Diagnosis and treatment of common feline and canine neoplastic diseases

Question 1

What are common oral tumours?

Answer 1

most are highly malignant

oral melanoma
oral SCC
fibrosarcoma
ancathomatous ameloblastoma
peripheral odontogenic fibroma
gingival hyperplasia

Question 2

What is the clinical presentation and tumour behaviour of oral melanomas?

Answer 2

oral cavity/sublingual: more aggressive, can have no pigment
cutaneous/ocular: less aggressive

metastatic rate: 80%
lymph nodes then lungs

Question 3

How do we stage oral malignant melanomas?

Answer 3

3 view chest x-rays
CT vs surgical planning
FNA or resection of bilateral and retropharyngeal lymph nodes

Question 4

What is the treatment for the primary tumour of oral malignant melanoma?

Answer 4

surgery: mandibulectomy or maxillectomy usually required
adjuvant RT if resection is known or suspected to be incomplete

Question 5

What is the systemic treatment of oral malignant melanoma?

Answer 5

immunotherapy: xenogeneic DNA vaccination

Question 6

What is the prognosis for oral malignant melanomas?

Answer 6

reported MSTs after Sx 5-17mo
most dogs will die to metastatic disease

Question 7

What is the tumour behaviour oral squamous cell carcinomas?

Answer 7

locally aggressive, low metastatic rate

Question 8

How do we stage oral SCC?

Answer 8

3view thoracic x-ray vs ct
regional lymph node aspirate (even if normal size)
CT scan vs skull/oral xray

Question 9

What is the treatment for oral SCC?

Answer 9

Sx when possible: total/partial mandibulectomy/maxillectomy

RT: adjuvant tx if resection is incomplete

Question 10

What is the systemic tx for SCC?

Answer 10

unproven survival benefit

carboplatin-based chemo
toceranib phosphate
NSAIDs
metronomic chemo
biphosphonates

Question 11

What is the prognosis for oral SCC?

Answer 11

smal and rostral lesions can be cured

bulky and invasive lesions often can’t be surgically removed, rendering radiation outcomes much more guarded

Question 12

What are clinical signs for skeletal tumours?

Answer 12

lameness
reluctance to move or pain/swelling associated with bone

on xray: lysis and destruction of the cortical bone and infiltration of medullary cavity

Question 13

What are the 2 categories of skeletal tumours?

Answer 13

neoplasia
osetomyelitis (fungal)

Question 14

What are common neoplastic skeletal tumours?

Answer 14

osteosarcoma
chondrosarcoma
haemangiosarcoma
fibrosarcoma
multiple myeloma/lymphoma
metastasis
osteoma/chondroma

Question 15

What is the clinical presentation and tumour behaviour for osteosarcomas?

Answer 15

85% of bone tumours
mostly appendicular skeleton (distal radius, proximal humerus)
large/giant breeds

very painful tumour: cortical lysis
high metastatic rate

Question 16

How do we treat osteosarcoma?

Answer 16

if not mets: amputation + chemo with carboplatin
limb sparing surgery (distal radius)

if amputation not possible:
- palliative radiotherapy +/- carboplatin, analgesia, biphosphnates, risk of pathologic fracture

Question 17

What is the prognosis of osteosarcoma?

Answer 17

MST: 7-9 mo
20% of dogs alive at 2 y

Question 18

What are the clinical signs of abdominal masses?

Answer 18

vomiting
diarrhoea
weight loss
lethargy

palpable abdominal mass +/- abdominal pain

if ruptured (emergency): hemoabdomen, septic peritonitis

Question 19

What are the potential categories of abdominal masses?

Answer 19

Neoplasia
abscess
granuloma/gossipiboma
cysts

Question 20

How do we treat abdominal tumours?

Answer 20

surgical excision with margins
consider excision (or biopsy) of abnormal loco-regional lymph nodes
chemotherapy

Question 21

What is the clinical presentation and tumour behaviour?

Answer 21

breed: GSD, Lab, Golden
50-75% of all malignant splenic tumours

haemoabdomen can occur: collapse, pale mm, weak pulses
CBC: anaemia and/or thrombocytopenia

high mets rate: important to stage

Question 22

What is the treatment for splenic haemangiosarcoma?

Answer 22

splenectomy +/- chemotherapy

systemic: doxorubicin, metronomic cyclophosphamide

Question 23

What is the prognosis for splenic haemangiosarcoma?

Answer 23

MST: 5-7mo
10% dogs alive after 1 y

Question 24

What are the clinical signs of intrathoracic tumours?

Answer 24

cough
haemoptysis
dyspnoea/tachypnoea
exercise intolerance
collapse

Question 25

What is the treatment for intrathoracic tumours?

Answer 25

surgical excision: pulmonary tumours, thymoma, some cardiac tumours

chemotherapy: mediastinal lymphoma, adjuvant chemotherapy after Sx if mets/aggressive

excision may not be possible = palliative tx