[sverdl68]

Thank you in advance for taking the time to read Bentley’s story and offer your experiences, advice and/or comments!

As a short background summary, my 6 year old Yorkie, Bentley, received conflicting biopsy results for an oral tumor and subsequent re-growth about 6 weeks apart (two different doctors and two separate surgeries). On September 15, 2019 Bentley was diagnosed with a solitary plasma cell tumor and on October 23, 2019 the tumor re-growth (occurring in the same area 25 days after the first surgery) was diagnosed as lymphoma based solely on the presence of large lymphocytes as interpreted by the pathologist (with no identification of type or characteristic of cells). To date, Bentley does not have any swelling in any of his lymph nodes/organs and/or any other signs of lymphoma or illness separate from this tumor. The conundrum is how a benign plasma cell tumor diagnosis can turn into a terminal lymphoma diagnosis in such a short period of time without any corresponding clinical symptoms?

Has anyone had a similar situation with their fur babies (or know of a similar situation) and/or have any helpful comments? Bentley is 12 days post-second surgery (as of Monday, November 4, 2019) and we are running against the clock to determine the right treatment plan to ensure the tumor doesn’t grow back a third time.

As a more detailed background, I found a “growth” in Bentley’s mouth around his upper left canine tooth extending to his second pre-molar (teeth 206-204) on September 8, 2019. On September 15, 2019, I scheduled him for surgery and had the growth removed and biopsied. The tumor was diagnosed with as an oral plasma cell tumor - extramedullary plasmacytoma (EMP) - classified as benign but locally aggressive. With this tumor, if any cells are left behind then the tumor usually grows back.

While I was in the process of figuring out the next steps for radiation (since I knew the first “exploratory” surgery likely did not remove all of the cells), the tumor started re-growing on October 11, 2019 – 25 days after the initial surgery. I found a specialist board certified surgeon and Bentley had his second surgery for October 23, 2019 (full removal of tumor and soft tissue up to the palate of his mouth across the same three teeth). I received the biopsy from the second surgery a few days ago and it strongly suggests lymphoma (extremely malignant and dogs with lymphoma usually pass away in 1-2 months without chemo treatment). The biopsy report stated that the “case was very difficult to interpret”, however, because they saw “increased large lymphocytes exhibiting moderate mitotic activity”, the pathologist favored lymphoma over inflammation (atypical of course). I suspect that the pathologist didn’t complete any “staining” to identify the cells and did not provide any further details in the report regarding cell characteristics, which the report from the first surgery had. The surgeon requested a re-biopsy (re-cut and staining) of the tumor and sent the pathologist all prior medical history, clinical notes, photos, prior biopsy, etc., which I am waiting on in the meantime.