Last year a very observant owner noticed a lump on his dogs tongue, and brought him to the surgery for examination.
There were no other abnormalities found on clinical examination.
From a patients point of view it is important and necessary to make an accurate diagnosis, check for other associated conditions, and remove the mass.
How did we approach this case:
Firstly we performed cytology (we use a thin needle to take a small sample that we can examine under a microscope). From this we could tell that this was not an infectious or inflammatory process, and that it was a true growth (tumour).
Once we knew we were dealing with a tumour, it became important to find out whether it was likely to be malignant (the bad tumours that either spread to other parts of the body, or recur when removed), or benign (no further problems once removed, or may spontaneously disappear).
We also knew that it was unnecessary to send bacterial cultures and antibiograms (grow bacteria and find out which antibiotics they are sensitive to) to a laboratory, as there was no indication of infection.
However we knew that it was important to check to see if there was any evidence of related underlying disease, and to check for potential spread of the mass. Screening blood tests and chest x-rays were negative for related problems.
Once these routine procedures were completed we performed a wedge biopsy, in which we cut a small section or wedge from the mass. This was then sent to an external laboratory where the mass is sliced into very thin sections and examined under a microscope by a veterinary pathologist. The advantage of histopathology over cytology at this stage is that the structure of the mass is maintained, and a more detailed analysis of the mass can be made.
Cytology and histopathology are complementary procedures.
Now we waited for the histopathology report:
The histopathologist confirmed that this was calcinosis circuscripta. With the information we had available, we knew the following important points:
There were no other abnormalities found on clinical examination.
From a patients point of view it is important and necessary to make an accurate diagnosis, check for other associated conditions, and remove the mass.
How did we approach this case:
Firstly we performed cytology (we use a thin needle to take a small sample that we can examine under a microscope). From this we could tell that this was not an infectious or inflammatory process, and that it was a true growth (tumour).
Once we knew we were dealing with a tumour, it became important to find out whether it was likely to be malignant (the bad tumours that either spread to other parts of the body, or recur when removed), or benign (no further problems once removed, or may spontaneously disappear).
We also knew that it was unnecessary to send bacterial cultures and antibiograms (grow bacteria and find out which antibiotics they are sensitive to) to a laboratory, as there was no indication of infection.
However we knew that it was important to check to see if there was any evidence of related underlying disease, and to check for potential spread of the mass. Screening blood tests and chest x-rays were negative for related problems.
Once these routine procedures were completed we performed a wedge biopsy, in which we cut a small section or wedge from the mass. This was then sent to an external laboratory where the mass is sliced into very thin sections and examined under a microscope by a veterinary pathologist. The advantage of histopathology over cytology at this stage is that the structure of the mass is maintained, and a more detailed analysis of the mass can be made.
Cytology and histopathology are complementary procedures.
Now we waited for the histopathology report:
The histopathologist confirmed that this was calcinosis circuscripta. With the information we had available, we knew the following important points:
- It was a benign mass
- There were no indications of it being associated with any other condition.
- It was likely to resolve completely with removal.
The final part:
We anaesthetised the patient and removed the mass.
This healed without complication and our patient is continuing to live in good health.
Happy dog, happy owners, happy result.
For your interest:
Calcinosis circuscripta is a rare condition in dogs (and other species), where a mass is formed by abnormal calcium deposits. Complete removal is usually curative.
