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How to deal with the incidental mass

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Abstract

This lecture covers the approach to the incidentally found cutaneous and subcutaneous mass. This can be a very broad spectrum from a pinpoint mass to a football-sized tumour which wasn’t there yesterday! Topics addressed include: is it OK to remove a tumour without knowing what it is?; which masses are deserving of some additional testing or staging before surgery?; a brief discussion on surgical margins; that I do sometimes assume a mass is a lipoma!

As more animals undergo imaging evaluations in veterinary practice, and as these assessments increase in sensitivity, the possibility of finding an ‘incidentaloma’ (incidentally found mass) increases. These are occasionally found in canine patients, often when staging is performed for more obvious external conditions. In the limited veterinary literature on abdominal incidentalomas, 4% of dogs undergoing abdominal ultrasonography in one study were found to have adrenal masses, and 9% in another study on CT. Splenic masses are a relatively common incidental finding and one report documented that 30% of incidentally found splenic nodules were malignant. These findings are challenging for vets and clients in attributing relevance, especially in patients with other neoplastic diseases. This presentation focuses on common presentations of abdominal incidentalomas and uses case studies to demonstrate decision making for these patients. The aim is to develop awareness of the significance of incidentalomas and skills in how to manage them.

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