Mass: To Remove Or Not To Remove?

Lisa writes: “My Husky has a cyst on his upper back that is slightly over an inch around and tall. It has not burst or drained. My veterinarian said to leave it alone or he could have surgery to remove it but that it would probably come back. Will it come back? I’d like to have it removed because I’m worried our groomer will not be careful enough when bathing him. He can’t reach it. I’m concerned about whether it causes him pain. I’m trying to make an educated decision about how to go forward. Thank you, Lisa.
Lisa certainly has valid concerns and we will address all of them.

Larger cyst, subcutaneous fat dissected away to reveal incised wall of cyst.
Larger cyst, subcutaneous fat dissected away to reveal incised wall of cyst.

First, let’s define “cyst.” It’s a term that’s thrown around and used lightly, but is actually a structure with a specific set of parameters. Dorland’s Medical Dictionary defines cyst as “any closed cavity or sac, normal or abnormal, lined by epithelium, especially one that contains a liquid or semisolid material.”
Second, we can’t actually say for a fact what a growth or mass is until after it is surgically removed, sectioned, stained, and evaluated by a pathologist. Up to that point we can make an educated guess. And we might be right much of the time, but it still isn’t a fact until the pathologist speaks.
Third, Lisa, in her position as pet owner, has concerns about the lump. That, alone, is often reason enough to remove something. There is a lot of value in putting a person’s mind at ease. I’m not saying that every owner request is to be honored, especially if it is whimsical, but this situation seems to be valid.
Fourth, while there are a few types of growths, mostly cancerous, which tend to recur locally, there are steps that can be taken surgically to minimize the likelihood of regrowth in the same area. For example, if there is adequate skin in the area (and the “upper back” usually has an abundance of loose skin) the mass can be excised with wide margins.
In fact, this list of considerations applies to many pet owners’ situations when considering whether to have surgery performed.
See you tomorrow, Dr. Randolph.

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