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SA DX & TX II > Exam 2 - Skin Tumors > Flashcards

Exam 2 - Skin Tumors Flashcards

1
Q

what 3 questions should be asked for approaching a patient with a skin tumor? why is this important?

A

what is it? where is it? how do we get rid of it?

a lot of mistakes are made in private practice because treatment is prescribed before tumor type is ever known

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2
Q

what is tumor grade? why is it important?

A

it is determined by pathology - can’t be determined by cytology

gives prognostic indicators & different grading schemes are used for different tumor types

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3
Q

what is tumor stage?

A

determining where the tumor is located - looking to see if the tumor is localized or if it has spread to other parts of the body

local, regional, or distant

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4
Q

what are the 3 general tumor types?

A
  1. epithelial - carcinomas
  2. mesenchymal - sarcomas
  3. round cell - hematopoietic & mesenchymal origin
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5
Q

where do epithelial tumors arise from?

A

epithelial surfaces - skin, respiratory tract, gi tract, urinary tract

glands

organs

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6
Q

where do mesenchymal tumors arise from?

A

mesenchymal & connective tissue

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7
Q

where do round cell tumors arise from?

A

hematopoietic & mesenchymal origin

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8
Q

what is the easiest/cheapest way for figuring out tumor type?

A

stick a needle in it - FNA & cytology

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9
Q

why do you want to know the type of tumor your patient has?

A

allows for treatment planning

prognosis with & without therapy

direct staging

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10
Q

what is the difference between an incisional & excisional biopsy for approaching a patient with a tumor that couldn’t be diagnosed with cytology?

A

incisional - removal of part of the tumor (tru cut, punch, & wedge)

excisional - marginal excision of the entire tumor

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11
Q

when may incisional biopsy be preferred over excisional? what about excisional over incisional?

A

incisional if the tumor is located in an area with less skin - distal limb, prepuce, anus

excisional if in an area with a lot of skin

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12
Q

why is it important to plan when doing a biopsy for a patient with a skin tumor?

A

do NOT biopsy in a manner that may prevent or interfere with a definitive or curative surgical procedure later

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13
Q

T/F: surgery cures more cancer than any other treatment modality

A

true

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14
Q

the best chance for a cure/best outcome of neoplasia is with the _______ ___________

A

first surgery

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15
Q

what components make up staging a skin tumor?

A

dependent upon the tumor type - FNA of the draining lymph node, thoracic rads, abdominal ultrasound +/- FNA & cytology of liver & spleen, or CT/MRI for large infiltrative tumors

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16
Q

what are the 3 treatment modalities available for skin tumors?

A

surgery, radiation, & chemotherapy

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17
Q

treating or getting rid of a tumor is dependent on what?

A

what the tumor type is & where the tumor is (staging)

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18
Q

what does in situ mean?

A

carcinoma that has NOT penetrated the basement membrane of the epithelium - cells are neoplastic/dysplastic

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19
Q

what are some common skin tumors in dogs & cats arising from the follicular epithelium?

A

SCC in situ & SCC

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20
Q

what are some common skin tumors in dogs & cats arising from the hair follicle?

A

trichoblastoma complex

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21
Q

what are some common skin tumors in dogs & cats arising from glandular structures?

A

sebaceous gland tumors & apocrine gland tumors

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22
Q

what are some common skin tumors in dogs & cats arising from the ear canal?

A

hemangioma/hemangiosarcoma, melanoma, histocytoma, plasma cell tumor, & lymphoma

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23
Q

squamous cell carcinoma in situ is primarily a disease in what animals?

A

cats

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24
Q

what is actinic keratosis in regards to SCC in situ? what clinical signs does it cause?

A

SCC in situ that arises secondary to UV exposure affecting lightly haired animals with pigmented skin - white kitties with light noses that like to be in the sun (noses & ear tips)

solar elastosis & fibrosis of the skin

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25
Q

what clinical signs are seen in SCC in situ in cats?

