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Onco Board Review 2 > GI Tumors, Liver (+ some mammary) > Flashcards

GI Tumors, Liver (+ some mammary) Flashcards

1
Q

Name three PNS seen with GI smooth muscle tumors.

A

hypoglycemia, nephrogenic DI, erythrocytosis

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2
Q

What is the met rate for hepatic leiomyosarcomas?

A

100%

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3
Q

What IHC markers differentiate leiomyosarcomas from GISTs?

A

Leiomyo: actin+, desmin+ (neg for c-kit, CD34, S-100)
GIST: cKIT+, CD34+ (variable reactivity to actin, desmin, S-100)

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4
Q

What is the MST for GI leiomyosarcomas/GIST in patients that survive surgery?

A

37.4 months

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5
Q

Aside from c-kit, what marker may be more sensitive/specific for canine GIST than c-kit? (Dailey 2015)

A

DOG1 (identified in 2 tumors that were c-kit negative, at minimum authors recommend combining with c-kit)

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6
Q

What parasite is known to cause esophageal sarcomas?

A

Spirocerca lupi

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7
Q

Which is not associated with Spirocerca lupi-induced sarcomas?

  1. neutrophilia
  2. hypertrophic osteopathy
  3. thoracic spondylitis
  4. microcytic hypochromic anemia
  5. hypoglycemia
A

hypoglycemia

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8
Q

What is the most common canine gastric tumor?

A

adenocarcinoma

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9
Q

What % of GISTs form in the stomach?

A

20%

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10
Q

What is the MST for dogs undergoing pylorectomy and gastroduodenestomy?

A

33 days

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11
Q

Pancreatic nodules larger than what size are suggestive of neoplasia in cats?

A

> 2cm

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12
Q

What PNS is associated with pancreatic carcinoma in cats?

A

ventral glistening alopecia

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13
Q

What compound can experimentally induce pancreatic duct adenocarcinoma?

A

N-ethyl-N’-nitro-N-nitrosoguanidine

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14
Q

What is the MST for salivary gland carcinomas treated with sx +/- RT for dogs and cats?

A

550 days for dogs

516 days for cats

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15
Q

What are the top 3 intestinal tumors in cats and dogs?

A

Cats: LSA, ACA, MST
Dogs: LSA, ACA, Leio/GIST

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16
Q

What does the term carcinoid mean?

A

Tumors that arise from the diffuse endocrine system (enterochromaffin cells) rather than intestinal epithelium.

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17
Q

Which IHC markers differentiate leiomyosarcomas from GISTs?

A

Leio: actin, desmin
GIST: cKIT, CD34 (DOG1)

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18
Q

What is the MST for dogs with colorectal ACA treated with surgery?

A

2-4 years

survived 15 months with stool softeners alone

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19
Q

What is the MST for cats with colonic ACA treated with surgery and DOX? (Withrow)

A

280d (9 months) vs. 56 days without

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20
Q

What is the MST for dogs with intestinal ACA treated with surgery?

A

114 days, 7-10 months

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21
Q

What is the MST for dogs with GI leiomyosarcoma or GIST treated with surgery?

A

1.1 - 2 years, 38 months

if they survive the preoperative period

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22
Q

Diffuse cytoplasmic KIT staining detected in what % of GIST? (Takanosu 2016)

A

70% (and 30% stippled cytoplasmic staining)

also mutations in exon 11 of c-kit ID’s in 74% with RT-PCR

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23
Q

Why can hypoglycemia occur with leiomyosarcoma?

A

Production of IGF

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24
Q

Where are GISTs more likely to occur? Where are leiomyosarcomas more likely to occur? (Withrow p.414)

A

GIST - large intestine (specifically cecum)
Leio - stomach and small intestine
(note that in Hayes 2013, 67% of GISTs occurred in small intestine)

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25
Q

What is the metastatic rate and common locations for feline intestinal adenocarcinoma?

A

50% will spread to local LN; 30% to peritoneal cavity; 20% to lungs

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26
Q

What exon is c-kit mutation on for canine GIST?

