Mast cell tumor Sep. 15th 2011 I.

Indroduction Cutaneous mast cell tumors are very common in dogs and cats(see as appendix 1). However, the histologic type, biologic behavior, therapy and prognosis are quite different between these two species. II. Canine MCT 1. Clinical feature MCTs can occur in any tissue of the body, but are most common in skin. Presentation is varied and can be mistaken for other tumors, especially for lipomas. MCTs secret histamine, which may lead to gastric ulceration, and its possible to be the only clinical signs other than cutaneous mass. 2. Diagnosis FNA(see as appendix 2) Some granules of MCTs are not stained, which may be revealed by Wright-Giemsa stain. FNA DO NOT provide grading!! 3. Clinical staging WHO staging Stage Description 0 Incomplete excised dermal MCT(histologically identified), N0 I One tumor confined to dermis, N0, M0 II One tumor confined to dermis, N1, M0 III Multiple dermal tumors or large infiltrating tumor, N0N1, M0 IV Any T, any N, M1 4. Grading Grade Images Description I Well differentiated Clearly defined cytoplasmic boundaries with regular, spherical, or ovoid nuclei; rare or absent mitoses; abundant, large, deep-staining cytoplasmic granules II Intermediate grade Cells closely packed with indistinct cytoplasmic boundaries; nucleus-to-cytoplasm ratio lower than in anaplastic type; infrequent mitoses; more granules than in anaplastic type III Anaplastic, undifferentiated Highly cellular, undifferentiated cytoplasmic boundaries; nuclei irregular in size and shape; frequent mitoses; sparse cytoplasmic granules 5. Treatment Surgery, radiation treatment and chemotherapy(see as appendix 3) Histamine blocking agent can be given if the patient present systemic clinical signs and it also prevents histamine-related breakdown of wound. 6. Prognosis Prognosis is mostly correlated with histologic grading, so CYTOLOGY is very important.

III. Feline MCT 1. Clinical features Feline MCTs can be cutaneous or visceral. The former is less aggressive than Canine MCTs while the latter occurs in spleen, intestine and other abdominal organs. 2. Others Diagnosis Histologic grading Cutaneous type Biopsy Mastocytic Compact(well-differentiated) Diffuse(anaplastic) Histiocytic Visceral type Imaging and biopsy

Treatment Prognosis

Cutaneous type compact diffuse histiocytic Narrow margin Sx Wide margin Sx Leave alone Worse worse good Worse prognosis if multiple masses are present.

Visceral type Splenectomy, chemo, hospice worse

References: 1. Cancer management of small animal practice 2. Decision making in small animal oncology 3. Small animal clinical oncology 4th

Appendix 1: Frequency of skin tumors in dogs Tumor type frequency Histiocytoma 12% Perianal adenoma 12% Mast cell tumor 10% Lipoma 8% hemangiopericytoma 7% Frequency of skin tumors in cats Tumor type frequency Basal cell tumor 15~26% Mast cell tumor 13~21% Fibrosarcoma 15~17% Squamous cell carcinoma 10~15% Sebaceous adenoma 2~4%

Appendix2: Fine needle aspiration(FNA) FNA, needle core biopsy, punch biopsy and open biopsy are all valuable in small animal medicine, which provide cytologic information and help clinicians make decision on treatment. Among all, FNA is the most useful because it can be performed with proper restraining. Materials: large-gauge needle, syringe and slides Technique:

Appendix3: