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SA DX & TX I > Exam 1 - Principles of Surgical Oncology: Specific Skin/SQ Tumor Types > Flashcards

Exam 1 - Principles of Surgical Oncology: Specific Skin/SQ Tumor Types Flashcards

1
Q

before pursuing surgery, what should you always do in the case of suspected cancer?

A

STAGING!!!!!!! PLAN!!!!!! ALWAYS DO AN FNA EVEN IF IT FEELS LIKE A LIPOMA!!!

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2
Q

if 1 represents a marginal excision & 2 represents a wide excision, what is the importance of this picture?

A

if you only did a marginal excision, you wouldn’t get the whole tumor

if you did a wide, you would get clean margins

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3
Q

what is an example of a radical excision?

A

amputation of a limb

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4
Q

what kind of excision should be done in the case of a benign skin tumor?

A

marginal excision

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5
Q

what are some examples of a benign skin tumor?

A

epidermal/follicular cyst, & sebaceous gland adenoma

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6
Q

what is the general type of tumor? how would you remove it?

A

benign skin tumor - marginal excision

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7
Q

when removing a lipoma, what’s different about the incision made?

A

incise over the center

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8
Q

how is a lipoma removed?

A

shell the lipoma out making sure to keep the capsule intact

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9
Q

why are you more concerned about hemostasis in large lipomas?

A

they may have neovascularization

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10
Q

if there is excess skin after a lipoma is removed, what can you do?

A

excise the skin

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11
Q

what is this

A

giant lipoma

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12
Q

what is different when removing an intramuscular lipoma?

A

may require an en bloc removal of a muscle belly

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13
Q

what is this?

A

intramuscular lipoma

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14
Q

what would you expect to see on a CT scan of a patient with an infiltrative lipoma?

A

linear striations throughout the mass

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15
Q

how do you treat an infiltrative lipoma?

A

treat like a malignant skin mass - remove with margins & follow with radiation

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16
Q

what is scary about infiltrative lipomas?

A

high rate of recurrence even with aggressive surgery

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17
Q

what is this?

A

ct of a infiltrative lipoma - linear striations throughout the mass

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18
Q

T/F: a liposarcoma is easy to diagnose pre-op

A

FALSE

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19
Q

T/F: CT characteristics may be helpful in diagnosing a liposarcoma

A

true!

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20
Q

what are some CT characteristics that may be helpful if you think your patient has a liposarcoma?

A

heterogenous, soft tissue opacity, nodular in appearance, mineralization, & regional lymphadenomegaly

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21
Q

how do you treat a liposarcoma?

A

like other soft tissue sarcomas - wide surgical excision

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22
Q

when removing a mast cell tumor, surgical dose depends on what?

A

grade of tumor!

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23
Q

what do you do if you don’t have a biopsy of a mast cell tumor before surgical excision?

A

assume a higher grade

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24
Q

if appropriate margins can’t be obtained in a mast cell tumor removal, what should be considered?

A

neoadjuvant therapies!

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25
Q

what are examples of neoadjuvant therapies for mast cell tumors?

A

prednisone 1mg/kg - up to 80% reduction in tumor volume in 70% of cases

radiation

chemo

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26
Q

when removing grades I-II mast cell tumors, what is appropriate for surgical excision?

A

2cm laterally & 1 fascial plane deep - adequate for most lower grade tumors

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27
Q

what does proportional margins entail in mast cell tumor removal?

A

margin is equal to the widest diameter of the tumor - can be applied to smaller, low grade MCT

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28
Q

what is an example of a proportional margin taken in a mast cell tumor removal?

A

1cm tumor = maximum lateral diameter is 1 cm

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29
Q

what margins does this represent?

A

proportional

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30
Q

this surgical excision type is appropriate for what types of mast cell tumors?

A

grades I-II

2 cm laterally & 1 fascial plane deep

31
Q

name the tumor

A

mast cell tumor

32
Q

when removing a grade III mast cell tumor, what are the appropriate margins?

A

3cm laterally & 1 fascial plane deep

33
Q

when you have a mast cell tumor, you may have a higher incidence of high grade if the tumor is located in what anatomical locations?

A

preputial, scrotal, subungal, oral, & perivulvar

34
Q

how do feline cutaneous mast cell tumors tend to behave like?

A

benign manner

35
Q

why are wide margins typically unnecessary in removing a feline cutaneous mast cell tumor?