A

exon 11

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27
Q

What gene is frequently mutated in human colorectal carcinoma and also noted to be mutated in dogs? (Youmans 2012)

A

APC (adenomatous polyposis coli)

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28
Q

What is the median DFI/MST for cats with colonic adenocarcinoma treated with subtotal colectomy and adjuvant carbo? (Arteaga 2012)

A

DFI 251d (8 months); MST 269d (9 months)

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29
Q

What was the complication rate for rectal pull-through surgery in dogs with rectal masses? MST? (Nucci 2014)

A

78.4% incontinence - permanent in 54.8%
MST was 1150d for all dogs and 726d for malignant rectal tumors
(conclude high complication rate but good outcome)

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30
Q

What cytokine may be important in pathogenesis of inflammatory colorectal polyps in mini-dachshunds? (Ohta 2013)

A

IL-17

There are several papers looking at markers for this disease that I didn’t include

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31
Q

What cells do GISTs originate from?

A

interstitial cells of Cajal

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32
Q

What % of GI leiomyosarcomas were reclassified as GIST? (Russell 2007 and Maas 2007)

A

58-67%

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33
Q

What features were associated with worse survival for GIST treated with Palladia (both microscopic and macroscopic? (Berger 2018)

A 
High MI (did not give cut-off!) and metastasis at diagnosis
Could by type 1 error (false +)
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34
Q

What apoptotic marker was significantly higher in cats with GI LSA vs. IBD? (Swanson 2012)

A

Bcl-2

but note that positive expression in both groups was pretty high

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35
Q

Do cats with GI LSA have gremlin mutation in MMR? (Aberdein 2012)

A

No

evaluated due to MMR defect in HNPCC

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36
Q

Can cytology be used to diagnoses GI disease in dogs? (Maeda 2017)

A

Maybe, there was 81.4% agreement in this study looking at chronic enteritis vs. intestinal LSA in dogs.
(for enteritis vs. LSA - Sn was 98.6% but Sp only 73.5%)

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37
Q

When PARR was used for canine intestinal LSA, what % were accurately diagnosed? (Ohmura 2017)

A

76%

correctly identified 22/29 cases; 85% were T cell

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38
Q

What % of cats with gastric LSA experienced remission? What was duration of first remission? (Gustafson 2014)

A

75% remission

median remission 108d (3.6 months)

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39
Q

Is serum gastrin a reliable prognostic indicator for canine gastric carcinoma? (Seim-Wikse 2014)

A

No

it is in humans

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40
Q

What cytologic features (on squash prep) are specific for malignancy in gastric ACA? (Riondato 2014)

A

signet rings and microvacuolation

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41
Q

What dose of radiation is recommended to treat recurrent sialoceles refractory to surgical management? (Poirier JVIM 2018)

A

Minimum total dose of 16 or 20 Gy in 4 Gy fractions appeared effective

42
Q

What was ORR to radiation for sialoceles? (Poirier JVIM 2018)

A

100%
(54% CR, 45% PR)
Those that had progression had only received 12 Gy

43
Q

What is the most common gastric neoplasia in horses? (Taylor JVIM 2009)

A

SCC (19/24 cases)

MST was 4 weeks (all cases)

44
Q

Which EMT factors are potential targets for canine mammary carcinoma? (Xavier 2018)

A

ZEB1 and ZEB2

45
Q

How did medical therapy (toceranib/piroxicam/thalidomide) alone compare to medical therapy with hypofractionated RT for inflammatory mammary carcinoma? (Rossi 2018)

A

Improved response and survival

ORR 100%, TTP 156d, MST 180d (vs. 34d and 109d)

46
Q

Dogs with what characteristics may benefit from OHE at the time of mammary carcinoma removal? (Kristiansen 2016, randomized controlled trial)

A

grade 2
ER-positive tumors
increased peri-surgical serum E2 concentration

47
Q

What were the results of combination iniparib and carboplatin to treat dogs with tumors? (Saba PLoS One 2016)

A
  • iniparib developed as PARP inhibitor but MOA not understood, positive effects in human trials
  • DLT included fever, anorexia, diarrhea, neutropenia, thrombocytopenia (attributed to carbo)
  • Unable to identify MTD of iniparib but was tolerated
  • No detectable drug/metabolites in the tumors themselves
48
Q

What phenotype are tumor-associated macrophages?

