Soft tissue sarcomas

image of Soft tissue sarcomas
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Soft tissue sarcoma is a catch-all classification referring to tumours that arise from the embryonic mesoderm and, as such, can occur anywhere in the body. This chapter reviews aetiology and pathogenesis; presentation and clinical signs; clinical approach; histological subtypes; management and prognosis.

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14.2 Soft tissue sarcomas eventually invade the overlying skin and become ulcerated. This often prompts veterinary attention, as with this long-standing STS of the pinna.
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14.3 Feline injection site sarcomas (ISSs) typically occur over the interscapular area or body wall. To achieve a cure, 3 cm margins and a resection of at least one uninvolved fascial plane below/around the tumour is recommended at the first surgery.
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14.4 The reactive zone contains satellite deposits of cancer cells. These microscopic tumours are easily left behind in the wound if a marginal excision is performed by peeling the mass out.
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14.5 This slow-growing axillary grade I STS in an elderly Rottweiler had been present for 6 years, but was beginning to interfere with walking.
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14.6 Plain radiographs of the extremities will show the mass to be of soft tissue rather than fat density, as in this STS of the caudal thigh.
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14.7 Contrast CT showing a grade II myxosarcoma of the proximal right thigh in a dog. The close anatomical relationship with both the femur and pelvis shows that amputation alone would not cure this dog: hemipelvectomy to remove the ilium would also be necessary.
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14.8 Grade I PNST over the hock in an elderly German Shepherd Dog.
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14.9 Infiltrative lipoma. CT images show an area of fat density pushing between the muscles of the right limb. Intra-lesional excision. Umbilical tape can be seen retracting and protecting a nerve. Gross tumour will be left behind and postoperative radiation should be considered.
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14.10 Subcutaneous HSA of the ventral neck in a cat. Chest radiographs revealed disseminated metastatic disease.
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14.11 Fibrosarcoma on the rostral edge of the pinna in an elderly cat. This was treated by 3 cm excision, pinnectomy and total ear canal ablation, and closed with a single-pedicle advancement flap from the dorsal neck.
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14.12 Grade I STS of the lateral stifle. An outline of the subcutaneous mass is drawn, followed by a 3 cm skin margin. This type of preoperative planning helps in choosing reconstructive options before excising the tumour .
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14.13 A marginal excision of the mass shown in Figure 14.5 . The deep margin of the mass was peeled off the pectoral muscles. Residual disease was assumed. Given the age of the dog and the slow-growing history of the mass, the owner opted for a conservative palliative surgery to improve quality of life.
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14.14 To prevent ‘tissue slip’, the deep fascia is sutured to the skin edge to ensure that ink does not ‘under-run’ the fascial layer, giving misleading results on tumour margins. A thin layer of India ink () is applied to the cut surfaces with a cotton bud.
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14.15 Recurrence of an STS in the radiation field on the antebrachium of a dog.
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14.16 A ‘dirty’ scar over the elbow of a dog is being excised with 3 cm margins. The antebrachial fascia (in forceps) is forming the deep margin. The residual tumour was completely excised.
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14.17 Treatment planning in feline ISS.
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14.18 Using bone cutters to cut the dorsal spinous processes in a cat during ISS resection. The surgeon is moving from cranial to caudal. The dorsal border of the scapula in the foreground has also been resected.
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