C09989035 / invoice 10000

25/02/2026 HISTORY
Presented for new lump - noticed last week, came up quickly and feels firmer than other lumps he has. 
Multiple lipomas already sampled
Did have a mass removed from L tarsus 2023 - we did incisional biopsy (soft tissue sarcoma) and referred to CARE for surgery due to location. Unable to get margins based on location. Do not have histo report from CARE (only our incisional biopsy report) .
Unsure if relevant or not but with his previous lump he was shaky and seemed sore just before it appeared, and that happened again this time. 
Also has lump on R medial antebrachium - FNA'd as lipoma and does sometimes bother him. 
O going overseas on 10/3 for 3 weeks 
is otherwise well - does have itchy skin ongoing
Current meds: fluoxetine 20mg SID

EXAM - lump focused
BAR, sweet boy, a little nervous
HR 90 RR WNL
Derm: L lateral thigh/hip approx 9mm firm, mobile mass. FNA - Not hugely exfoliative however can see some spindle cells with poorly defined borders, some cells with large foamy cytoplasm, did see an adipocyte. 
Also has lipoma upper medial R foreleg that has grown a little - prev fna lipoma

ASSESSMENT
New firm lump LH lateral thigh/hip - concern re: soft tissue sarcoma given Hx of incompletely excised sarcoma on L tarsus in 2023. ddx. other neoplasm (benign vs malignant) vs inflammatory lump

PLAN
Based on some suspicious cells would recommend excisional biopsy - based on location should be able to get margins
O going away in 2 weeks - wanting to know if can wait until they are home (5 weeks) - advised impossible to know without knowing what it is. Most likely would be OK but cannot be sure not an aggressive mass. 
Options offered:
1. Excisional biopsy here ASAP before O goes away. Suture removal generally by 10d post op but may be able to do intradermals if appropriate. 
2. Wait until back from holiday for excisional biopsy - cannot guarantee won't get bigger quickly. 
3. Take more FNAs and send for cytology then decide. May be inconclusive. 

Usually would also rec taking RF lipoma off too if bothering him a little however is in more mobile more difficult spot for healing and O going away in 14d so elected to leave that for now and just remove LH lump. 

O elected option 1. Booked for tomorrow, estimate discussed. Had bloods in December so pre-ga bloods up to O. 

**JF - if doable and appropriate for location and removal, could you do intra-dermals as O going away on 10/3 so will be a little tight for suture removal although could do it. If going to be worse for healing then do whatever is best for healing of course! Thx - HS**

25/02/2026 LS emailed CARE for histopath report

02/03/2026 SUBJECTIVE
Reason for visit/main concern: POC after lump removal LH flank
EDUD normally, no CSVD+, normal level of energy. 
Current medication/supplements: meloxicam, amoxyclav, gaba, traz
Current preventatives:
Current diet:

OBJECTIVE
BAR
mm pink and moist, CRT <2sec
Lymph nodes: normal submandibular, prescapular and popliteal
Cardiac auscultation: NE
Pulmonary auscultation: NAD, normal BV sounds, no resp effort RR: panting
Sx still some serosanginous fluid coming from mid point of sx site, comfortable, no heat/swelling, 
Dental Grade: 0/4
Temperature: NE
BCS: /9 

ANALYSIS
Recovering well post GA, sx holding 

PLAN
Continue with rest and pressure bandage
Continue with oral meds
Next point of contact (recall/rv/reminder): POC with vet when finished abx
INI RV/after hours emergency centre

MARGINS: The histologic tumour free distances are: Lateral, 8 mm; Deep, 20 mm (formed by a thick layer of fibrous connective tissue
and fat).
DIAGNOSIS
Soft tissue sarcoma, grade 1.
COMMENTS
The histologic findings are consistent with a soft tissue sarcoma. Soft tissue sarcomas are locally infiltrative neoplasms that are
generally slow to metastasise and have a low metastatic rate. Metastasis of grade 1 tumours is considered to be rare (< 10 % of cases
metastasise). Higher grade tumours (grades 2 & 3) show increased malignant behaviour with increased capacity for metastasis. These
tumours often require excision with a wide margin of normal tissue as local recurrence is frequently reported.

4/3 0930 JF STO and inform of above. Only got 8mm lateral margins so justified to make big incision. O says healing well. RV tomorrow. O pleased.