A

erosions of the epidermis, proliferation, crusted plaques, +/- pain with palpation

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26
Q

what is bowen’s carcinoma?

A

SCC in situ that is occurring in MULTIPLE SITES!!!!

happens regardless of UV exposure

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27
Q

what locations do bowen’s carcinoma occur? what clinical signs are associated with it?

A

multiple sites - haired & unhaired areas, areas with & without UV exposure

heavily scaled!!!! crusted & pigmented papules & plaques +/- erosions

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28
Q

T/F: in a cat with bowen’s carcinoma, you will continue to see the animal develop lesions regardless of treatment

A

true

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29
Q

what lesion is this?

A

SCC in situ - white kitty that loves the sun :/

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30
Q

what is the prognosis of SCC in situ?

A

it is non-invasive - so metastasis has not occurred but if left alone & untreated, it could progress & eventually met

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31
Q

what is the treatment of choice for SCC in situ?

A

surgery!!!!!!

other options include - imiquimod cream, strontium plesiotherapy, photodynamic therapy, & cryosurgery

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32
Q

when is strontium-90 plesiotherapy useful for SCC/SCC in situ?

A

very small & very superficial lesions only!!

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33
Q

what is cryosurgery?

A

destruction of tissue with controlled use of freezing & thawing - 3 cycles are usually performed

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34
Q

how does cryosurgery work for destruction of tissue?

A

development of ice crystals both intracellularly & extracellularly resulting in cell death

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35
Q

when is cryosurgery useful for treating SCC in situ/SCC?

A

when it is a superficial lesion & is <4mm in diameter

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36
Q

T/F: a cat will look busted after cryosurgery, so you should warn the owner

A

true

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37
Q

what are the clinical signs associated with SCC?

A

variable clinical presentation - erythemic, ulcerated, crusted lesions

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38
Q

what is linked to causing SCC in cats?

A

UV exposure

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39
Q

T/F: metastasis at the time of death in cats with SCC is 40%

A

true

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40
Q

what is the treatment of choice for SCC?

A

surgery!!!!

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41
Q

what is the most common location for SCC in labs & goldens?

A

nasal planum in labs & golden retrievers

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42
Q

what dogs are at risk for getting cutaneous SCC?

A

breeds with light pigmentation & thin hair coat

bloodhounds, bassett hounds, standard poodles

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43
Q

T/F: like cats, SCC on the nasal planum in dogs is related to sun exposure

A

FALSE - not related to sun exposure in dogs!!!

very invasive & locally aggressive, mets reported in 25% of cases

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44
Q

T/F: in cutaneous SCC in dogs, there is a can be a link to UV exposure

A

true

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45
Q

T/F: radiation therapy for nasal planum SCC is effective

A

false - not effective

46
Q

when is radiation therapy useful for SCC?

A

cutaneous forms - used in more so palliative care

47
Q

what is the treatment of choice for SCC in dogs?

A

surgery!!!

48
Q

is chemotherapy useful for treating SCC in dogs?

A

doesn’t appear to help

49
Q

what is the treatment of choice for dogs & cats with trichoblastomas?

A

surgery

50
Q

where are trichoblastoma tumors commonly seen in dogs & cats? what dog breeds are predisposed?

A

head & neck - dogs

head, neck, limbs, trunk - cats

poodles & setters

51
Q

T/F: trichoblastomas are very common tumors seen in dogs & cats are are benign

A

true

52
Q

what cat breed is at risk for trichoepitheliomas?

A

persian cats

53
Q

what is the treatment of choice for trichoepitheliomas in dogs & cats?

A

surgery

54
Q

what dog breeds are at risk for getting trichoepitheliomas?

A

bassett hounds, coonhounds, english springer spaniels, & setters

55
Q

what anatomic locations are trichoepitheliomas commonly seen?

A

limbs, neck, & back - dermal tumors that can extend into the subcutis

56
Q

what is malignant trichoepithelioma?

