Question Details
Splenic Spindle Cell Sarcoma With Metastasis To Omentum
by artemys2 - December 8, 2016
Hi Steve and Erin, I will be seeing a 14 yr old, FS, Bichon who had a splenectomy done 11/11/16 and revealed splenic spindle cell sarcoma. with metastasis to omentum. She also had 2 mammary masses removed 10/3/16 which turned out to be simple mammary gland adenocarcinomas, low grade with clean margins. Thoracic rads at that time were clear of pulmonary metastasis. Patient also has a heart murmur and is being treated with enalapril.
Have either of you treated a splenic spindle cell sarcoma? I have not seen the patient yet so I can't give you info on tongue or pulse. I was considering XCHT with XFZYT or Tan Yu Tang with Xue Yu Tang. Would Xian Fang Huo Ming Yin be appropriate given the history of mammary adenocarcinomas?
Any thoughts would be greatly appreciated.
Thanks,
Jen
Replies
by bannink
December 9, 2016
Hi Jen,

Yes, splenic sarcomas (non-hemangiosarcoma) occur with some frequency. I see a number of them a year. Splenic sarcomas generally have an aggressive behavior with high met rate. Prognosis for most is around 6-8 months with surgery alone. This of course depends on the mitotic index and subtype. Given that this one has metastasized, we are already behind the eight ball. I'd be aggressive.

Lacking a tongue and pulse, XCHT and modified XFZYT would fit what I usually end up reaching for in these guys.

I've also used the HSA modifications of CHJLGMLT if there is more heat. In the face of mets, I really feel the XCHT is an important formula. As far as the XFHMY, my thought would be that it would depend on how the patient presents to you. I've never used that formula for an internal tumor, myself. Certainly the splenic sarcoma is the bigger life-threatening issue here. The mammary tumors are likely to be a non-issue unless she gets others.

Personally I usually don't use TYT+XYT as first line treatments for something like this. But others may have a different opinion.

Erin
by artemys2
December 9, 2016
Thank you so much Erin. I am so grateful to have someone like yourself to be able to consult with on complicated oncology cases.
Jen
by naturevet
December 9, 2016
Hi Jen,

I would agree that you're looking at XCHT, and one of the internal Blood movers: either Modified Xue Fu Zhu Yu Tang, or perhaps Ge Xia Zhu Yu Tang. XFHMY is more for external tumors

S
by artemys2
December 9, 2016
Thanks Steve! I saw the dog this morning. She looked amazingly well despite what she has been through recently and he appetite is still great! Her tongue was red with a clear coat, normal thickness. Her pulse was thin, deep and weak all over. I do muscle testing and we started her on XCHT and XFZYT + E Zhu along with nutritional supplements thymex, cataplex D, K9 whole body support, and spleen pmg. The oncologist started her on Rimadyl 25 mg - 1/2 PO BID and Palladia 15 mg - 1 PO EOD. If she does well on the palladia he wants to start cyclophosphamide as well.
I will definitely keep GXZYT in mind for the future.
Thanks for all your help. You both are amazing!
Jen
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