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Oncology > Anal sac tumors > Flashcards

Anal sac tumors Flashcards

1
Q

What are most anal tumors (round cell, sarcoma, carcinoma)?

A
  • Most are carcinomas

- Epithelial tissues

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2
Q

Where do anal tumors tend to spread?

A
  • Lymph nodes more, less via blood

- Sub-lumbar lymph nodes most often

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3
Q

How would an anal sac apocrine gland adenocarcinoma tend to behave locally?

A
    • Tend to stick together and are well circumscribed

- The bigger it is, the less obvious

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4
Q

What are the three main anal tumors?

A
  1. Perianal adenoma
  2. Perianal gland carcinomas
  3. Anal sac carcinomas
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5
Q

Perianal adenoma - who gets?

Malignant/benign?

A
  • Benign

- Intact male dogs

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6
Q

Perianal gland carcinomas - who gets?

Malignant/benign?

A
  • Malignant (often more diffuse than perianal adenoma)

- Possible male predominance

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7
Q

Anal sac carcinomas - who gets?

Malignant/benign?

A
  • Malignant!
  • Older dogs
  • Lots of chondrodystrophic breeds (e.g. Springer spaniel, dachshund, malamute, cocker spaniel German Shepherd)
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8
Q

How do anal sac carcinomas tend to present?

A
  • Anal sac mass

- HYPERCALCEMIA!

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9
Q

Staging for anal sac carcinomas

A
  • CBC/Chem/UA
  • Hypercalcemia due to PTHrp in 25-50%)
  • Chest rads
  • Image the abdomen (>50% have metastasized to lymph nodes at diagnosis)
  • Image tumor
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10
Q

Anal sac carcinoma hypercalcemia vs lymphoma

A
  • Often NOT as sick as lymphomas, which change very acutely
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11
Q

Surgery for anal sac carcinomas

A
  • Remove mass and nodes
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12
Q

Radiation therapy for anal sac carcinomas

A
  • Seems to be the best for mass and nodes
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13
Q

Chemotherapy for anal sac carcinomas

A
  • Carboplatin/cisplatin
  • TKI
  • May not work as well
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14
Q

Survival times for anal sac carcinomas

A
  • Can be long
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15
Q

Other perianal tumor possibilities

A
  • Soft tissue sarcoma
  • LSA
  • Mast cell tumor
  • Melanoma
  • Squamous cell carcinoma
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16
Q

Tumors on the inside presentation in general

A
  • Could present with very vague signs
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17
Q

Therapy options for tumor on the inside in general

A
  • Surgery
  • Radiation
  • Chemotherapy
  • Anti-angiogenic
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18
Q

Surgery for internal tumors

A
  • Works if tissue is expendable
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19
Q

Radiation for internal tumors

A
  • Tumor tissue has to sit still and surrounding tissues must tolerate radiation
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20
Q

Chemotherapy for internal tumors

A
  • Often poorly response

- Often the gut, kidney, and respiratory system are pretty resistant to toxic things already (MDR genes high there)

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21
Q

Anti-angiogenic therapy for internal tumors

A
  • In human med for GI carcinomas and lung
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22
Q

What type of tumors do most organs give rise to?

A
  • Carcinomas!
  • GI tract including pancreas and liver
  • Kidney/bladder
  • Ovaries/uterus
  • Testicles/prostate
  • Adrenal glands
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23
Q

Round cell or sarcomas in the abdominal organs - where do they arise?

A
  • Spleen/lymph nodes
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24
Q

Signalment for GIT tumors

A
  • Usually middle aged or older
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25
Q

GIT presentation

A
  • Depends on where in the GIT the tumor is
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26
Q

Gastric tumor presentation

A
  • Weight loss, vomiting, melena
27
Q

Small intestinal tumor presentation

A
  • Melena, diarrhea, weight loss
28
Q

Colon tumor presentation

A
  • Diarrhea, weight loss, hematochezia
29
Q

Hepatobiliary tumor presentation

A
  • Weight loss
  • Inappetance
  • Vomiting
  • PU/PD
30
Q

Staging for GIT tumors

A
  • NECESSARY!
  • Abdominal imaging (ultrasound is best)
  • Chest rads
  • +/- cytology of mass and all other masses found
  • Exploratory
31
Q

Treatment for lymphoma in GIT

A
  • Chemotherapy
32
Q

Prognosis for adenocarcinoma of intestines

A
  • Depends on surgical margins
33
Q

Metastasis of GI adenocarcinoma

A
  • > 44% met but can be late
34
Q

Chemo for GIT adenocarcinoma

A
  • Often ineffective
  • Doxorubicin, carboplatin
  • Gemcitabine
  • Metronomic chemotherapy
  • TKI
35
Q

Leiomyoma/leiomyosarcoma - where do you see theses?