A

highly invasive tumor with invasion into surrounding tissues & has lymphatic involvement

57
Q

what is the treatment of choice for malignant trichoepithelioma? why?

A

surgery with wide excision recommended!!!!

higher mitotic index & highly metastatic to regional lymph nodes & lungs!!!!

58
Q

T/F: the benefit of adjuvant or systemic therapy is unknown when treating malignant trichoepithelioma

A

true

59
Q

sebaceous adenomas are common in what animals?

A

dogs - rare in the cat

60
Q

what dog breeds commonly get sebaceous adenomas?

A

mini schnauzer, beagles, poodles, & cocker spaniels

61
Q

what is the treatment of choice for sebaceous adenoma?

A

surgery

62
Q

what animals are commonly affected with sebaceous carcinomas? where are they commonly located?

A

uncommon tumor with local infiltration & rare mets but affects intact males - cavies, cocker spaniels, & terrier breeds

head & neck

63
Q

what is the treatment of choice for sebaceous carcinomas?

A

surgery with wide margins

64
Q

what dog breeds are commonly affected by apocrine gland tumors? where are they commonly seen?

A

uncommon malignant locally invasive tumor with low met rate but seen in treeing walker coonhounds & goldens on the front legs

65
Q

what is the treatment of choice for apocrine gland tumors?

A

wide surgical excision

66
Q

what tumor is this breed associated with?

A

apocrine gland tumors

67
Q

T/F: apocrine gland tumors are the same as anal gland apocrine gland adenocarcinoma

A

false - not at all the same

68
Q

what dogs are at risk for developing hemangiosarcoma due to UV exposure?

A

dogs with minimal skin pigmentation & thin hair coats - pitties, dalmatian, whippets

69
Q

what dog is the poster child for cutaneous UV-exposure induced hemangiosarcoma?

A

whippets

70
Q

T/F: cutaneous hemangiosarcoma is more common in the dog than in cats

A

true

71
Q

what locations are cutaneous hemangiosarcomas seen?

A

inguinal & axillary region

around the muzzle

72
Q

T/F: cutaneous dermal hemangiosarcoma without clinical or histological evidence of sub-dermal infiltration is often considered benign which is the opposite of hemangiosarcoma in other locations which is highly metastatic & aggressive

A

true

73
Q

what are some poor prognostic factors of ear canal tumors in cats?

A

mitotic index of 2 or less

presence of neurological signs

histology

extension beyond the ear canal

74
Q

what are some identified poor prognostic factors of ear canal tumors in dogs?

A

there is extension of the tumor beyond the ear canal

75
Q

what does melanoma arise from?

A

melanocytes

76
Q

T/F: melanomas involving the haired skin not in close proximity to mucosal margins often have benign behavior which is very different than oral malignant melanoma

A

true

77
Q

what is the treatment for melanoma?

A

surgical excision with 1-2cm margins - often curative

78
Q

what kind of tumor is seen in the picture?

A

melanoma

79
Q

where do histiocytomas arise from?

A

benign tumor that arises from epidermal dendritic or langerhan cells

80
Q

what animals commonly get histiocytomas?

A

head & limbs of young dogs <3 years old - bulldogs, pitties, greyhounds, boxers, & bostons

81
Q

what is the hallmark of the pictured tumor?

A

rapid growth followed occasionally by regression - but factors determining spontaneous regression are unknown

82
Q

when to do surgery in an animal with a histiocytoma?

A

if there is:

rapid growth, ulceration/infection, location is odd, development in an older patient (very rare), cytology is not conclusive, or failure for it to resolve in a timely fashion

83
Q

T/F: plasma cell tumors most commonly occur as the cutaneous form

A

true

84
Q

what are the common locations where plasma cell tumors are seen?

A

limbs, heads, & ears - solitary, smooth, raised pink nodules

85
Q

what dog breeds are at risk for plasma cell tumors?