A

M2

49
Q

What is one of the most highly recurrent amplified genes in canine mammary carcinoma? (Borge PLoS One 2015)

A

MYC

50
Q

What was significant about overweight dogs and mammary tumors? (Lim Vet Path 2015)

A

proportion of grade 3 tumors and aromatase expression

51
Q

How did ulceration influence survival of mammary carcinoma? (Tran 2016)

A

MST 118d if present and 443d if absent

52
Q

How did surgical margins influence survival of mammary carcinoma? (Tran 2016)

A

MST 70d if incomplete, 872d if complete

53
Q

What was the effect of OHE at the time of tumor removal in dogs with benign mammary tumors? (Kristiansen 2013)

A

OHE at time of tumor removal can reduce risk of new tumor development by 50%
(new mammary tumors developed in 64% of intact dogs and 36% of spayed)

54
Q

What gene was identified that may play a role in MGT in English sprinter spaniels? (Borge 2013)

A

ESR1 (estrogen receptor 1 gene)

55
Q

Overexpression of what protein, which is normally restricted to testis and ovaries, was identified in 82% of oral melanomas, 100% of nasal tumors, and 100% TVT? (Chen 2013)

A

MAGE-A

56
Q

What two factors were identified as independent prognostic markers of canine malignant mammary tumors? (Santos 2013)

A

MMP-9, Ki67

57
Q

What breed had the highest proportion of malignant MGTs and over-expression of BRCA-1? (Im 2013)

A

Shih Tzus

Cytoplasmic and membranous expression of BRCA1 was associated with ER/PR negative and triple negative (ER/PR/HER2) phenotypes and basal-like molecular structure in Shih Tzu dogs.

58
Q
  1. What cytokine was associated with negative prognosis in cats with HER2-over expressing mammary tumors? 2. Which cytokine was expressed in more primary tumors than metastatic? (Marques 2018)
A
  1. CXCL12

2. CXCR4

59
Q

What was the complication rate for cats undergoing staged bilateral mastectomy vs. single session bilateral mastectomy? What was the complication rate for unilateral mastectomy? (Gemignani JAVMA 2018)

A

bilateral staged = 35.7% vs. bilateral single session = 40.6%
unilateral = 19.7%

60
Q

What was the PFS for unilateral mastectomy vs. bilateral? (Gemignani JAVMA 2018)

A

289d (9.6 months) for unilateral vs. 542d (18 months) for bilateral

61
Q

What were 4 significant risk factors for disease progression in cats with mammary carcinoma (Gemignani JAVMA 2018)

A

unilateral mastectomy, tumor ulceration, LN metastasis, tumors arising from fourth mammary gland

(LN mets and distant mets were significant for disease-specific survival)

62
Q

What Ki67 cutoff was determined to be reasonable for feline mammary cancer? (Soares 2016)

A

14%

63
Q

What are 3 independent prognostic factors for feline mammary carcinoma used for grading? (Mills Vet Path 2015)

A

lymphovascular invasion, nuclear form, MI

64
Q

COX2 was over expressed in what percentage of canine and feline mammary carcinomas? (Millanta VCO 2016)

A

83% canine, 81% feline

65
Q

What was the conclusion about feline mammary tumors and ER/PR/HER2 and BRCA expression? (Wiese/Kiupel 2013)

A

Commonly triple negative but BRCA mutations are uncommon

66
Q

What factors were associated with shorter survival for intestinal LSA (univariate)? What was MST? (Sogame 2018)

A

anorexia, sepsis

MST 62d

67
Q

T/F: Dogs with intestinal LSA treated with a CCNU-based protocol did better than CHOP. (Sogame 2018)

A

False - no difference in this study

68
Q

A cranial mediastinal mass accounts for what % of acquired myasthenia gravis in cats? (Hague 2015)

A

52%

69
Q

How does sonographic appearance of thymoma differ from lymphoma? (Patterson 2014)

A

cystic (57%) and heterogenous (94%) in comparison to lymphoma
(LSA more likely to be solid and split 50/50 between homogenous and heterogenous)

70
Q

T/F: Thyroid transcription factor-1 is a specific marker of benign but not malignant feline lung tumors.