A

typically behave in a benign manner & often not possible because they are frequently on the face

36
Q

T/F: subcutaneous mast cell tumors involve the cutaneous layer/skin

A

false!!!

37
Q

what is the prognosis for subcutaneous mast cell tumors?

A

good prognosis - behave like low grade cutaneous mast cell tumors

38
Q

what is this?

A

subcutaneous mast cell tumor - histopath

39
Q

these are examples of what?

A

feline cutaneous mast cell tumors

40
Q

how would you remove a feline cutaneous mast cell tumor?

A

proportional margins

41
Q

where are the most common locations for soft tissue sarcomas?

A

limbs & trunk

42
Q

how do soft tissue sarcomas feel?

A

firm & fixed on palpation

43
Q

what is prognosis of soft tissue sarcomas dependent on?

A

ability to achieve complete margins & the grade of the tumor

44
Q

what is the origin of soft tissue sarcomas?

A

mesenchymal - multiple subtypes

45
Q

what is this?

A

soft tissue sarcoma

46
Q

why not biopsy a soft tissue sarcoma?

A

only correct 60% of the time

47
Q

why is grading of soft tissue sarcomas very important?

A

prognosis, possible neoadjuvant/post-op treatment, & margins needed during surgical excision

48
Q

what are the guidelines for surgical removal of soft tissue sarcomas?

A

2-3cm laterally & 1 fascial plane deep recommended when achievable

49
Q

why is surgical removal of soft tissue sarcomas more difficult on limbs?

A

hard to get the necessary margins - need to consider neoadjuvant vs. post-op radiation & potentially radical excision (amputation)

50
Q

recommended margins for surgical removal?

A

2-3cm laterally & 1 fascial plane deep - soft tissue sarcoma

51
Q

how may you go about removing this soft tissue sarcoma?

A

radical excision - amputation of the limb

52
Q

what is this an example of?

A

soft tissue sarcoma that came back due to incomplete margins in 1st surgical removal

53
Q

why must you refer feline injection site sarcomas?

A

they are very locally aggressive & advanced imaging is necessary as the first surgery may be the only chance

54
Q

what are the recommended margins for surgical removal of a feline injection site sarcoma?

A

5cm laterally & 2 fascial planes deep

55
Q

what are the necessary margins needed for surgical excision?

A

5cm laterally & 2 fascial planes deep

56
Q

if a dog presents with a mammary tumor, what are the chances it is benign or malignant?

A

50/50

57
Q

if a cat presents with a mammary tumor, what are the chances it is malignant?

A

85%

58
Q

if a dog’s mammary tumor is larger (2+cm) & ulcerated, it is more likely to be what?

A

malignant

59
Q

during removal of a mammary tumor, what is also recommended?

A

spay - impact on survival may be controversial

60
Q

when removing mammary tumors, when should you take the underlying fascia?

A

never - except for when the mass is adhered

61
Q

what is a lumpectomy?

A

removal of the mammary mass with ~1cm margin

62
Q

what is a single mastectomy?

A

removal of a single gland, with 1-2 cm margin around the tumor

63
Q

what is a regional mastectomy?

A

removal of glands 1-3, or glands 3-5 en bloc

64
Q

what is a unilateral mastectomy?

A

removal of an entire mammary chain

65
Q

what is a bilateral mastectomy?

A

removal of both mammary chains

66
Q

when removing a mammary tumor in the dog, surgical dose depends on what?

A

tumor behavior, tumor size, & number of tumors

67
Q

in cats, what is the current recommended treatment for mammary tumors?

A

bilateral chain mastectomy in all cases - may need to be staged

68
Q

what are the recommended margins for mammary tumors in cats for surgical excision?

A

1-2cm margins around tumor/tumors - otherwise smaller margins

69
Q

what is the goal of removing a mammary tumor in cats?

A

remove mammary tissue & lymphatics

70
Q

for digit tumors in dogs, are benign or malignant tumors more common?

A

malignant

71
Q

what are the most common malignant digit tumors in dogs?

A

SCC (50%)&raquo_space; melanoma&raquo_space; STS&raquo_space; MCT&raquo_space; osteosarcoma

72
Q

T/F: staging isn’t important in digit tumors

A

false - it is very important

73
Q

how do you treat digit tumors?

A

digit amputation is indicated but you still need to consider margins

74
Q

how would you treat this?

A

digit amputation

SA DX & TX I (59 decks)

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