Leiomyosarcoma or Leiomyoma (Uterine tumor or fibroid)

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hmbay

Post   » Thu May 17, 2012 12:50 am


This is about Pippa, 2.5 years old, Female, Standard TriColor

OK, so this is probably something no one has run into and I'll post pictures in a reply so you can see this thing.

Our Pippa just out of nowhere expelled a a mass a bit larger than a large fava bean plus what appeared to be encapsulating tissue and a fair amount of blood.

Our local vet had never heard of this and referred us to the fancy pet hospital over the hill, and the vets we brought her to (this of course happened on a Sunday, doesn't it always?) at Adobe Animal Hospital in Los Altos, were flabbergasted. And these guys see a lot of guinea pigs. They had no idea what the mass was or why it was expelled. They even said it could be a fetal mass even though she's been with us for a year (away from any males).

So we paid to have lab work done on it and the vet called today to say it is a Leiomyosarcoma http://en.wikipedia.org/wiki/Leiomyosarcoma which is a smooth muscle soft tissue malignant tumor (if it were benign, it would be a Leiomyoma - I'm going to call the vet back to make sure they are sure which one it is). What's amazing, of course, is that Pippa performed the "surgery" herself and removed it by expelling it from her uterus.

There was a fair amount of bleeding which is what worried us more - probably about a teaspoon or two.

And she lost about two ounces in the process - probably the weight of the mass, the encapsulating tissue, and the blood.

Throughout all of this, no behavioral changes! Pippa is running around, eating, pushing around her paddock mates (she's the Queen pig), and the only change was that she was talking a little more but we figure that was because she was away and wanted the others to know that she was back in charge.

OK, so here's the deal: leiomyosarcomas are Rare in Humans, and cancers are Rare in pigs, and it is extremely Rare to have this spontaneous expulsion, so this is rare on top of rare on top of rare.

The vet is recommending either monitoring for blood in urine or other symptoms indicating that there may be another leiomyosarcoma in there, or spaying her, which involves the usual risks, because it is possible that there are other small leiomyosarcomas in her uterus.

So the questions I've got are:

1. Has anyone dealt with leiomyosarcomas or leiomyomas or uterine tumors or fibroids?

2. Any opinions of risk on getting her spayed? She is very healthy so we figure surgical risk is low but we've never had a pig spayed.

Thanks,
Karri & Joe

Tracis
Let Sleeping Pigs Lie

Post   » Thu May 17, 2012 12:56 am


Welcome to Guinea Lynx, and I hope that Pippa continues to do well. She is very fortunate to have observant caretakers. :)

Not sure if you've read these pages in the Medical Guide, but they might be helpful, since they reference spays and surgery:

http://www.guinealynx.info/spay.html

http://www.guinealynx.info/ovarian_cysts.html

Hopefully, others with more experience will have more advice for you.

Josephine
Little Jo Wheek

Post   » Thu May 17, 2012 1:37 am


Yes, I've dealt with several in pigs. Spaying is the treatment of choice if the pig is stable otherwise. Unfortunately, one was in a rescue pig and the mass actually grew to more than half her weight? Will have to dig up the thread. I only had her a couple of weeks and had been working her up with two vets for a spay when she succombed to some nasty side effects (we actually think she suffocated due to the huge massive tumor invading her chest/pushing on the diaphragm). So, yes, I am ALL for spay!

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LS in AK
Upside-down & Backwards

Post   » Thu May 17, 2012 1:43 am


Hi, also, and welcome! I am glad to hear your Pippa is still in reasonably good health considering what has been going on. Hope you can find the information here that you need to make a good decision on what to do for Pippa in the long run.

I lost a 5 and a half year old sow a year ago to complications from spay surgery to remove a uterine tumor. I'll give you the run down on what happened in Lily's case. Hopefully, you will find the information helpful.

Lily (a black American self) began having pain while urinating/defecating at about 2.5 yo. We treated a UTI, but the pain while defecating remained afterward. The pain came and went, along with occasional blood spotting, for the next 3 years. We always treated for a UTI, but the symptoms always returned after finishing with antibiotic therapy. As we failed to find the source of the problem, we ended up easing her symptoms with once daily metacam starting when she was about 4.5 yo. She was on the metacam for over a year with only occasional episodes of pain and bleeding, and no adverse side effects from the long-term pain meds.

About a month before we found her tumor, she came down with an ear infection. Then, a few days before I was set to make an emergency move, I found her sitting hunched in the corner of the pig pen, coat puffed out, looking miserable. Over the next week, between the move, a vet consultation, and emergency spay surgery, she passed a large amount of blood, the nature of which was very dark, thick, and smelly - almost like huge clots were being shed from her uterus. Because we did find a large tumor, the spay was necessary. Due to my inexperience and a bunch of stupid mistakes by me and the vets I was working with, however, Lily went into stasis sometime before/after surgery and died after a 5 week battle to save her (Yes, it took us that long to figure out she was in stasis. Now I know. And the animal hospital ended up changing some of their small animal surgical policies afterward.)

In hindsight, I believe that Lily's frequent pain/bleeding while defecating was sign of a reproductive problem from the beginning. I really think that tumor was growing in her for quite awhile before we caught it, and that she would probably still be with me now if I'd done a preventive spay when she was still reasonably young and healthy.

I am aware of the risks of spays, so I do not want to say that is necessarily the best or only course to take with Pippa, but of all my girls, I've had three spayed, and the only one that pulled through was the pig that had no pre-existing condition. Seems that once the sows start developing problems and losing body condition, spays become that much more dangerous, with complications more likely.

If I were you (and just saying, from my own experience) I would get Pippa spayed now while she is still healthy and risk is minimal, as a preventive measure.