A

cocker spaniels, WHWT, boxer, yorkie, & GSD

86
Q

T/F: plasma cell tumors are typically benign

A

true - rare form of multiple cutaneous plasmacytoma that has a more aggressive biological behavior similar to malignant melanoma

87
Q

what is the treatment for cutaneous plasma cell tumors?

A

surgery - considered to be curative

88
Q

what clinical signs are seen in animals with cutaneous epitheliotropic T cell lymphoma?

A

generalized or multifocal lesions

nodules, plaques, ulcers, erythemic or exfoliative dermatitis, focal hypopigmentation, & alopecia

may have peripheral lymph node involvement seen in late stages of disease

89
Q

what disease is pictured?

A

cutaneous epitheliotropic t cell lymphoma

90
Q

what are the 3 clinical stages of disease in cutaneous lymphoma?

A
  1. scaling, alopecia, & pruritus
  2. erythema, thickened/ulcerated, exudative lesions
  3. proliferative plaques & nodules with proliferative ulceration
91
Q

what treatment is used for cutaneous lymphoma?

A

chemotherapy - lomustine has an 80% response rate with median remission of 3 months

radiation

surgery

supportive care - antibiotics & analgesia

92
Q

what tumor type is seen here?

A

plasma cell tumor

93
Q

what tumor type is seen here?

A

cutaneous hemangiosarcoma

94
Q

what treatment is indicated for cutaneous hemangiosarcoma when sub-dermal invasion & involvement of subcutaneous tissues & muscles is present? why?

A

surgical excision & adjuvant therapy is required

prognosis is worse

95
Q

what is the prognosis for an animal with cutaneous hemangiosarcoma with sub-dermal invasion & involvement of subcutaneous tissues & muscles?

A

poor prognosis

96
Q

what is field carcinogenesis?

A

prevalence of tumor-related alterations in normal-appearing tissues

97
Q

when is surgical excision recommended as treatment for cutaneous hemangiosarcoma?

A

when the lesion is confined to the dermis - MST 2 years +

when there is sub-dermal invasion & involvement of subcutaneous tissues/muscles

98
Q

what is the most common malignant tumor in the ear canal? what dog breeds are commonly affected?

A

ceruminous gland adenocarcinoma

cocker spaniels & GSD

99
Q

what is the recommended approach which diagnosing a ceruminous gland adenocarcinoma?

A

CT scan for treatment planning because it is a locally invasive tumor & it has metastasis to local lymph nodes & the lungs

100
Q

what treatment is recommended for ceruminous gland adenocarcinomas?

A

complete surgical excision - TECA & lateral bulla osteotomy

radiation therapy

101
Q

T/F: with complete surgical excision of ceruminous adenocarcinomas, there is a low recurrence rate in dogs & approximately 25% recurrence in cats

A

true

102
Q

what tumor type is seen in the photo?

A

ceruminous gland adenocarcinoma

103
Q

what is the typical appearance of ceruminous gland adenomas?

A

exophytic, pedunculated, +/- ulcerative mass

104
Q

what dogs are commonly affected by ceruminous gland adenomas?

A

cocker spaniels & poodles

younger than dogs with the malignant ceruminous gland adenocarcinoma

105
Q

what is the appearance of ceruminous gland adenomas in cats?

A

darkly pigmented tumor, small <5mm, & multiple masses

106
Q

what benign tumor is pictured?

A

ceruminous gland adenoma

107
Q

what is the treatment of choice for ceruminous gland adenomas?

A

surgical removal

108
Q

what tumors are sebaceous gland tumors? what tumors are apocrine gland tumors?

A

sebaceous glands & apocrine glands - adenomas & carcinomas

109
Q

what dog breed is commonly affected with malignant trichoepithelioma?

A

bassett hounds

110
Q

is this tumor type associated with UV exposure?

A

nope

111
Q

is this tumor type associated with UV exposure?

A

yes

SA DX & TX II (62 decks)

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