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Teaser's Bulging Eye

Teaser is a lovely, quiet chocolate Labrador whom we got to know quite well earlier this year as she made regular trips to see us over a four month period. 

Her problem started in the spring when her owners noticed a bulge above her left eye, which also appeared to push her eyeball forward. What made this presentation even more unusual was that the swelling varied from day to day, some days it was barely noticeable and at other times it was very obvious.

This history was suggestive of either some sort of inflammatory lesion (abscess) behind the eye or a tumour called a mast cell tumour, which can vary in size in response to chemicals released from the tumour.

Mast cell tumours are quite commonly removed from the skin of dogs and very occasionally develop in other parts of the body. A CT scan and a biopsy confirmed that Teaser did indeed have a mast cell tumour growing behind and above her left eye.

Mast cell tumours can vary in behaviour from benign to malignant. Most mast cell tumours in the skin can be cured by excision with a 1-2cm margin around and below the tumour. Occasionally mast cell tumours can be highly malignant, spreading to the lymph nodes, liver and spleen and leading to the death of the patient.

       

Reconstructed slices from the CT scan showing the mast cell tumour above and behind the left eye (viewed in a soft-tissue window).

Fortunately Teaser’s CT scan showed no evidence of enlarged lymph nodes or signs of spread elsewhere. The CT scan allowed the exact location and extent of the tumour to be defined in three-dimensions but it was clear that removal of the tumour with an adequate margin of normal tissue around it would not be possible, even if the eyeball was sacrificed. The alternative strategy was to remove the gross tumour alone and use chemotherapy to try and destroy the microscopic residual tumour cells left in the adjacent tissue.

With precise information from the CT scan, surgery was performed to remove the mast cell tumour from behind Teaser’s eyeball, whilst preserving the eyeball and her vision.

Following surgery Teaser began a 12 week course of vinblastine/prednisolone chemotherapy, which she tolerated well with no significant side-effects. Over the course of 12 weeks, she made 8 visits to the hospital for this treatment, all done on an outpatient basis whilst her owners waited or went for a coffee.

Earlier this week Teaser was seen for a recheck 3 months after finishing treatment. We are pleased to say that she has recovered well and there are no signs of tumour regrowth. Although recurrence in the future is still possible, it is extremely gratifying to have treated Teaser’s tumour and preserved a visual eye. 

Thank you to Teaser's owners for allowing us to share her story.

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