Difference between revisions of "Labrador cross with mass on antebrachium"

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(Created page with "<b><big> <u>Signalment</u>: :7-year-old male neutered Labrador cross <u>Presenting sign</u>: :7 x 5 cm firm mobile mass on the caudal aspect of the proximal antebrachium, w...")
 
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question="What would be your next step?"
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choice1="Excisional biopsy of the mass"
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choice2="Incisional biopsy of the mass using a Tru-Cut biopsy needle under sedation"
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choice3="Incisional biopsy, taking a wedge of tissue from the edge of the lesion under general anaesthesia, including a small section of grossly normal tissue, in a way that does not compromise further resection under general anaesthesia."
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choice4="FNA cytology in-house"
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feedback1="'''Incorrect'''. This is definitely not the way to proceed. Revise principles of surgical oncology."
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feedback2="'''Incorrect'''. Not a bad choice, but as the mass is so large and the sample is so small, the sample may be friable and necrotic, leading to difficulty in interpretation, so this should not be your first option. It would be best to perform a fine-needle aspirate (FNA) before histopathology, in case a diagnosis can be reached using cytology only (e.g. lipoma, mast cell tumour, abscess)."
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feedback3="'''Incorrect'''. Correct technique for a histopathological diagnosis, including an idea of behaviour. However, it would be best to perform FNA before histopathology, in case a diagnosis can be reached using cytology only (e.g. lipoma, mast cell tumour, abscess)."
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feedback4="'''Correct'''. It is best to perform FNA before histopathology, in case a diagnosis can be reached using cytology only (e.g. lipoma, mast cell tumour, abscess.) The FNA reveals blood only, but suspicion of sarcoma is increased, as sarcomas do not exfoliate cells readily and it is common to aspirate blood with soft-tissue sarcomas. Abscess and lipoma are ruled out, and a mast cell tumour is unlikely. You proceed to incisional biopsy (technique as described in option 3)."
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Revision as of 17:31, 28 September 2012

Signalment:

7-year-old male neutered Labrador cross

Presenting sign:

7 x 5 cm firm mobile mass on the caudal aspect of the proximal antebrachium, which has grown over the past three months. Otherwise clinically well, with no evidence of lameness and no other history of illness. Physical exam is otherwise within normal limits.



100

Please select an option

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1

What would be your next step?

Please select an option Incorrect. This is definitely not the way to proceed. Revise principles of surgical oncology. Incorrect. Not a bad choice, but as the mass is so large and the sample is so small, the sample may be friable and necrotic, leading to difficulty in interpretation, so this should not be your first option. It would be best to perform a fine-needle aspirate (FNA) before histopathology, in case a diagnosis can be reached using cytology only (e.g. lipoma, mast cell tumour, abscess). Incorrect. Correct technique for a histopathological diagnosis, including an idea of behaviour. However, it would be best to perform FNA before histopathology, in case a diagnosis can be reached using cytology only (e.g. lipoma, mast cell tumour, abscess). Correct. It is best to perform FNA before histopathology, in case a diagnosis can be reached using cytology only (e.g. lipoma, mast cell tumour, abscess.) The FNA reveals blood only, but suspicion of sarcoma is increased, as sarcomas do not exfoliate cells readily and it is common to aspirate blood with soft-tissue sarcomas. Abscess and lipoma are ruled out, and a mast cell tumour is unlikely. You proceed to incisional biopsy (technique as described in option 3).

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