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Posts: 26
My 23 yr old cat was diagnosed last week with extramedullary plasma cytoma cancer in her left rear leg.   I wondered if anyone else has dealt with this diagnosis. Angel is everything to me and I have had the privilege of having her 23 years come June 11th.
Everyone involved with her care feels that all the recommended treatment of either amputation and radiation or chemo are not good options due to her age and kidney and thyroid disease that she already has.   I do not want to put her through anything that will cause her to feel worse or shorten our time together.    At this time she is still eating pretty well most days and is not acting uncomfortable. 
Any comments would be greatly appreciated.   
Thank you so much.

Posts: 820
Dear heartcat

Firstly I am amazed your cat is 23.  There are not a lot of cats reaching that age nowadays.  I don't know anything about the condition you are talking about. My Rupert had a heart murmur and died of kidney failure at fifteen.  This is a really tricky decision you have to make.  I guess if it does not bother your cat now maybe you could wait and see.  It is hard not knowing what to do.  Then later you find out things you could have tried.  Because of her age it would be tricky.  You have done the right thing asking on here and I want to wish you well on your decision and I am sure everyone on here will support you which ever way you decide to go.

Ruperts Mum   

Posts: 774
Plasmacytomas are classically defined as the malignancies of terminally differentiated B lymphocytes. They may primarily affect the bone marrow, as in multiple myelomas, or may arise extramedullarily, as (muco)cutaneous plasmacytomas or solitary plasmacytomas of internal organs.

Since plasmacytomas are considered to be the tumours of terminally differentiated B cells, they are generally classified under the heading of lymphoid and haematopoietic tumours. Extramedullary plasmacytomas should be differentiated from multiple myelomas, a term used for the systemic proliferation of malignant plasma cells or their recognisable precursors, with the involvement of bone marrow. On the other hand, localised, and at first seemingly benign, proliferations of mature plasma cells are categorised as solitary or extramedullary plasmacytomas. Histologically the two are indistinguishable [52]; the only way to tell them apart is by the recognition of other abnormalities specific to multiple myeloma. Observation of at least two of the following abnormalities indicates that the tumour is not primarily a (muco)cutaneous lesion but is secondary to multiple myeloma: bone marrow plasmacytosis, osteolytic bone lesions, serum or urine monoclonal gammopathy and light chain (Bence-Jones) proteinuria [56].

Macroscopically plasmacytomas do not possess any distinguishing characteristics. Oral plasmacytomas appear as red, lobulated protruberances, which are usually gingival and rarely invade the bone. Cutaneous plasmacytomas are usually intradermal nodules, although they may occasionally appear pedunculated, in which case they tend to be traumatised and ulcerated.

Cytological examination of plastacytomas reveals plasma cells with the characteristic eccentric nuclei. However, they are often composed of cells with different morphologies, and mature-type plasma cells may be in the minority.

Histologically, plasmacytomas are composed of densely packed tumour cells supported by fine strands of collagenous stroma. Though often well differentiated, recent studies have revealed considerable diversity in the cell morphology of plasma cell tumours. Consequently, plasmacytomas in dogs may be described as hyaline, vacuolar, cleaved, asynchronous, monomorphous blastic and polymorphous blastic (Figure 2) [47].

Figure 2. Haematoxylin and eosin stained histological sections show four different cell types found in canine plasmacytomas: a) cleaved, b) asynchronous, c) monomorphous blastic, and d) polymorphous blastic. Immunohistochemical staining of tumour cells with a monoclonal antibody against immunoglobin light chain can be used to reveal the plasma cell origin of the tumour cells.

Immunohistochemistry is frequently used as a valuable adjunct to light microscopy and allows a definitive diagnosis in most cases of plasmacytoma [10, 34]. As these tumours are monoclonal proliferations of plasma cells, staining for immunoglobulin light chains shows immunoreactivity limited to either kappa or lambda light chains. Tumours positive for both kappa and lambda light chains have not been reported [34, 13]. An interesting feature of both normal canine plasma cells and plasmacytomas is the predominance of lambda light chains [47], a feature which is also common to cats, horses and cattle [4] but not to man [41] or pigs [4], in which species lambda and kappa light chain positive plasma cells and plasmacytomas are present in almost equal numbers. Canine plasmacytomas may also be positive for IgA, IgG or IgM [34].

Canine (muco)cutaneous plasmacytomas are mostly benign [52] and thus differ from both multiple myelomas [28, 67] and extramedullary plasmacytomas of internal organs, which often metastasise [29, 66]. After surgical excision of (muco)cutaneous plasmacytomas, dogs have remained tumour-free for long periods [12], although metastasis to lymph nodes has been reported in a few cases [47]. Whether these metastases originated from primary (muco)cutaneous plasmacytomas or from multiple myeloma remains unclear, because tests were not carried out to exclude the possibility of primary multiple myeloma.

