The Skin Masses that Should Ring the Alarm Bells

From Episode 184 in the Surgery Feed - With Dr Claire Cannon

I’m working my way through an epic multi-specialist session on mast cell tumours that I recorded at last year’s Green Cross Symposium. Here’s a little practical pearl that I kind of suspected, based on cases gone wrong, but never knew for a fact:

• Canine MCTs on the muzzle, perineum (including scrotum), and possibly the pinnae are generally more likely to have lymph node metastasis.

• Practically, this means that if you FNA a mass in one of these locations and identify mast cells, at least regional lymph node cytology, but possibly node removal, should be part of the surgical plan. (MUCH more on lymph node sampling for MCTs in the episode in question.)

• Pro tip: One paper showed that masses on the pinna, when they metastasise, tend to metastasise to the prescapular lymph node, which is not necessarily where you would think based on regional anatomy.

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