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SA DX & TX II > Exam 1 - Oral & GI Tumors > Flashcards

Exam 1 - Oral & GI Tumors Flashcards

1
Q

what are the 3 most common oral tumors in dogs?

A
  1. malignant melanoma
  2. squamous cell carcinoma
  3. fibrosarcoma
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2
Q

what dog breeds are commonly affected by oral tumors?

A

cocker spaniel, GSD, GSP, weimaraner, goldens, gordon setters, mini poodles, chows, & boxers

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3
Q

what are the most common oral tumors in cats?

A
  1. squamous cell carcinomas
  2. fibrosarcoma
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4
Q

what should you look at during your physical exam for an animal with an oral mass? why do a sedated oral exam?

A

look at the tonsils, palpate lymph nodes, retropulse the eyes, check nasal airflow, & auscult the lungs

these tumors are painful - get an FNA or biopsy of the mass

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5
Q

for animals with oral tumors, what does their labwork typically look like?

A

usually normal - may see increased BUN if they are swallowing blood

may see a left shift

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6
Q

why should you do chest radiographs prior to sedating an animal with an oral tumor?

A

look for mets & avoid atelectasis

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7
Q

why is it important to know what lymph nodes drain what structures for animals presenting with masses?

A

best diagnostic chance on getting a sample with definitive answers

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8
Q

what is needed for diagnosing & staging oral tumors in small animals?

A

lymph node aspirates, CT scan

CBC/Chem/UA, chest rads, skull rads, & dental rads

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9
Q

why is a biopsy for histopathology necessary for squamous cell carcinomas?

A

they are very inflammatory - an FNA won’t give a great sample

histopathology will

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10
Q

what is the most common treatment option for oral tumors? what are the requirements of the procedure?

A

surgical removal - local tumor is removed & underlying bone is very commonly removed

2 cm margins are needed & any positive lymph nodes are removed

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11
Q

what kind of tumor do you think this is?

A

malignant melanoma

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12
Q

this dog had mandibular osteosarcoma & got a bilateral rostral mandibulectomy - why?

A

OSA very commonly crosses midline

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13
Q

what complication is commonly seen after a partial maxillectomy? how is it avoided?

A

oronasal fistulas

close the hard palate to the skin & place a feeding tube after surgery to prevent chewing & damage during the healing process

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14
Q

what is the biggest complication seen post-op for animals with oral tumors that were surgically removed?

A

incisional dehiscence!!!!

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15
Q

what complications are commonly seen post-op for animals with oral tumors that were surgically removed?

A

incisional dehiscence, epistaxis, increased salivation, mandibular drift (may have to file down remaining canine teeth), malocclusion, & difficulty prehending food

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16
Q

malignant melanoma is a disease of dogs with ______ _______ _________

A

pigmented oral cavities

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17
Q

what breeds commonly are affected by malignant melanoma? what age?

A

cockers, poodles, chows, & goldens

older dogs - 10-12 years

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18
Q

T/F: 33% of melanoma tumors are amelanotic

A

true

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19
Q

T/F: malignant melanomas are aggressive both locally & systemically with a metastatic rate > 80%

A

true

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20
Q

what history & clinical signs are associated with patients with malignant melanoma?

A

owner noticed a mass

facial deformity, halitosis, blood in saliva, difficulty eating, lymphadenopathy, & exophthalmus

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21
Q

T/F: chemotherapy is effective for treating malignant melanoma

A

false - not very effective but may help to slow metastasis

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22
Q

why is radiation therapy good for malignant melanoma therapy?

A

can be used in place of therapy for gross disease - can be used after surgery for incomplete margins

melanoma is very responsive to radiation - need high doses at a low frequency (looks like a palliative protocol but 6x6 protocol is seen as curative)

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23
Q

T/F: there are acute & chronic side effects seen with radiation therapy for treating malignant melanoma

A

true - side effects will occur only in the radiation field

acute - inflammatory side effects, occur 2-3 weeks after RT, skin changes (sunburn), fatigue, decreased appetite

chronic - fibrosis/permanent, occur ~6 months post RT, fibrosis (scar tissue formation) and decreased ability to heal a wound or bone fracture

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24
Q

what vaccine is available for malignant melanoma?

A

merial vaccine (conditional approval by the FDA) can use on stage 1-2 tumors that are small & haven’t metastasized

very expensive - based on human tyrosinase vaccine/DNA plasmid vaccine

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25
Q

what are some poor prognostic factors for malignant melanoma in dogs?

