under a short sedation or anaestetic. I am running several online cods where I discuss this technique and its clinical applications if you are interested. Regards, Chiara

RE: Oral plasma cell tumour

David Mills — Fri, 14 Aug 2020 23:34:30 GMT

Hi all, thanks for the valuable input.

The plan after discussion with the owner is to proceed to an intent-to-cure maxillectomy early next week.

Electochemotherapy I have read about but no real understanding of (charity practice).

RE: Oral plasma cell tumour

Ex Member — Fri, 14 Aug 2020 15:41:50 GMT

Oral plasmacytomas have low risk of metastasis albeit malignant plasmacytomas or multiple plasmacytomas and bone invasion are possible. I would run a haematology and serum biochem to spot any cytopenia or gammopathy although hopefully they will be absent. I would do cytology of local lymph nodes and at least oral radiographs to check for bone invasion. As of treatment, best would be maxillectomy with wide margins with likely curative intent, or if no sigificant bone invasion, conservative surgery with adjuvant radiotherapy or electrochemotherapy or melphalan. Alternatively palliative radiotherapy, electrochemotherapy or melpahalan only. The most cost effective would be maxillectomy or conservative resection with two fortnightly treatments of electrochemotherapy. Happy to help with the latter if you need electrochemotherapy or just to know more about it.

Dr Chiara Penzo DVM PhD Dip.ECVIM(Oncology)MRCVS

Referral Oncology Service

Willows Veterinary Centre & Referral Service

RE: Oral plasma cell tumour

Rob Davis — Thu, 13 Aug 2020 14:18:46 GMT

If you can achieve decent margins (probably 1cm is fine though this is a little arbitrary) then these tend to do well. CT definitely makes surgical planning easier, but if that's not a option then as Evelyn says, taking out what you can reasonably achieve and hoping for the best is not an unreasonable option as long as the owner is fully informed.

RE: Oral plasma cell tumour

Evelyn Barbour-Hill — Wed, 12 Aug 2020 13:46:24 GMT

£3000 isn't so bad, should cover everything essential, but to my mind if you need to keep to a budget and the owner is keen to try, a plan could be a generously-sized maxillectomy ASAP without CT or even without prior lymph node assessment, and take the chance.

Feel free to dump on me for suggesting this.

RE: Oral plasma cell tumour

Sarah Wheadon — Wed, 12 Aug 2020 12:55:18 GMT

Had one recently, and this was the plan. Sadly however, it grew by the day and within a week had deteriorated to the pint where referral surgeons regarded any intervention as 'heroic' . Hope yours has a happier outcome.