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Thank you for your reply.
Margin is being reviewed by histopathology. We are awaiting the results, but may be afew more days.
I do not believe that Lymph nodes or liver were biopsied.
I am inmy office, but need to go home. Can I sign off and log on again?
Thank you, Manuel
I am back on line from home. and am waiting for your response.
If special staining was not performed on the biopsy sample (typically you have to request this), you will want to do so. Many tumors initially classified as leiomyosarcomas are really gastrointestinal stromal tumors (GISTs). In general the STs may not be that different and most cases that are completely excised had longterm survival. The prognosis is better with the GIST tumors. I have one patient now who has been under the care of a oncologist since I surgically removed a cecal GIST 1.5 years ago. She did develop a second tumor in her abdomen near her bladder a few months back, but it was resected completely as well. She is doing great!
1 Department of Clinical Sciences of Companion Animals, University of Utrecht, Utrecht, The Netherlands.
OBJECTIVES: To reclassify canine small intestinal and cecal leiomyoma (LM) and leiomyosarcoma (LMS) into smooth muscle and gastrointestinal stromal tumors (GIST) using histologic and immunohistochemical (IH) analysis and to report clinical findings and survival data. STUDY DESIGN: Retrospective review of cases. ANIMALS: Dogs (n=47) with small intestinal (40 LMS; 7 LM) and 25 dogs with cecal tumors (23 LMS; 2 LM). METHODS: Clinical and survival data were reviewed. Tissue sections were reevaluated for light-microscopic malignancy criteria and examined for expression of SMA, desmin, vimentin, S-100, and CD117 (KIT) by immunohistochemistry. RESULTS: Reclassification resulted in 2 LM, 9 LMS, 19 GIST, and 17 GIST-like tumors in the small intestine and 23 GIST and 2 GIST-like tumors in the cecum. GIST-like tumors were morphologic and IH identical to GIST but lacked KIT expression. No significant difference in survival was observed for tumor type, location, histologic, or IH characteristics; however, dogs with cecal tumors were significantly older in age, presented more commonly with intestinal perforation and peritonitis, and less commonly with weight loss. Cecal tumors had more histologic malignancy criteria than small intestinal tumors. After excision, 1 and 2 year recurrence-free periods were 80.1% and 67.2% for small intestinal and 83.3% and 61.9% for cecal tumors. CONCLUSION: Prognosis for intestinal tumors with histologic smooth muscle appearance is good after excision and not related to tumor type, location, histologic, or IH characteristics. CLINICAL RELEVANCE: Clinical importance could not be demonstrated for reclassification, but may be for future treatment, of intestinal smooth muscle or stromal tumors.
1 Matthew J. Ryan Veterinary Hospital, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA.
OBJECTIVE: To reexamine (via immunohistochemical techniques) canine tissue samples that had been previously classified as gastrointestinal leiomyosarcomas (GILMSs), identify and differentiate gastrointestinal stromal tumors (GISTs) from GILMSs, and compare the biological behavior and clinical course of GISTs and GILMSs in dogs. DESIGN: Retrospective case series. ANIMALS: 42 dogs. PROCEDURES: Medical records of 42 dogs for which a histologic diagnosis of GILMS was confirmed were reviewed for signalment, clinical signs, physical examination findings, results of initial diagnostic tests, surgical findings, adjunctive treatment, location of the tumor, completeness of resection, and outcome after surgery. Archived tumor tissue specimens from each dog were restained via immunohistochemical techniques to differentiate tumor types. Long-term follow-up information was obtained from the medical record or through telephone interviews with owners and referring veterinarians. RESULTS: On the basis of immunohistochemical findings, 28 of 42 tumors were reclassified as GISTs and 4 were reclassified as undifferentiated sarcomas; 10 tumors were GILMSs. In dogs, GISTs developed more frequently in the cecum and large intestine and GILMSs developed more frequently in the stomach and small intestine. Median survival times for dogs with GISTs and GILMSs were 11.6 and 7.8 months, respectively; if only dogs surviving the perioperative period were considered, median survival times were 37.4 and 7.8 months, respectively. These differences, however, were not significant. CONCLUSIONS AND CLINICAL RELEVANCE: In dogs, many previously diagnosed GILMSs should be reclassified as GISTs on the basis of results of immunohistochemical staining. The biological behavior of these tumors appears to be different.
I hope this information was helpful. I'm pulling for you and your dog. Please let me know how things go, or if you have any other questions.
Thank you for your response and pulling for Riley. He is a sweetheart!!
One of the studies mentions CD117 (KIT). Does this mean that if it the tumor is tested for CD 117, and it is positive for this protein, that it could be treated with STI-571 [GLIVEC] as is being done with human patients with relative high success?
Riley lives in Tampa with one of our daughters. I am not sure of your location, but do you know any sarcoma oncologists in the Tampa, Florida area?
Is Gleevec the same as GLIVEC? and has it been shown to work on canines? What is the cost [order of magnitude?]
Also what are some of the RTK inhibitors that are being tested?
Dr. Devlin: I have received 2 notifications of responses since your above response at 11:01, but there has been no text.You have been very helpful and informative, and will wait for your response. Perhaps there is a glitch somewhere.
Dr. Thank you so much for the valuable information.
You have been very helpful. We are on or way to pick up Riley and will be able to discuss with the current vet options based on your comments.
Thank you again and best regards XXXXX XXXXX of us, including Riley.