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SA DX & TX I > Exam 1 - Canine Hemangiosarcoma > Flashcards

Exam 1 - Canine Hemangiosarcoma Flashcards

1
Q

what kind of tumor is hemangiosarcoma?

A

neoplastic endothelial cells

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2
Q

what risk factors are there for canine hemangiosarcoma?

A

middle aged to older dogs

large breed dogs - GSD, goldens, labs

possible hormone association

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3
Q

what are the steps of formation & spread of hemangiosarcoma?

A
  1. dysregulated maturation of bone marrow progenitor cells
  2. movement to peripheral vasculature
  3. malignant cells can lay dormant
  4. tumors in different organs can develop simultaneously or metastasize from one tumor
  5. bone marrow progenitor cells
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4
Q

what is the importance of angiogenesis in hemangiosarcomas?

A

the dysregulation of angiogenic pathways is what allows for the spread/growth

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5
Q

what are the angiogenic activators?

A

VEGF, bFGF, PDGF, & angiopoietin-2

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6
Q

what is the importance of angiogenic activators in hemangiosacomas?

A

upregulated in the tumor & circulating blood in patients with hemangiosarcoma

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7
Q

what is the most common primary site for hemangiosarcomas?

A

spleen

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8
Q

what is the rule for splenic masses in dogs?

A

50% of splenic masses are malignant & 50-75% of malignant splenic tumors are hemangiosarcomas

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9
Q

63-70% of non-traumatic hemoabdomens are caused by what?

A

ruptured hemangiosarcomas

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10
Q

how does metastasis of hemangiosarcomas occur?

A

hematogenously or intracavity implantation following rupture

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11
Q

what is the second most common site of hemangiosarcomas?

A

heart - right atrium or auricle

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12
Q

what is the most common heart tumor?

A

cardiac hemangiosarcoma

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13
Q

what are the most common sites for metastasis with hemangiosarcomas?

A

liver, omentum, peritoneum, & lungs

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14
Q

what is the most common tumor that metastasizes to the brain?

A

hemangiosarcoma

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15
Q

what are the common physical exam findings of a patient presenting with hemorrhagic shock & has a ruptured hemangiosarcoma?

A

tachycardia, poor pulse quality, pale mucus membranes, & abdominal fluid wave

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16
Q

what arrhythmias are commonly seen in animals present with hemorrhagic shock due to a ruptured hemangiosarcoma?

A

ventricular tachycardia & premature ventricular complexes

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17
Q

cardiac tamponade is commonly present in what kind of hemangiosarcoma?

A

ruptured cardiac hemangiosarcoma

18
Q

what physical exam findings are common in a patient with a ruptured cardiac hemangiosarcoma?

A

muffled heart sounds, pulsus paradoxus (exaggerated drop in blood pressure upon inspiration), ascites, & circulatory collapse

19
Q

if you palpate a splenic tumor and feel that it is very large, does this make you more or less concerned about malignancy?

A

less - the bigger tumors are typically not malignant, hemangiosarcomas are harder to diagnose prior to rupture

20
Q

ultimately, what is the only treatment of hemangiosarcoma?

A

surgical removal of the bleeding mass

21
Q

what are the diagnostic techniques & work-up that should be used for hemangiosarcoma?

A

chemistry, UA, coag panel, blood type, VCM

thoracic rads - 3 views

abdominal ultrasounds - limitation, you can’t make a histological diagnosis

echocardiogram - some patients present with v tach & VPC

CT scan

22
Q

what does T1 mean?

A

tumor is less than 5cm in diameter & is confined to the primary site

23
Q

what does T2 mean?

A

tumor is 5cm or greater or ruptured & is invading subcutaneous tissues

24
Q

what does T3 mean?

A

tumor is invading adjacent structures, including muscle

25
Q

what does N1 mean? N2?

A

N1 - regional lymph node involvement

N2 - distant lymph node involvement

26
Q

for a visceral hemangiosarcoma, what surgeries are indicated?

A

splenectomy, liver lobectomy, & nephrectomy

full abdominal explore & biopsy of abnormal tissue

27
Q

is surgery ever possible for cardiac hemangiosarcoma?

A

possible in some cases - right atrial appendage masses

28
Q

what are the indications for surgical removal of intramuscular & subcutaneous hemangiosarcomas?

A

wide margin is required because they are locally invasive & cause edema & hemorrhage

29
Q

chemotherapy is indicated in all cases of hemangiosarcoma because it is highly metastatic except in what type?

A

dermal hemangiosarcoma

30
Q

what is the primary drug used in chemotherapy for hemangiosarcoma?

A

doxorubicin based chemotherapy protocols +/- metronomic cyclophosphamide (goal to achieve anti-angiogenesis)

31
Q

hypofractionated (palliative) radiation therapy is used in what types of hemangiosarcoma?

A

cardiac, subcutaneous, & intramuscular hemangiosarcoma

32
Q

what radiation therapy is used for metastatic disease?

A

whole lung/whole abdomen radiation therapy

33
Q

what is the prognosis for splenic hemangiosarcoma with surgery alone?

A

extremely poor - 19-86 days

34
Q

what is the prognosis for splenic hemangiosarcoma with surgery & chemotherapy?

A

5-7 months

35
Q

T/F: stage is important in predicting survival in hemangiosarcoma

A

true

stage 1 - 239-355 days
stage 2 120-148 days

36
Q

T/F: 1 year survival of hemangiosarcoma is less than 10%

A

true

37
Q

what is the prognosis for primary renal hemangiosarcoma?

A

9 months

38
Q

what is the prognosis for retroperitoneal hemangiosarcoma?

A

37.5 days

39
Q

what is the prognosis of subcutaneous & intramuscular hemangiosarcoma?

A

surgery & chemo ~3 years for subcutaneous vs. 9 months for intramuscular

inoperable tumors treated with chemo alone may offer palliation

40
Q

what is the prognosis for cardiac hemangiosarcoma when treated with surgery & chemotherapy?

A

175 days

41
Q

T/F: a pericardiectomy is considered palliative & has no survival benefit

A

true

42
Q

chemotherapy alone has a ___ objective response rate for ~4 months

A

41%

SA DX & TX I (59 decks)

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