A

True

71
Q

What was the response rate of thymomas to hypo fractionated RT? (Goto 2017)

A

50%, median time to response was 22d

tx with 48-49 Gy in 6-7 fractions

72
Q

What are two recently evaluated markers, aside from TTF-1, that may help identify lung tumors? (Beck 2017)

A

surfactant protein-A and napsin A

73
Q

Which TK receptor showed increased expression in lung tumors? (Mariotti 2014)

A

PDGFR-alpha

74
Q

What were the most common clinical signs associated with HO? (Withers 2015)

A

leg swelling, ocular discharge and/or episcleral injection, lameness, lethargy

75
Q

What were the most common laboratory findings associated with HO? (Withers 2015)

A

anemia, neutrophilia, elevated ALP

76
Q

Which breeds appeared to be over-represented with cartilaginous tumors of the larynx and trachea? (Ramirez 2015)

A

Arctic breeds (Alaskan Malamute and Siberian Husky)

77
Q

T/F: Hypercalcemia and myasthenia gravis/megaesophagus at the time of diagnosis of thymoma are associated with a worse outcome.

A

False (Robat 2013)

78
Q

What features were associated with poor prognosis for thymoma? (Robat 2013)

A

presence of another tumor at diagnosis, lack of surgical excision, higher pathological stage

79
Q

What % of dogs had recurrence after surgery for thymoma? (Robat 2013)

A

17%

80
Q

What % of dogs with thymoma were hypercalcemic? (Robat 2013)

A

34%

81
Q

What is the MST for thymoma with surgery vs. without? (Robat 2013)

A

635d with surgery (21 months)

76d without surgery (2.5 months)

82
Q

T/F: Primary hepatobiliary tumors are more common than metastatic tumors in cats.

A

True

83
Q

T/F: Most canine primary liver tumors are benign.

A

False

84
Q

Most common liver tumor in dog?

A

Hepatocellular carcinoma

usually massive

85
Q

What is the etiology of HCC in woodchucks? What gene does this affect?

A

Woodchuck hepatitis virus (affects c-myc)

also viral link in humans

86
Q

What is the metastatic rate for diffuse HCC in dogs?

A

93-100%

87
Q

What is the most common hepatobiliary tumor in cats?

A

bile duct adenoma

88
Q

What % of bile duct carcinomas metastasize to RLN/lungs in dogs?

A

88%

89
Q

What is the most common primary liver sarcoma in the dog?

A

leiomyosarcoma
(also HSA and FSA)
metastasis 86-100% to spleen, lungs

90
Q

What is a benign liver tumor in cats thought to be associated with chronic hypoxia?

A

myelolipoma

91
Q

What is the reported intraoperative mortality rate for HCCs treated with surgery?

A

4.8%

92
Q

Name 3 prognostic factors for massive HCC.

A
  1. surgical treatment (+)
  2. R sided mass (-) - worse due to intraop death
  3. increased ALT and AST (-)
93
Q

What is the MST for massive HCC treated with surgery?

A

1460d (4 years)

94
Q

What is the MST for dogs that do not receive surgery for HCC?

A

270d (9 months)

95
Q

What was the objective response to 3D-CRT for inoperable massive HCC in dogs? (Mori 2015)

A

5/6 dogs (83%)
RT induced liver dz in 1 dog, rest well tolerated
Total dose ranged from 18-42 Gy

96
Q

Most common liver tumor in cats?

A

benign biliary cystadenoma

97
Q

Dog breed that may be overrepresented with HCC?

A

miniature schnauzer

98
Q

How do bile duct carcinomas differ between cats and dogs?

A

Dog - intrahepatic more common

Cat - extrahepatic more common

99
Q

Metastatic rate of liver carcinoids?

A

93%

typically nodular/diffuse, younger age

100
Q

Does gemcitabine provide benefit for HCC? (Elpiner 2011)

A

no obvious benefit, survival similar to other reports

101
Q

What % of liver masses were correctly localized on ultrasound? (Wormser 2016)

A

51.8%

correct localization 3.2x more likely with R or L compared to central

102
Q

What % of cats had increased ALT activity with CCNU? (Musser 2012)

A

6.8%

Onco Board Review 2 (20 decks)

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