My lovely 13yr old otherwise healthy cat Geronimo has just had an inconclusive biopsy for a bleeding lump on his front paw suggesting either hermangio sarcoma or angio metosis. From what I can see both illnesses act the same but the hermangio sarcoma sounds a lot more serious than the angio metosis, as it is apparently a very aggressive cancer.

The lump on his paw was very small and looked just like part of his pad - it was a black plaque - and he has had this for at least 3 years, if not longer, as periodically, mostly when he was most active in the summer, his paw would bleed, with apparently no associated pain or illness. Unfortunately I have only just taken him to the vet this year, as for the first time he exhibited pain and was limping.

As he has had this for some time, I am tempted to believe that it is unlikely it is the hermangio sarcoma, as surely he would have died by now? Apparently both illnesses are very rare, so it could be that we just don't know enough about either of them.

I am waiting to see the vet again and discuss options, but for the moment the recommendation is to amputate his toe (not sure which one) and perhaps do X-rays / scans to see if there are any other tumours.

I love my cat and want to do what's best for him (including avoiding unnecessary stress and surgery), but also can't really afford to spend £thousands - if he does have tumours elsewhere, I'd rather leave him in peace while he is happy and comfortable and with great sadness have him put to sleep when / if he is suffering.

Is anyone out there familiar with these diseases / had a similar diagnosis or faced similar choices? I've read other posts and found them really helpful, but would love to hear from anyone whose cat has been diagnosed with either of the above.

Thanks in advance for your input.

Hi there and welcome!

What a terrible predicament to be in! As you mention Hermangiosarcome is very aggressive cancer and you need to act promptly to prevent it spreading but amputating (this is ususal in cases like this) in the absence of any positive diagnosis .........the fact the biopsy was inconclusive combined with the length of time leads me to think as you do. However there's also a chance the original lump may have become malignant in he intervening time.

There's also something else called an Hemangioma, have the vets mentioned this at all? This is benign. I would make a point of asking them about this. Have they removed the lump completely at this stage?

In your postition I would go ahead and have the X-Rays, scans etc ( peace of mind if anything else ) get a second opinion re the biopsy or failing that have another one done ( sometimes the original tissue sample isn't good enough and maybe this is why it was inconclusive ) and take it from there. You need to act promptly though...time is of the essence here!

Hope the results are negative. do keep us posted!

sorry to hear about Geronimo. Hoping it is not as serious as it could be.

Thank you so much for getting back to me and for the good wishes!

To give a bit more detail: under the surface plaque the tissue was friable, not an encapsulated mass... and because it is on the side of the foot more or less in between two toes, although they think they got most of it out, they weren't able to leave the usual safe margin around it - eg; cut out the extra centimetre or whatever. The main reason for amputating the toe(s) is to ensure they remove all the dodgy tissue and get a clean margin around it... and it would enable another biopsy, including bone. I don't know yet how big an impact the loss of a toe or two will have on a fairly active and agile cat. Will ask the vet, but am hoping and suspect it will be less major than it sounds! He hopped around fairly happily on 3 legs with a bandage, so will probably adapt fine! I'm just reluctant to do anything unneccessary..

Thank you also for the tip about hemangioma, I will look it up.

Vet visit on Tuesday. I'll update then!

The reason I suggested the hemangioma is that the two can be indistinguishable sometimes on a biopsy and of course the length of time he has it! I'm thinking there would be clear sign of it spreading internally at this point!

Also even with hemangiosarcoma the prognosis is fairly good if it's confined to the skin but if it's located in internal organs etc then it's a different matter entirely and far more aggressive. The scan should tell you more.

I certainly understand your reluctance to do unnecessary treatment and removing a toe would result in some degree of lameness , but if on the other hand there's still doubt about biopsy results, you'll be effectively removing the risk elements implied by this, by having it done.

Ask your vet to speak to an oncologist as well about chemotherapy and radiation treatment if he arrives at a clearer diagnosis re hemangiosarcoma.

Geronimo is well - no further idea on which he has, still undecided whether to put him through another operation as he seems perfectly well and happy.

This is strange! Do you know Geronimo ( great name! ) actually crossed my mind the other day. I wondered if the vets had managed to refine things further and get a clearer diagnosis. Good to hear he's still well though!

Have they ruled out an hemangioma at this stage?

The biopsy result was either hermangio sarcoma or hermangioma - the lab guys veered on the side of sarcoma because they couldn't see the vessel growth (can't remember precise words) you would expect in hermangioma - but the vet said that it was perfectly possible that that was because it was such a small sample and so friable that it had got completely mushed up and there was no decent tissue to get a proper slide from.

I'm tending to think that because he has had it for at least 3 years, maybe it is hermangioma - and given that he's 13 anyway, maybe it's better to just leave him be and see how he goes. He's 100% back to normal and happy now. I'd hate to put him through the operation and then have him get ill in 6 months time anyway.

I do realise that as so little is known about both diseases, it's perfectly possible that hermangio sarcoma does lurk quietly in the body before it is noticed, and it's only once it gets noticed that it's at the stage where it's spreading aggressively... but my instinct is not to meddle when he appears well. My vet could see both points of view but said in conclusion that she would remove the toe as a preventative measure - even though it would not necessarily be 100% effective as the original problem was so close to the pad, even with toe removal they still may not be able to get as large an area of clear flesh as they might like. Hmm..

Another Geronimo update - he's still well and happy, no sign of anything unusual, fingers crossed he stays well for years to come..

Thanks for updating us. I saw your other post and wondered about him. Glad to hear he's still fit and well-with all toes intact!