Mast Cell Tumor!

Have you seen this kind of cell before? 🔬🦠Thanks to Dr. Hess for sharing this great photo! This is a Mast Cell Tumor!

Mast cell tumors are neoplasms (cancer) that arise from mast cells in the connective tissue. Mast cells are part of the immune system that release histamine and other substances in allergic reactions and other inflammatory conditions. The cause of mast cell tumors is unknown.

Affected Animals: In dogs, the average age of affected animals is 8 years old. Breeds that are considered at increased risk include, but are not limited to: boxers, Boston terriers, English bulldogs, pugs, golden retrievers, and Chinese SharPeis. Of these breeds, Shar-Peis can be younger when they develop tumors and may be more prone to developing multiple lesions.

In cats, the average age of affected animals is 10 years, but kittens can also be affected. Males and Siamese cats may be predisposed.

Clinical Signs: Lesions can be variable in their presentation and range from soft to firm, pink to flesh colored, and can be raised or in the subcutaneous tissue. Size can vary and although typically solitary, they can be multicentric. In dogs,

masses occur predominantly on the trunk, but can also be found elsewhere such as the limbs and head. In the cat, the head and neck are preferred sites.

Diagnosis: Diagnosis can be made by performing a fine needle aspirate and seeing numerous mast cells on cytology (looking at the cells under the microscope). When diagnosis cannot be made via cytology, then a biopsy with histopathology is diagnostic.

Treatment: Treatment decisions for cutaneous mast cell tumors in the dog are based on the location of the tumor, clinical stage, and histologic grade. Management of mast cell tumors includes but is not limited to, surgical excision, chemotherapy and/or radiation therapy. In cats, mast cell tumors are generally benign and treatment may be limited to surgical excision or cryotherapy.

Prognosis: Prognosis in the dog ranges from excellent to poor, depending on the location of the tumor, histological grade and whether metastatic disease is present. In the cat, given that the majority of these cutaneous tumors are

benign, the prognosis tends to be good.

Hepatocutaneous Syndrome

Hepatocutaneous Syndrome 

Also Known As: necrolytic migratory erythema, superficial necrolytic dermatitis, and metabolic epidermal necrosis.

Transmission or Cause: Hepatocutaneous syndrome is a disease characterized by degeneration of the skin cells likely as a consequence of a nutritional imbalance, resulting from metabolic abnormalities caused by severe liver dysfunction or a pancreatic tumor. 

Affected Animals: Hepatocutaneous syndrome is a disease that generally affects older dogs with no consistent breed predisposition. There have been very few reports of cats affected by hepatocutaneous syndrome. 

Clinical Signs: Skin disease is the usual presenting complaint, although some dogs will exhibit systemic illness (lethargy, poor appetite, weight loss) prior to the skin eruptions. The skin lesions frequently occur in areas of trauma such as the muzzle, lower legs, and footpads. Lesions can also affect the mouth, ear flaps, elbows, and genitalia. Most lesions consist of crusting, erosions or ulcerations, but blisters may also occur. Footpads are often severely thickened and fissured and are often painful. 

Diagnosis: Diagnosis is based on supporting history, physical examination, bloodwork abnormalities (such as elevated liver enzymes and low protein levels), and skin biopsy results. Abdominal ultrasonography frequently reveals a pathognomonic “honeycomb” pattern of the liver (due to liver degeneration) or less commonly a pancreatic tumor. In cats, the most common finding is a pancreatic tumor. 

Treatment: If a pancreatic or liver tumor is identified and able to be surgically excised, the skin lesions may normalize for an extended period of time, but because these tumors metastasize (spread to other areas of the body) quickly, surgery is not curative. In cases of end stage liver disease, surgery is not possible, and the goal of therapy is to increase quality of life and decrease uncomfortable skin lesions with supportive care and addressing the nutritional abnormalities. Supportive care includes supplementing protein and necessary minerals and enzymes through the diet and oral supplements or by weekly intravenous amino acid infusions that are performed in the hospital on an outpatient basis until improvement in the skin is noted. Unfortunately, despite the supportive care, the disease will progress. 

Prognosis: As this disease is a cutaneous marker for serious internal disease, the prognosis is poor with a survival time of less than a year in most cases.

Erythema Multiforme

Erythema Multiforme 

Transmission or Cause: The cause of this condition is unknown. Precipitating factors include medications, dietary substances, vaccines, and some infections, possibly including feline herpes virus and canine parvovirus. In many cases, the cause is idiopathic. 

Affected Animals: An uncommon to rare skin disorder that can affect both dogs and cats. 

Clinical Signs: The lesions associated with Erythema Multiforme can be vast and variable, but generally will present acutely and have a symmetrical appearance. In most cases, dogs and cats will have reddened flat or slightly elevated lesions that may or may not be crusted. 

Other clinical signs can include vesicles, bullae, ulcers, hives, hair loss and scaling. Lesions are typically found in the inguinal, axillary or head region but may also be found in the oral cavity, on foot pads, ears and mucocutaneous junctions. 

Humans with Erythema Multiforme will generally develop a typical target lesion, which is a round, sharply demarcated lesion with a least three different zones of color: a dark red disk is surrounded by concentric rings of edematous tissue and peripherally located reddened tissue. Although animals can develop similar lesions, they rarely develop the human equivalent of the typical target lesion. Some animals will present with systemic signs of illness, including fever, anorexia and depression. 

Diagnosis: Diagnosis is made via clinical presentation in conjunction with biopsy. 

Treatment: Many cases of Erythema Multiforme are mild and may be self-limiting. In any case, attempts to identify and correct underlying causes should be made. In cases of persistent disease, then immunosuppressive medications, such as prednisone, cyclosporine and azathioprine may be beneficial. However, when medications are tapered, recurrences can occur especially in idiopathic cases. 

Prognosis: Prognosis is guarded to fair depending on the severity of the skin lesions, whether an underlying cause can be identified and treated, and overall response to treatment.

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