[Felvtalk] Has anyone gone with radiation treatment for FeLV+ with cancer?

Marsha martia at lynxe.com
Sun Mar 15 15:36:17 CDT 2015


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.


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