Abdominal Tumors 3-7, 10 - 16.

Question 1

The ____ is a receptacle for metastasis and receives mets 2.5
more frequently than developing ____ tumors in dogs

Answer 1

liver;primary

Question 2

____ tumors more common then ___in CATS

Answer 2

Primary; mets

Question 3

____ tumors are more common in dogs vs. ____ in cats

Answer 3

Malignant; benign

Question 4

4 general categories of primary tumors and ______ is VERY important

Answer 4

morphology

Question 5

What are the 4 CLASSIFICATIONs OF

PRIMARY HEPATOBILIARY TUMORSs

Answer 5

• HEPATOCELLULAR
• BILE DUCT
• NEUROENDOCRINE (CARCINOID)
• MESENCHYMAL

Question 6

_______ is most common in cats but this is NOT

considered a primary liver tumor

Answer 6

Hemolymphatic (LSA)

Question 7

For primary hepatobiliary

The prognosis for any given patient is influenced greatly by the _____ of the tumor

Answer 7

histology

Question 8

What are the 3 main morphology’s associated with primary HB tumors? They can either be these 3 types

Answer 8

1. Massive (large solitary confined to single liver lobe)
2. Nodular (multifocal involving one or several lobes)
3. Diffuse (multifocal or coalescing nodules involving ALL liver lobes or diffuse effacement of parenchyma

Question 9

Which forms are easiest to treat b/c tumor can be removed surgically not so much with others*??

Answer 9

The MASSIVE forms

Question 10

Massive(label the tumor type)

53% - 84%

37% - 46%

0%

36%

Answer 10

53% - 84% Hepatocellular (most common for massive)

37% - 46% (bile duct)

0% (neuroendocrine carcinoid)

36% (mesenchymal

Question 11

Describe the age and breed of HB tumors?

Answer 11

Disease of older animals w/ no real breed predisposition

Question 12

HCC and _____ occur slightly more frequently in _____ dogs w/ slight _____
predisposition in bile duct tumor

Answer 12

HCC and sarcomas occur slightly more frequently in male dogs w/ slight female
predisposition in bile duct tumor

Question 13

~ 75% of dogs and 50% of cats are ______ at diagnosis = Found while
chasing LEZ

Answer 13

asymptomatic

Question 14

Clinical signs of HB tumors are variable/non-specific?

Answer 14

Anorexia, wt. loss, V, PU/PD ascites

– Icterus seen w/ biliary or diffuse neuroendocrine tumors

– Seizures rare but often from paraneoplastic hypoglycemia, HE from massive liver
destruction or CNS mets

Question 15

HEPATOCELLULAR TUMORS reported tumor types?

Answer 15

HCC, Hepatocelluar adenoma & hepatoblastoma

Question 16

WHat is the Most common primary liver tumor in dogs (~50% of cases) & people

Answer 16

HCC

Question 17

_____ ______ more common than HCC in cats

Answer 17

Hepatocellular adenoma

Question 18

_______= Rare tumor of primordial hepatic stem cells

Answer 18

Hepatoblastoma

Question 19

_______ FORTUNATELY accounts for ~75% of cases of

massive HCC

Answer 19

Left-sided lobe (LL/LM/Papillary process)

Question 20

Treatability = Dictated by ______ subtype

Answer 20

morphologic subtype

Question 21

What is the significance of the Liptak JM study with canine HCC in reference to margins?

Answer 21

Margins = Local recurrence did not develop even if MICROSCOPICALLY
incomplete margins

Question 22

Liver is capable of recovering from loss of______ of total mass =

Remaining volume can hypertrophy to original size within ___weeks

Answer 22

< 65 – 75%; 6 weeks

Question 23

What are the 2 main mechanism for liver regeneration?

Answer 23

• Quiescent hepatocytes “primed” or stimulated to grow (TNF & IL-6)
• Continued growth mediated by growth factors (Hepatocyte GF and transforming GF alpha

Question 24

What are the Two recognized tumor types: of the bile duct?

Answer 24

– Bile duct adenoma (Benign)

– Bile duct carcinoma (Malignant)

Question 25

Bile duct adenoma (Biliary or another name is? Who is it common in?

Answer 25

Hepatobiliary cystadenoma

– Common in CATS representing more than 50% of ALL feline hepatobiliary tumors

Question 26

Most common

malignant hepatobiliary tumor in cat is? Is it top in dogs toos?

Answer 26

Bile duct carcinoma

2nd most in the dog (HCC 1ST)

Question 27

Disease of older cats and most commonly an incidental finding unless mass becomes very large

– Ultrasonographic characteristics usually sufficient for diagnosis w/out invasive
testing

Answer 27

HEPATOBILIARY CYSTADENOMA

Question 28

HEPATOBILIARY

CYSTADENOMA cyst lining consists of?

Answer 28

simple cuboidal epithelium

Question 29

With HEPATOBILIARY

CYSTADENOMA what is reported with benign neglect?

Answer 29

Long-term survival times reported w/ benign neglect

– Still need to discuss Remote possibility of malignant transformation should be discussed w/ owners

Question 30

When should we resct hepatobiliary cystadenoma?

Answer 30

• Resect only if causes clinical dysfunction, demonstrating rapid growth or is large
enough where dysfunction is imminent

– Variable survival times reported w/ surgery = 12 – 42+ months w/ most dying
of unrelated causes if survive surgery

Question 31

What is a parasitic risk factor for BILE DUCT CARCINOMA

Answer 31

trematode infestation in dogs and cats

Question 32

What is often demonstrated in bile duct carcinoma in cats?

Answer 32

– Cats = CARCINOMATOSIS (diffuse intraperitoneal mets)
= 67% - 80% of cases

Met rate = 87% (LN’s, lungs, peritoneum) in another study

Question 33

If massive subtype of bile duct carcinoma what is noted with surgical resection? What about chemo and RT?

Answer 33

– Surgical resection warranted but reported survival
times are poor and most dead < 6 months
• CHEMOTHERAPY and RT NOT EFFECTIVE

Question 34

Diffuse Mdx for hepatobiliary tumors is most commonly in this tumor type

Answer 34

neuroendocrine carcinoid 67%

0% in massive mdx

Question 35

Hepatocellular is least likely this MDX

Answer 35

Diffuse 0-19%

Question 36

Mesenchymal tumors are more likely this MDX

Answer 36

Nodular 64%