Diagnosis and treatment of common feline and canine neoplastic diseases Flashcards
What are common oral tumours?
most are highly malignant
oral melanoma
oral SCC
fibrosarcoma
ancathomatous ameloblastoma
peripheral odontogenic fibroma
gingival hyperplasia
What is the clinical presentation and tumour behaviour of oral melanomas?
oral cavity/sublingual: more aggressive, can have no pigment
cutaneous/ocular: less aggressive
metastatic rate: 80%
lymph nodes then lungs
How do we stage oral malignant melanomas?
3 view chest x-rays
CT vs surgical planning
FNA or resection of bilateral and retropharyngeal lymph nodes
What is the treatment for the primary tumour of oral malignant melanoma?
surgery: mandibulectomy or maxillectomy usually required
adjuvant RT if resection is known or suspected to be incomplete
What is the systemic treatment of oral malignant melanoma?
immunotherapy: xenogeneic DNA vaccination
What is the prognosis for oral malignant melanomas?
reported MSTs after Sx 5-17mo
most dogs will die to metastatic disease
What is the tumour behaviour oral squamous cell carcinomas?
locally aggressive, low metastatic rate
How do we stage oral SCC?
3view thoracic x-ray vs ct
regional lymph node aspirate (even if normal size)
CT scan vs skull/oral xray
What is the treatment for oral SCC?
Sx when possible: total/partial mandibulectomy/maxillectomy
RT: adjuvant tx if resection is incomplete
What is the systemic tx for SCC?
unproven survival benefit
carboplatin-based chemo
toceranib phosphate
NSAIDs
metronomic chemo
biphosphonates
What is the prognosis for oral SCC?
smal and rostral lesions can be cured
bulky and invasive lesions often can’t be surgically removed, rendering radiation outcomes much more guarded
What are clinical signs for skeletal tumours?
lameness
reluctance to move or pain/swelling associated with bone
on xray: lysis and destruction of the cortical bone and infiltration of medullary cavity
What are the 2 categories of skeletal tumours?
neoplasia
osetomyelitis (fungal)
What are common neoplastic skeletal tumours?
osteosarcoma
chondrosarcoma
haemangiosarcoma
fibrosarcoma
multiple myeloma/lymphoma
metastasis
osteoma/chondroma
What is the clinical presentation and tumour behaviour for osteosarcomas?
85% of bone tumours
mostly appendicular skeleton (distal radius, proximal humerus)
large/giant breeds
very painful tumour: cortical lysis
high metastatic rate
How do we treat osteosarcoma?
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
What is the prognosis of osteosarcoma?
MST: 7-9 mo
20% of dogs alive at 2 y
What are the clinical signs of abdominal masses?
vomiting
diarrhoea
weight loss
lethargy
palpable abdominal mass +/- abdominal pain
if ruptured (emergency): hemoabdomen, septic peritonitis
What are the potential categories of abdominal masses?
Neoplasia
abscess
granuloma/gossipiboma
cysts
How do we treat abdominal tumours?
surgical excision with margins
consider excision (or biopsy) of abnormal loco-regional lymph nodes
chemotherapy
What is the clinical presentation and tumour behaviour?
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
What is the treatment for splenic haemangiosarcoma?
splenectomy +/- chemotherapy
systemic: doxorubicin, metronomic cyclophosphamide
What is the prognosis for splenic haemangiosarcoma?
MST: 5-7mo
10% dogs alive after 1 y
What are the clinical signs of intrathoracic tumours?
cough
haemoptysis
dyspnoea/tachypnoea
exercise intolerance
collapse
What is the treatment for intrathoracic tumours?
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
