non-inflammatory masses cases

Question 1

identify the mass
state how you would manage the case

Answer 1

Adipocytes - consistent with Lipoma
* Watch for growth (make sure to measure at every consult), depending on location consider surgical removal due to patient comfort (this is large so in this case might be best to remove now)
* No action unless nature changes (e.g. becomes more fixed, less circumscribed, firmer)

Question 2

identify the mass
state how you would manage the case

Answer 2

Follicular Cyst
* measure at every consult, monitor for change
* could excise

Question 3

identify the mass
state how you would manage the case

Answer 3

Mast cell tumour
* Excisional biopsy not possible at this site – so incisional biopsy to grade + stage (regional LNs, imaging/FNA liver + spleen)
* Seek advice of oncologist - act quickly as will grow
* Radiotherapy?
* Tyrosine kinase inhibitor? (Ki67 may help predict their efficacy)
* Tigilanol tiglate (Stelfonta)? For non-metastatic, non-resectable MCTs but concern re proximity to nares

Question 4

identify the mass
state how you would manage the case

Answer 4

histiocytoma
* Frequently resolve spontaneously
* keep an eye on it

Question 5

identify the mass
state how you would manage the case

Answer 5

Abscess (cat bite)
Lance (gravity dependant site) (big enough to continue to drain), flush, analgesia
Cat is pyrexic but not systemically unwell, if cat becomes systemically unwell and still pyrexic then give antibiotics

Question 6

identify the mass
state how you would manage the case

Answer 6

Clinical appearance suggestive of feline injection site sarcoma (fibrosarcoma)
Incisional biopsy to confirm

If confirmed, likely to need staging and radical excision (3cm margins) +/- chemotherapy +/- radiotherapy – usually referral
Discussion with owner in light of cost implications and guarded prognosis (frequently recur)