pedal mass in a crossbred dog author: david granteditor: david lloyd © european society of...

Pedal mass in acrossbred dog

Author: David GrantAuthor: David Grant Editor: David LloydEditor: David Lloyd

© European Society of Veterinary Dermatology © European Society of Veterinary Dermatology


History - 2

• The dog was lame on the affected foot but otherwise in good health

HistoryHistory


A mobile, ulcerated mass of 5 cm diameter was present over the third digit. It was not painful on palpation. There were no other lesions; no lymphadenopathy.

Clinical signs - 1

SignsSigns

Lateral view of the mass


How would youapproach this case?

SignsSigns

• What are the next steps you would take?

• Make a list of your principle differential diagnoses

• List any samples you would collect

• List any tests you would perform to assist in making a definitive diagnosis


Case investigation

DifferentialsDifferentials

• Principle differential diagnoses• Neoplasia e.g. Schwannoma, haemangiopericytoma,

fibroma, fibrosarcoma• Bacterial pseudomycetoma• Actinomycetosis, Nocardiosis, Eumyctic mycetoma• Foreign body reaction


Tests

TestsTests

• Tests• Surgical excision and histopathology were logical

diagnostic and therapeutic steps


Results

TestsTests

Histopathology (Joan Rest)Shows a mass of elongated cells in onion-skin patterns with moderate quantities of intervening collagen.

Some nuclei are pallisaded. Other areas are looser in texture. Characteristic of a schwannoma. Where an edge is present there is a well-defined border.


What is yourdiagnosis?

• Do the investigations permit a definitive diagnosis?

• Are there any additional investigations which you think may need to be done?

TestsTests


Diagnosis

• Schwannoma

TestsTests


Prognosis

• Prognosis is quite good• Tumour not attached to subjacent tissue• No evidence of local spread• Histology does not suggest malignancy• But little skin available locally to facilitate removal

TestsTests


How would you deal with this case?

• Should preliminary cytology have been done?

• Is surgical excision wise as an initial procedure?

TherapyTherapy


Therapy - 1

TherapyTherapy

• Justification for immediate excision• Lesion characteristic of neoplasm, clinically• Dog in pain• If an infection, surgery would still be necessary• Good prognosis if complete removal possible• Although schwannomas may recur after excision;

they do not metastasize• Warning: limb amputation could be necessary

ultimately


Response to surgery

NotesNotes

• Complete removal and coaption was possible giving a good cosmetic result as seen here after 10 days

• No recurrence after 1 year


Review

NotesNotes

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pedal mass in a crossbred dog author: david granteditor: david lloyd © european society of...

Documents

removal tests

screen history

mass slide

good health history

therapy justification

clinical signs

surgery notes

signs lateral view