Essays 51-60 Flashcards
what is STS
soft tissue sarcoma
diagnosis of STS
FNA
biopsy
CBC
xray
abdo us
surgical approach of STS depends on
location
size
infiltration
histologic grade
outcome goals
procedure of STS surgery
marginal/ wide/ radical resection
one fascia layer deep
resect en block
treatment of STS
active surveillance
staging surgery
metronomic chemo
electrochemo
adjuvant radiotherapy
post op radiotherapy
surgical decision making
establish good candidates
define goals - palliative or curative
surgical technique
wide clipping
positioning
neutering first for mammary tumours
early vascular isolation
eliptical incision
down to fascia
control hemorrhage
closure in 2-3layers
bandage pressure
post op pain management
histopath
surgery for benign small mammary tumours
lumpectomy
surgery for mammary tumours located in middle of gland
simple masectomy
surgery for mammary tumours if more than 1 glands involved
regional masectomy
bad ways of thinking of oncologic surgery
animal too old
tumour too big
only if it grows
only a lipoma
cut it out quickly
no need for histopath
rules of planning oncology surgery
make sure patient is a good candidate
warn owner
good anatomy knowledge
proper preoperative planning
appropriate lateral margins
outline incision
rules of incision of oncology surgery
incision flowing tumour margins
avoid touching tumour by hand
rules of excision of oncology surgery
early ligation
gentle manipulation
monofilament suture
control haemorrhage
remove enlarged ln
rules of closure of oncology surgery
avoid lavage
avoid dead space
avoid drain if possible
change gloves, equipment
tension free closure
safety margin definition
to make sure both macroscopic and microscopic tumour cells are resected
safety margin width depends on
tumour invasiveness
grade
1cm - benign, carcinomas, grade 1 mast cells,
2cm - grade 2 mast cells
5cm - FISS
tumour for papule/ plaque
any skin tumour
tumour for macule/ patch
melanoma, ETCL
tumour for cyst/ erosion/ ulcer
sebaceous gland tumour
tumour for crust
SCC
tumour for seborrhea oleosa
ETCL
tumour for fistules, sinus
lymphangioma
tumour for pruirtis
mass cell
breed predisposition of sebaceous gland tumours
beagle, cocker, dachsund, setter, shih tzu
nodular sebaceous hyperplasia
limbs/ trunnk/ eyelid
beagle, cocker, poodle
sebaceous epithelioma
shi tzus, lhasa aposos
sebaceous adenoma
eyelid/ leg
sebaceous gland adenocarcinoma
head/ legs
cocker
therapy of skin tumours
spontaenous healing
chemo
photodynamic therapy
radiotherapy
chemotherapy
amputation
surgery
FISS pathogenesis
inflammatory reaction
uncontrolled fibroblast and myofibroblast proliferation
causing tumour formation
risk factors of FISS
multiple vaccines at same site
long lasting injection
microschips
diagnosis of FISS
CT, MRI
histology
not excisional biopsy
ISS Vs non ISS
larger, rapid growth rate, arise from subcutis, interscapular, mesenchmyal origin
treatment of FISS
surgery - excision after imaging
4-5cm safety margins
2 fascial layers
chemo - doxorubicin, cyclophosphamide
electrochemo
tyrosine kinase inhibitor
prevention of FISS
avoid multiple injections in same site
FISS recommendations
avoid intrascapular
distal limb better
documents type and location of vaccine
3-2-1 rule of FISS
- The mass is evident 3 or more months post-vaccination
- The mass is larger than 2 cm in diameter
- The mass is increasing in size more than 1 month after vaccine administration
