Wednesday, December 2, 2015

Large and Rare Tumor Successfully Removed

Meet Louis, a three year old Cocker Spaniel cross, who over several months developed a large, firm mass attached to the left portion of his skull. The mass deviated his left eye and felt like a bony growth under his skin.

A CT scan demonstrated a rather uncommon tumor, whose name has changed multiple times over the years and is referred to today as a Multilobulated Osteochondroma (MLO). These tumors usually arise from the flat bones of the skull. Although they are typically evident on the outside of the skull, they tend to grow just as aggressively on the inside, often compressing the brain.

This tumor was exceedingly large and besides the extensive nature of the mass, my concern was that its removal might compromise the drainage of blood from the brain, thus leading to Louis’ death. We fortunately have very specialized equipment that not only allows us to look at a mass from all directions but has the ability to construct an accurate three dimensional model giving us specific landmarks for growth removal.

I have included 3-D reproductions of the mass from the front, the side and the top. I’ve included a cross sectional view that shows the mass compressing Louis’ brain. I colored the brain red-brown and the mass in green so that you can appreciate the amount of pressure exerted.

The surgery involved removing the entire boney mass and then additionally, to ensure wide margins, removing a significant portion of the left boney orbit that holds the left eye, the left frontal sinus and much of the right frontal sinus. Closing the surgical incision so the brain is protected and adding material to insure no access for infection from Louis’ nasal passages to his brain, are problems we have seen and solved many times in the past. Several techniques I learned, while rotating with human neurosurgeons, were helpful.

Included is a picture of Louis the day after surgery and one week after surgery.  We are going to remove his staples in about two weeks and may have to trim the extra skin which developed as the mass slowly stretched the area out of shape.

This tumor, even with the finest of excisions, does tend to grow back. However, this
may occur years from now. I have removed the same type of tumor from some dogs two, three and four times while they continued to live a normal, happy life. Louis looks pretty darn handsome already and is back to behaving like his usual sweet self.

When faced with extremely complicated cases, VCA VRA is known for its excellent results over the past three decades. Our experienced staff and cutting edge technology are available 24/7 should your furry friend be in crisis.