A

tumors > 2cm

tumors in the back of the mouth do worse

evidence of metastasis

recurrence of tumor

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26
Q

T/F: malignant melanoma carries a poor prognosis in dogs even if local control is achieved

A

true - MST is only 5-10 months

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27
Q

what is the most common malignant tumor in cats & second most common malignant tumor in dogs?

A

oral squamous cell carcinoma

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28
Q

what are some risk factors for oral SCC in cats?

A

flea collars, high intake of canned food (especially tuna), & exposure to cigarette smoke

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29
Q

T/F: the more rostral the oral SCC, the lower the metastatic rate

A

true

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30
Q

what oral SCC locations have a high metastatic rate in dogs?

A

tonsilar & tongue SCC in dogs, > 70%

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31
Q

T/F: oral SCC in cats are very locally invasive

A

true

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32
Q

when does metastatic disease occur in oral SCC?

A

late in the disease process - largely unknown in cats

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33
Q

what history & clinical signs are associated with patients with oral SCC?

A

owner notices mass in the mouth - halitosis

weight loss, difficulty chewing, facial deformity, bloody saliva, epistaxis, & loss of teeth in the face of minimal dental disease

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34
Q

what is the treatment of choice for oral SCC in cats? what is required?

A

surgery!!! surgery may be curative if margins are achieved (2cm) techniques & complications are the same as malignant melanomas

35
Q

cats don’t tolerate oral surgery well for oral SCC, so what should you do?

A

feeding tube placed for all cats with oral surgery!!!!!

36
Q

T/F: oral SCC in cats is responsive to radiation therapy

A

false

37
Q

when is radiation therapy indicated for a cat with oral SCC?

A

primary treatment - palliative to alleviate bone pain

adjunct therapy - incomplete surgical margins

many fractions of small doses, place a feeding tube, & be aware of acute & chronic side effects

38
Q

what chemotherapy is used for oral SCC in cats?

A

NSAIDS, carboplatin, mitoxanthrone - in combination with RT

39
Q

what dogs have an excellent to good prognosis for oral SCC?

A

dogs with small rostral tumors

40
Q

what are some poor prognostic factors of oral SCC in dogs?

A

dogs with large or caudally located tumors

dogs with tonsillar or tongue SCC

41
Q

what is the prognosis for cats with oral SCC?

A

poor prognosis in general - MST is 4-6 months for palliative care & may get up to 1 year with surgery/radiation

42
Q

what may be the first sign seen in a dog with tonsillar SCC?

A

change in their bark

43
Q

what dogs are commonly affected by oral fibrosarcomas?

A

large breeds - goldens & labs that are young to middle aged (6-7 years)

44
Q

T/F: oral fibrosarcomas may appear very benign on histopathology but act very aggressively

A

true

45
Q

what is the metastatic rate of oral fibrosarcoma?

A

~30%

46
Q

what is the 2nd most common oral tumor in cats & 3rd most common in dogs?

A

oral fibrosarcoma

47
Q

what history & clinical signs are associated with patients with oral FSA?

A

owner may notice a mass - often associated with the soft & hard palate

same other signs as other oral tumors

48
Q

T/F: metastatic lesions of oral FSA are usually seen in the lungs & lymph nodes first

A

false - yes to met lesions in lungs but lymph nodes are rarely affected

49
Q

what is the median survival time for oral FSA in dogs?

A

surgery alone - ~1 year

surgery + RT - ~ 18-24 months

50
Q

what is the prognosis of oral FSA in cats?

A

unknown but likely poor because of their low tolerance for big oral surgeries

51
Q

what is the overall prognosis for oral FSA in dogs & cats?

A

guarded

52
Q

what is the therapy indicated for oral FSA?

A

aggressive surgery with margins of 3-5cm when possible - but even with good margins, they often reoccur - underlying bone MUST BE REMOVED

radiation therapy - adjuvant therapy for incomplete margins but has severe side effects, can be palliative for gross disease

53
Q

T/F: gastric cancer in dogs & cats is very rare

A

true

54
Q

what animals are affected by gastric cancer?

A

male dogs - chows & belgian shepherds

gastric carcinoma - 8 years old & leiomyosarcomas - ~15 years olf

55
Q

what is the most common gastric tumor type in dogs? what is the metastatic rate?

A

70-80% are carcinomas

high metastatic rate of 70-80%

56
Q

what is the most common gastric tumor type in cats?

A

lymphoma is most common with small intestinal involvement

57
Q

what clinical signs are associated with gastric tumors in dogs & cats?

A

vomiting, hematemesis, weight loss, & anorexia

58
Q

what diagnostics are needed for working up a gastric tumor case?

