39. Spinal neoplasia

Question 1

most dogs present older in life for spinal neoplasia with what exception

Answer 1

EXCEPTION extra renal NEPHROBLASTOMA–young

Question 2

onset of clinical signs in animals is usually chronic and progressive except in what percentage of cases

Answer 2

50% may present with acute signslongest onset–intradural, extramedullaryshortest onset–intramedullary or intraaxial tumors

Question 3

most common clinical sign in dogs vs cats with spinal neoplasia

Answer 3

dogs–paincats–paresis/paralysis

Question 4

area of spine most often involved with spinal tumors in dogs

Answer 4

dogs–cervical spine

Question 5

most difficult area of spine to obtain percutaneous biopsy

Answer 5

vertebral body! (especially cervical and thoracic)

Question 6

tumors of the spinal cord that are highly radiation and chemo responsive

Answer 6

lymphomamultiple myeloma

Question 7

definitive radiation therapy MST for spinal tumors in dogs (primarily menigiomas)

Answer 7

MST 17 months

Question 8

types of extradural spinal neoplasia

Answer 8

1. vertebral neoplasia (OSA, Benign Exostosis/Osteochondroma, Lymphoma,

Question 9

types of intradural/extramedullary spinal neoplasia

Answer 9

1. meningioma2. PNS tumors3. extra renal nephroblastoma

Question 10

types of intramedullary spinal tumors

Answer 10

PRIMARY1. neuronal/glial tumors2. stromal tumorsSECONDARY

Question 11

T/Fvertebral neoplasia is the most common spinal tumor

Answer 11

TRUE–often involve vertebral body–result in extradural compression–can be primary (large breeds) or secondary (small breeds)–most are malignant (OSA–most common dogs/cats primary vertebral body tumor)

Question 12

T/Fin general, skeletal OSA in cats is associated with a very low metastatic rate regardless of anatomic location

Answer 12

TRUE

Question 13

locations in which spinal lymphoma can occur

Answer 13

primary or secondary1. intradural-extramedullary2. extradural3. intramedullary

Question 14

T/Fin cats, spinal lymphoma accounts for 27% of all confirmed spinal cord diseases

Answer 14

truetypically, spinal lymphoma affects Fe-LV positive catsin cats, typically TL spine most affected

Question 15

T/Fmore than 80% of cats with spinal lymphoma have extra neural sites of lymphoma

Answer 15

TRUEkidney, bone marrow&raquo_space;liver, spleen, LN

Question 16

spinal meningioma

Answer 16

most common primary spinal intramural–extramedullay tumor in dog (most common non lymphoma spinal tumor in cat)boxers predisposed

Question 17

most meningiomas of canine spine affect what area

Answer 17

cervical spine

Question 18

PNS tumors most commonly affect which limb

Answer 18

thoracic > pelvicusually involve caudal cervical C8-T2 (radial n)atrophy most often present over supraspinatus and infraspinatus

Question 19

other neurological syndromes that can be seen in dogs with a thoracic PNS tumor

Answer 19

–Horners–Absent CTRIPSIlateral

Question 20

three categories of PNS

Answer 20

1. spinal root: worse px2. plexus3. peripheral (distal) nerve: better px*location sign affects px

Question 21

survival of PNS tumors with surgical tx of clean margins and/or amputation

Answer 21

1416 dayssignificantly longer with peripheral group vs. plexus and spinal root groups

Question 22

survival of PNS tumors if lesion is in plexus with amputation alone

Answer 22

7.5 months DFI12 months MST(though not statistically different from nerve root group)

Question 23

survival of PNS tumors if lesion is at level of intervertebral foramen (near spinal root) with sx

Answer 23

1 month DFI5 months MST(though not statistically different from plexus group)

Question 24

signalment of dogs presenting with extra renal nephroblastoma

Answer 24

YOUNG dogsGSD, Golden retrieversT10-L2 vertebrae (reflect a T3-L3 myelopathy)hard to ddx btwn intramedullary vs intradural extra medullary

Question 25

2 patterns of cells seen in extra renal nephroblastoma

Answer 25

1. glandular—look like primitive glomeruli2. solid—sheets of blastemal (embryonic) cellstherefore, these tumors may arise from mesonephric or metanephric embryologic remnants that become trapped in developing dura/spinal cord

Question 26

tx for nephroblastoma

Answer 26

laminectomy/hemilaminectomydurotomy(areas of infiltration can be seen, precluding complete excision)

Question 27

tumors associated with secondary spread to spinal cord/CNS

Answer 27

HSACarcinomas (mammary, thyroid)