Chocolate Kisses

Hi everyone!

 

I called Charley’s surgeon this afternoon to inquire about the histopathology from his mass removal and lymph node removal.  The results were in, but she did not call to tell us the results since the oncologist will be the person to discuss treatment options.  She didn’t want to go into any more detail than was given in the report since we meet with his oncologist tomorrow afternoon.  I’m glad that I called today so I could read over the report before our appointment tomorrow and have time to digest the information.

 

Here are Charley’s histopathology results….skip this section if you don’t want to read medical jargon!!!

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DESCRIPTION:

1.  5 cm mass removed at incision (amputation) scar:

Representative sections are examined on 4 slides.  There is a somewhat multifocal and variable coalescing infiltrative neoplasm identified within the deep subcutaneous tissue.  Some areas of the neoplasm is densely cellular, other areas loosely dispersed.  Neoplastic cells are poorly differentiated and irregularly spindle-shaped with indistinct cell margins.  In some areas the cells form relatively solid haphazard sheets, sometimes with interspersed blood-filled cleft-like spaces.  In other ares the neoplastic cells form larger vascular type spaces containing variable numbers of erythrocytes.  There is little interspersed stroma.  In a few areas a small amount of collagenous-type stroma is observed.  There are also some areas where streams of eosinophillic amorphous stromal material reminiscent of ostoid are observed  within the neoplastic infiltrate.  The mitotic rate is up to 3 per high power field and the mitotic index is 22.  Mutifocal generally small areas of necrosis and hemorrhage are observed within the neoplasm.  There are some areas where small aggregrates and lobules of well-differentiated adipocyctes are identified intimately interspersed amoingst neoplastic cells/tissues.  The narrowest clean deep margin is approximately 2 cm in relation to the neoplasm.  The narrowest clean lateral margin identified is approximately 1 cm in relation to the neoplasm.

 

2.  Left prescapular lymph node, 1 x 3 cm tissue specimen with node

The section of lymph node with surrounding adipose tissue is examined.  Moderate hemosiderosis is observed within the lymph node.  There is also an area of vascular-like tissue proliferation within and mildly widening the subscapular sinus of the node.  Mesenchymal cells forming vascular-like spaces exhibit minimal to mild anisocytosis and anisokaryosis.  No mitotic figures are seen.

 

MICROSCOPIC FINDINGS:

1.  Left Prescapular Incision Site:

Poorly Differentiated Sarcoma.

Locally infiltrative.

Hemangiosarcoma versus Telangiectatic Osteosarcoma.

 

2.  Left Prescapular Lymph Node:

Chronic congestion with area of mildly atypical sinusoidal vascular-like proliferation.

 

COMMENTS:

The mass of the left prescapular incision site most likelu represents the recurrance of the the prior primary osseous sarcoma.  The recurrant mass may represent telengiectatic variant of osteosarcoma.  However, morphologically is somewhat more suggestive of hemangiosarcoma suggesting that the prior mass may have indeed been hemangiosarcoma of bone origin.  Margins in relation to the mass were clean in examined sections.  I am also suspicious of local metastasis to the subscapular sinus region of the prescapular lymph node.

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In a nutshell, the good news is that the surgeon was able to get clean margins!!!  Yippee!!!!  The expected news is that were are most likely dealing with a metastasis of osteosarcoma….the unexpected news is that Charley’s original bone tumor could have been an hemangiosarcoma instead of the poorly productive osteosarcoma that was originally thought.

 

The bottom line is we are still dealing with a highly aggressive sarcoma as we expected.  Charley sees the surgeon tomorrow at 3pm CST  to remove his staples (he is going to be so excited because he’ll be able to move without the staples pulling) and then we see Dr. Buss, his oncologist, to discuss treatment options.  Hopefully the treatment option will be the oral chemo that he mentioned previously which is Lomustine (also known as CCNU).  I will keep everyone posted after our visits tomorrow!

 

Thank you for all of your prayers, positive thoughts, hugs, and kisses.  It is greatly appreciated and we can’t thank you enough for all of your support!

 

♥  Hugs from me and chocolate Labby kisses from Charley!  xoxo  ♥