Anyone else who has experience with this, or even another take on my own story, please chime in.

Good luck with Pippa! I sincerely hope you can avoid what I had to go through. It was pretty awful. I felt like a pretty bad piggy owner for quite awhile afterward, too, because Lily's death could have been prevented if I'd known better.

Josephine
Little Jo Wheek

Post   » Thu May 17, 2012 1:45 am


http://www.guinealynx.info/forums/viewtopic.php?t=34977&post ... +sow&start=0

I lied. It only weighed 250 g and she weighed 900 g total. So, approximately 1/3 of her body was tumor. :(

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LS in AK
Upside-down & Backwards

Post   » Thu May 17, 2012 1:51 am


Oh, thanks, Josephine, for a more informed opinion on the spay issue. Looks like we posted replies at about the same time.

Charybdis

Post   » Thu May 17, 2012 1:55 am


I agree, I would spay. I had a pig with uterine fibroids and ovarian cysts but she also had congestive heart failure and many other health issues so she was treated with Lupron. For an otherwise healthy young pig, I would be scheduling the spay right away.

We have had many pigs spayed for medical reasons and have only lost two. One had a huge uterine tumor that had adhered to other internal organs. The other had two bladder stones removed at the same time and went into shock post-surgery.

User avatar
hmbay

Post   » Thu May 17, 2012 3:09 am


Thanks for the replies and support. It does sound like spaying is the wise course of action since the equivalent is suggested for humans with this rare condition also. And she is in fantastic condition - 43.5 ounces, shiny coat, bright eyes, tough nails, etc. Which makes it just more mind-blowing that she had a malignant tumor growing inside her.

Has anyone had an actual lab-confirmed leiomyosarcoma in their pig? I found a research paper that indicated that only one had been identified in research out of 138 tumors/cancers. If in fact this really is a sarcoma (meaning malignant) then it pretty much forces us to spay.

User avatar
hmbay

Post   » Thu May 17, 2012 3:46 am


Image

The encapsulating sac is on the left and the sarcoma is on the right.
I should have put a ruler next to it but it was about an inch long.

And my avatar is Pippa.

User avatar
Lynx
RESIST

Post   » Thu May 17, 2012 8:17 am


Even if it isn't malignant, it would likely be a good idea to spay (could still recur). Your picture is great. Let me know if you'd like it permanently added to your board.

All surgeries are risky but if you have a skilled, experienced vet, it will help a great deal. You might want to read over gl/postop.html

Josephine
Little Jo Wheek

Post   » Thu May 17, 2012 11:13 am


They weren't sure (if you read my link) on if it was a leiomyoma or what else. Yes, I did run a histo. If it was benign, it still cost her entire life since it grew.

User avatar
hmbay

Post   » Fri May 18, 2012 6:00 pm


So we discussed the matter with a couple of doctors and I just spoke with Dr. Nakamura at Adobe (who he actually put in the request to perform the surgery) and he recommended against the spay surgery because of the risk of the surgery and the nature of the tumor involved.

He said it was very unlikely to recur (as it was unlikely to happen in the first place) and we've got no evidence that there are other tumors in there.

Plus apparently this sort of tumor does not metastasize like other cancers.

He agreed that this was a very odd and rare situation to have the pig expel the tumor and not present symptoms before and after, other than the bleeding after. I'll update this string if there any further developments.

Thanks again for the advice and hopefully things will work out.

lils29

Post   » Tue Apr 24, 2018 11:36 am


Hi Hmbay!
I have just read your comments on this website. I have had the exact same experience 2 weeks ago. I noticed a few wee spots of blood on my Lilys fleece bedding but just thought she had a small cut so i tidied the cage and woke up first thing the next morning to see how she was doing and found a tiny bit more blood but nothing major at all. When i checked in her house i found a huge mass that she had expelled from her body during the night and rushed her straight to our vet who is an exotic pet specialist with the mass in a bag for them to inspect. They had never seen anything like it. We sent off the mass for a biopsy and were advised it was leiomyoma and wouldnt recommend any surgery. Our Lily also showed absolutely no signs of illness, she was playing with her sister, eating and drinking as normal before and after.

I was just wondering if you had any issues with your lil lady after this thread ? Thanks!

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Lynx
RESIST

Post   » Tue Apr 24, 2018 12:50 pm


Hi lils29. This is an old thread and the original poster is not likely to respond. Wikipedia tells me:
A leiomyoma, also known as fibroids, is a benign smooth muscle tumor that very rarely becomes cancer (0.1%). They can occur in any organ, but the most common forms occur in the uterus, small bowel, and the esophagus.
https://en.wikipedia.org/wiki/Leiomyoma

I'm glad you got a diagnosis for this. Have you considered having her spayed by an experienced, competent exotics vet? While no surgery is recommended, this would take care of any future issues like pyometra (an infection of the uterus) and ovarian cysts too.

lils29

Post   » Wed May 23, 2018 9:50 am


Hi Lynx
Sadly we got news this morning that Lily has cancer and there is nothing more they can do. After she passed the leiomyoma it came back clear and we thought we were ok. Lily then developed two tumors that we had removed and sent off to be tested in the lab. She also had an ultrasound to make sure nothing further was going on internally. Unfortunately our Vet gave us the news today that the tumors were a very aggressive form of cancer that is like to occur frequently and fast. We are devastated. It is her 4th Birthday today :(
The Vet said they could keep removing the tumours as they appear or spay her but at her age I dont really want to put her through much more. Myself and my partner are going to have a discussion tonight about what we should do next, we just want what is best for our lil girl. Its still so hard to take in because even through her surgery she has been eating, drinking, playing with her sister and has not shown at all that she is sick. We also have to factor in our Lola who will be devastated if her sister is not around anymore.

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