A
  • Often cecum
36
Q

Leiomyoma/leiomyosarcoma prognosis

A
  • Depends on surgical margins (in general, small intestine is better than large intestine)
37
Q

Metastatic potential of leiomyoma/leiomyosarcoma

A
  • Moderate
38
Q

Chemo for leiomyoma/leiomyosarcoma

A
  • May help

- Doxorubicin

39
Q

Gastrointestinal stromal tumors (GIST) metastatic potential

A
  • Low metastatic potential
40
Q

Treatment of GI stromal tumors

A
  • Traditional chemotherapy not helpful but TKI can be effective even with gross disease present
41
Q

Hepatic tumors - how to diagnose?

A
  • BE WARY OF MAKING A DIAGNOSIS WITH ULTRASOUND

- NEED A SAMPLE

42
Q

Feline hepatic tumors - benign or malignant more common?

A
  • Benign tumors more common
43
Q

Canine hepatic tumors - benign or malignant more common?

A
  • Malignant tumors more common but can be quite low grade
  • Surgical removal if possible
  • Chemo ineffective
44
Q

What are the most common bladder tumors?

A
  • Transitional cell carcinoma
45
Q

Signalment for TCC

A
  • Usually small breed older dog
  • Scottish terriers and shelties are over-represented
  • female tendency maybe?
46
Q

Presentation for TCC

A
  • Pollakiuria, stranguria, dysuria, urinary obstruction (if you treat like a UTI and doesn’t get better, you need to look again)
47
Q

Biologic behavior of TCC

A
  • Unusual metastasis; it’s possible (30-60%) but generally NOT detected initially and often not the cause of death
  • Generally cause signs locally and can cause the death or euthanasia of the animal
48
Q

Staging TCC

A
  • Thoracic rads
  • Abdominal imaging (ultrasound more common these days than contrast cystogram)
  • CT (only for radiation)
  • Biopsy or cytology
49
Q

Surgical biopsy or cytology for TCC before treating?

A
  • Ideally, yes!

- Biopsy is great, but often do a urinary catheter and drain or poke

50
Q

Prognosis for TCC surgery alone (complete resection)

A
  • 12-13 months

- Often can’t do this

51
Q

Prognosis for TCC: Surgery plus RT intraoperatively

A

15 months

52
Q

Prognosis for TCC: NSAID alone

A

6 months

53
Q

Prognosis for TCC: variety of chemo drugs possible

A

Carboplatin, vinblastine, metronomic chemo

  • Mitoxantrone
54
Q

Prognosis for TCC: Chemo PLUS NSAID

A

12 months

55
Q

Palliative radiation for TCC

A
  • Effective, but commonly used as a rescue or to un-obstruct
56
Q

Which thoracic structures can give rise to a tumor?

A
  • Heart and greater vessels
  • Trachea and lungs
  • Esophagus
  • Lymph nodes
  • Mesothelium
  • Thymus
57
Q

Most like history for tumors in the thorax

A
  • Labored breathing or cough/dyspnea, tachypnea
  • Difficulty swallowing/regurgitation
  • Poor blood circulation (low BP, sudden collapse)
  • Paraneoplastic association of hypertrophic osteopathy
58
Q

Signalment for tumors in the thorax

A
  • various, usually older animal

- May be from a smoking household

59
Q

Diagnosis and staging of tumors in the thorax

A
  • Most thoracic problems would be difficult without at least a thoracic radiograph
  • Thoracic CT, or cardiac ultrasound, or trans-esophageal ultrasound often needed as well
  • Biopsy can be difficult without surgical approach
  • Needle aspirates as well can be difficult and ill-advised
60
Q

Staging for primary lung tumors

A
  • Thoracic rads

- Thoracic CT is very helpful to identify presence of metastasis to other lung lobes or LN

61
Q

Treatment of primary lung tumors

A
  • Depends on size, type of tumor, and presence or absence of metastasis
  • Surgery is usually treatment
  • Chemo is minimally effective but Vinorelbine may be better than most drugs
62
Q

Good prognostic indicators for primary lung tumors

A
  • Adenocarcinoma or papillary carcinoma, low grade tumors
  • <5 cm diameter
  • Peripheral location
  • Negative node, no clinical signs
  • Survival ~1-2 years
63
Q

Bad prognostic indicators for primary lung tumors

A
  • SCC, poorly differentiated tumors, high grade tumors
  • > 5cm diameter
  • Pleural effusion
  • Presence of clinical signs
  • Positive nodes
  • Evidence of metastasis

Oncology (9 decks)

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