A

good physical exam with thorough abdominal palpation

CBC, chem, UA - hypoglycemia (intestinal leiomyosarcoma), increased BUN, anemia

chest rads - look for mets

contrast gastrogram

abdominal ultrasound

endoscopy for biopsy in dogs - need to do surgery for leiomyosarcomas & cats to get biopsies

59
Q

what dog breed is commonly affected by gastric lymphoma?

A

boxers

60
Q

what is the medical treatment that can be used for gastric lymphoma in boxers?

A

chemotherapy

61
Q

how is surgery used for treating gastric tumors?

A

tumor is often on the lesser curvature of the stomach, need to look at the vascular supply, do surgery in debilitated patients, & if leiomyosarcoma, you can shell it out

62
Q

what gastric cancer type in cats has a good prognosis?

A

small cell lymphoma

63
Q

what is the prognosis for malignant gastric tumors?

A

poor - MST <6 months

large cell lymphoma, early metastasis of carcinomas, & know that gastric mast cell tumors met early!!!

64
Q

what is the most common intestinal tumor in dogs? what about cats?

A

dogs - adenocarcinoma/lymphoma affecting older male large breed dogs

cats - mostly lymphoma, older males/siamese breeds, no retroviral association

65
Q

what intestinal tumor type is most common in the colon? what about the small intestines? what about the cecum?

A

colon - adenocarcinoma

small intestines - lymphoma

cecum - leiomyosarcoma or GIST

66
Q

what locations are adenomatous polyps commonly seen in dogs & cats?

A

colon of dogs

small intestines of cats

67
Q

what clinical signs are associated with intestinal tumors?

A

weight loss, diarrhea, vomiting, anorexia, melena, anemia, & hypoglycemia

68
Q

what is seen on CBC/chem/UA for an animal with an intestinal tumor?

A

cbc - anemia, leukocytosis

chem - hypoproteinemia, increased BUN, increased liver values, hyperglycemia, & hypoglycemia

69
Q

what is required in your physical exam for diagnosing a dog with an intestinal tumor?

A

thorough abdominal palpation feeling for a mass

rectal exam

feel for thickened intestines

70
Q

what diagnostic imaging is indicated for diagnosing & staging an intestinal tumor?

A

chest rads - look at lungs for mets, evaluate lymph nodes, & look for malignant effusion

abdominal rads - plain & contrast

abdominal ultrasound

endoscopy/laparoscopy/exploratory - get a biopsy

71
Q

how is surgery used to treat intestinal tumors?

A

used to alleviate many symptoms but 30-50% do metastasize

need to remove any suspicious lymph nodes or metastatic lesions

remove 5-10cm on either side of the lesion to decrease the chances of dehiscence - MCT need largest margins!!!!

or endoscopic removal of polyps

72
Q

when is chemotherapy appropriate for treating intestinal tumors? what is the protocol?

A

appropriate for lymphoma

small cell lymphoma - chlorambucil

large cell lymphoma - CHOP

adjuvant after surgery for MCT (VBL & pred), carboplatin/doxorubicin or 5-FU for carcinomas in dogs only, & piroxicam for rectal polyps in dogs

73
Q

T/F: with leiomyosarcomas, perforation is not a negative prognostic factor

A

true

74
Q

for non-lymphoid intestinal tumors, what is a poor prognostic factor?

A

metastasis at diagnosis of tumor

75
Q

what is the best predictive prognostic factor for cats with lymphoid intestinal tumors?

A

response to treatment!!

76
Q

T/F: immunophenotype of lymphoid tumors in dogs & cats doesn’t play a role in prognosis

A

true

77
Q

what is the MST of small intestinal adenocarcinomas?

A

with no surgery - MST is 2 weeks

with surgery - 115 days before recurrence or mets

78
Q

what is the MST of large intestinal adenocarcinoma?

A

with surgery, MST 20 months

79
Q

what are some poor prognostic factors of intestinal tumors?

A

extensive lesions with many adhesions

metastasis at diagnosis

carcinamatosis

80
Q

what is the prognosis/MST of a cat with solid small intestinal tumors?

A

15 months after surgery if they survive - immediate perioperative risk

81
Q

what is the prognosis/MST of a cat with solid tumors in the large intestine?

A

3-6 months with surgery

82
Q

what is the prognosis/MST of a cat with large cell gi lymphoma?

A

4-6 months with therapy

83
Q

what is the prognosis/MST of a cat with small cell gi lymphoma?

A

18-24 months with therapy

SA DX & TX II (62 decks)

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