The relationship between the localisation or cell type of the (muco)cutaneous plasmacytomas and their biological behaviour have been investigated to determine the prognosis of these tumours [47]. The clinical outcome of cutaneous plasmacytomas is not influenced by either anatomical site or histological appearance. However, well-differentiated tumours are most often found in the skin of the lip and the ear, whereas the poorly differentiated tumours preferentially affect the skin of the digits [5]. Results from one study suggested less benign behaviour for plasmacytomas with the polymorphous-blastic cell type [47], whereas in another study it was concluded that almost all cases had a good prognosis (author's observation).

Flow cytometric analysis can be employed to predict the biological behaviour of plasmacytomas. Recently, the ploidy of tumour cells and their relative c-myc content were compared between metastasising and non-metastasising plasmacytomas. A significant difference in ploidy was found between benign and malignant tumours: aneuploidy of tumour cells and high c-myc content were indicators of malignancy [20].

This was all I could find so far, but I'll keep looking.
Do you know what diagnostics were preformed to conclude that she has Extramedullary plasmacytoma? Also what does the leg look like? Is there a tumor on the leg itself? How is the kitty feeling? Does the leg bother her?

Posts: 774
I have not been able to find out much on extramedullary plasmacytomas in cats. Guess they are not  common. from what I could tell, diagnosing them is, or can be hard to differenciate them from other things. Still don't think I understand what I have read so far. Like I said there is not much written.
I don't know that I would put a 23 year old cat through an amputation. I would try chemo if they recomended it, mabey. Does the leg hurt her? Does she see, happy?
You know I have worked with animals since I was 9 years old, my first official job at 14yrs old, and I have done nothing since...I am 42 now, I have mabey seen one or two other 23 year old cats in my entire life. So you haqv done something rite. Of course this doesn't make anything any easier for you and her. But there is a limit to what you can do at this point other than to keep her comfortable. I am not a vet and this is just my opinion, but I wouldn't amputate if she were my cat.

Posts: 26
Dear rupertsmum
Thank you so much for your thoughts for Angel.     It helps so much to have a place to go for this kind of support for a furbaby because not everyone understands that kind of love and bond that we have with them.
I try  not to feel overwhelmed, but at times I do.
Thank you for caring, it really helps.

Posts: 26
Dear loudpurring
Thank you for all the information.   My vet diagnosed the tumor by doing an aspiration and sending it to the vet school where I live.    The oncologist report came back that it was the extramedullary plasma cytoma.   The type I don't know and I am not willing to put her through any more tests at this point to determine which one.    The night after the aspiration she would not move or eat, it was so hard to see her like that.
My vet strongly recommends continuing with her usual meds and fluids for kidney failure and not pursing chemo or radiation due to her advanced age and kidney and thyroid disease.    Angel has been getting acupuncture for 2 years and is on a maintenance schedule now and the vet that does it is also consulting other certified acupuncture vet friends for topical herbal treatments.   She also agrees that Angel's quality of life would be dramatically affected by chemo or radiation, amputation is not even being considered.   
As far as how Angel is, she is actually still eating well most days and getting around pretty well.   The tumor is on her left rear foot and is not large at this point.    So far Angel is still purring and still demonstrates a desire to be here and seems to have quality of life.    I have 2 very wonderful grown daughters and a wonderful 4 yr old grandson and a granddaughter on the way in September, but my girls have their own lives and we do not even live in the same town.    I have 7 indoor cats, including Angel.     Angel is my world and is my soulmate.   
Again thank you so much for your response and the information.   Support means so much during times like these when we are faced with a difficult situation.    Not everyone understands loving an animal that much.
God Bless.


Posts: 774
Dear Heartcat;
I would do the same as you if my cat had the same situation. I think it would be cruel to put Angel through an amputation. I also don't have any experience with chemotherapy with that type of cancer. I think you are doing rite by her and it is great that you have had her as long as you have. As I said before, You must be doing something very rite. I wish you and Angel more quality time together, and your (is it 6?) other cats. Me, I have always prefered the company of cats over anyone else. The more the better.
I wish you well and please keep us posted as to how Angel is doing

Posts: 5,100
Dear Heartcat,

I am so very sorry Angel is ill.  I am adding Angel and you to my prayer list.  It sounds like you have wonderfully supportive vets, which is such a blessing. 

Please keep us posted on how you and she are doing.  We will be here for you.

Sending healing hugs,

Betsy's forever mom

Posts: 1,328

Sorry about your kitty being ill. 23 yrs. old is so amazing--you must be some good momma and you must have so many memories of the times you've spent together. Take care of yourself.


Posts: 26
Dear loudpurring, woo woo woo,and nancee,
Thank you so much for your replies and encouragment and support.   I am just taking one day at a time with this, I guess I was anyway with her advanced age, but after having her so long, she became immortal in my  mind, but the cancer diagnosis made her mortal.    It hit me hard, but she is a fighter and has beaten the odds so far with the kidney failure and thyroid disease, and right now she is still in the fight and so am I.   I cannot fall apart on her now.
This site is a blessing for all animal owners and lovers to find someone else who really understands what you are going through.
Again, Thank you all so much, all the thoughts and prayers really mean a lot and are deeply appreciated.    I will keep everyone posted on this journey.
Thank you and God Bless.
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