I’m so sorry to read this, Marsha. You might join the Yahoo feline cancer group and post your question there.
Best hopes for Harley, Lance > On Mar 15, 2015, at 3:36 PM, Marsha <mar...@lynxe.com> wrote: > > Harley had a CT scan on Monday, and needle biopsy Friday. Saturday > (yesterday) the report came back that he has cancer. It is in the area of > his right middle ear and TMJ. By the CT images, it does not appear to be > something operable - it does not have distinct borders and there is no room > to get margins. I have many things to discuss with vets tomorrow: comfort > care for the time being for sure; how effective is radiation treatment vs. > benefit to Harley; are there any chemo protocols for this that can help? > Also they push for a full biopsy requiring surgery because the diagnosis will > be more "definitive" and they could stage the cancer then. But I question > the cost (both money and physical discomfort to Harley) vs. benefit to him. > How will the full biopsy change potential treatment? It will cost money, has > risk due to anesthesia, location of mass, and possible infection, and will > cause him some pain afterwards. Is it worth it for the extra bit of detail? > Below is the report if you're interested, and able to read the technical > stuff. One note on the final comment that radiographs are recommended to > rule out bone involvement: the CT scan showed already showed bone lysis > (erosion), but the pathologist did not have access to the info from the CT > scan. > > In the meantime, Harley has gotten meloxicam or buprenorphine when he doesn't > want to eat. The anti-inflammatory effects of meloxicam give him relief for > 4 days or so, allowing him to eat comfortably. I just worry about potential > kidney toxicity with that drug, so they have to be really careful about > dosing, and the risk goes up long-term. I wouldn't ordinarily say yes to > that drug, but it helps him. And if he's not going to make it long-term, the > kidney concern takes back seat to his comfort. The buprenorphine doesn't > help nearly as much, but may make him feel good. He has been eating all his > food for the last 5 days, and plays and grooms himself. A little more > subdued than usual, but he has a big burst of energy after his breakfast or > dinner. > > Marsha > > CLINICAL INFORMATION: > Mass adjacent to/involving the right tympanic bulla; painful to open > mouth; bulge palpated through skin medial to the right caudal mandible > suspected to be the mass; blind aspirate; concern for carcinoma; > patient is FeLV positive; regional node (and all peripheral nodes) > palpate normal > > SOURCE: > Mass adjacent to roof of mouth right side: 12 slides > > DESCRIPTION/MICROSCOPIC FINDINGS/COMMENTS: > > Microscopic Description: The smears are low to moderately cellular on > a clear background with moderate blood contamination, many scattered > platelet clumps and a low to moderate number of ruptured cells. Few > small, loosely cohesive clusters of polygonal to cuboidal epithelial > cells are observed. This population exhibits mild to moderate > anisocytosis and anisokaryosis. The cells have a small amount of > variably staining purple cytoplasm and a round central nucleus. The > nuclei have finely stippled to reticular chromatin and often 1-2, > small prominent nucleoli. There are also rare mesenchymal cells noted > displaying oval nuclei, one to three small nucleoli and moderate > amounts of basophilic cytoplasm. This population exhibits mild to > moderate anisocytosis and anisokaryosis and occasionally surrounds a > small to moderate amount of pink extracellular matrix. No infectious > agents or cytologic evidence of inflammation are observed. > > Microscopic Findings: EPITHELIAL NEOPLASIA; MILD TO MODERATELY > ATYPICAL MESENCHYMAL CELLS > > Comment: The observed epithelial population exhibits only mild atypia > but based on the number seen and the provided history raise concern > for a well-differentiated, malignant neoplasm. Cell morphology of > this population is most consistent with a basal cell, ceruminous gland > or apocrine gland population. Significance of the rare mesenchymal > cells is uncertain (they could be a fibrous component associated with > the mass/granulation tissue, connective tissue, possibly rare cells > associated with a well-differentiated mesenchymal tumor). Tissue > biopsy with histopathology is recommended for a specific diagnosis. > Radiographs of the area are also recommended to completely rule out > underlying bone involvement. > > _______________________________________________ > Felvtalk mailing list > Felvtalk@felineleukemia.org <mailto:Felvtalk@felineleukemia.org> > http://felineleukemia.org/mailman/listinfo/felvtalk_felineleukemia.org > <http://felineleukemia.org/mailman/listinfo/felvtalk_felineleukemia.org>
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