Head and Neck Tumors Flashcards
What dog breed is predisposed to ceruminous gland adenocarcinoma?
Cocker spaniels
Cocker spaniels are predisposed to _____________ (list cancer type)
ceruminous gland adenocarcinoma
What cancers is use of Palladia effective for?
- MCT (blocks tyrosine kinase like CKIT)
- Carcinomas expressing VEGFR2
What is the #1 differential for dogs and cats with nasal planum tumors?
SCC
What is the presenting signalment in a dog or cat with a nasal planum tumor?
- Crusting/erythema progressing to superficial ulcers
- History of failed empirical treatments with Abx’s
What diagnostics should be performed on a dog or cat with a suspect nasal planum tumor?
- Wedge or Punch biopsy under GA , don’t go full thickness through the nose, Biopsy the center of the lesion
- Cytology NOT effective
- Can sample LN but often not the regional LN
(low met rate, goes late, but not wrong to do rads to check)
What is the most important factor when deciding your treatment protocol for a patient with a nasal planum tumor?
Depth of invasion
- If superficial lesion < 1cm, do Cryoablation
- If deep lesion, do Nasal Planectomy
Treatment options for a nasal planum tumor in dogs/cats?
- Cryoablation if superficial lesion < 1cm
- Nasal planectomy
What is the MST for patients undergoing nasal planectomy to remove SCC from the nasal planum?
~20 months (1.5 yrs)
What is electrochemotherapy and what has it been used to treat in animals?
- Chemo drugs in combo with high voltage electric pulses
- Increases permeability of cells to allow more chemo to enter
- Has been experimented with superficial SCC in cats in different stages
What is true about the behavior of ear tumors in dogs vs cats?
- Cats more likely malignant ear tumors
- Dogs 50:50 between malignant and benign
What is the #1 differential for a malignant ear tumor in dogs and cats?
Ceruminous gland adenocarcinoma
(Other Ddx: SCC, undifferentiated carcinoma, plasmacytoma)
What diagnostic work up and staging should be performed on a dog or cat with an ear tumor?
- Shave or punch biopsy under sedation or GA
- CT to reveal osseous changes in bulla
- LN cytology
- Low metastasis rate, but not wrong to do rads
- Cytology NOT effective , usually bloody and friable, too deep in ear to reach with a needle
What treatment is reccommended for a patient with a malignant ear tumor?
TECA-BO (Total ear canal ablation w/ bulla osteotomy)
DONT DO LATERAL CANAL RESECTION - high recurrence late
List the negative prognostic indicators associated with ear tumors
- Extension beyond ear canal
- Diagnosis of SCC or undifferentiated carcinoma
- Presence of neuro signs
- Post op histo indicating high mitotic index or vascular/lymphatic invasion
Hemorrhage is NOT a prognostic indicator
What is the prognosis for cats and dogs treated with TECA-BO for an ear tumor?
Dogs: 4-8 years
Cats: 1-4 yrs (variable bc cats gets more malignant ear tumors)
Sinonasal tumors are common in what dog breeds?
Doliocephalic long nose breeds
What is the common presenting signalment in dogs with a sinonasal tumor?
- Month long history of UNILATERAL epistaxis
- Facial deformity in advanced cases
- Long nose dog breeds
What is the most common sinonasal tumor in dogs and cats?
Dogs: #1 adenocarcinoma, #2 SCC
Cats: LYMPHOMA LYMPHOMA LYMPHOMA
What diagnostic work up and staging should be performed on a dog or cat with unilateral epistaxis?
- Do BP, coags, tick panel to R/O non-neoplastic causes of epistaxis
- Trans nasal Biopsy (if no blood, not a good sample!)
- Rads of chest and skull (Open mouth DV view) , look for turbinate lysis
- CT/MRI > rads but $$$
- Regional LN cytology (10-25% incidence)
What is the MST in a patient with a sinonasal tumor if no treatment is done?
3 months, even worse if epistaxis present
What is available for palliative treatment of sinonasal tumors in dogs?
- NSAIDS in dogs (carcinomas over express COX-2)
- Low dose RT
- Chemo (but Goldie Coldmann, sinonasal tumors usually LARGE)
- Palladia (inhibits VEGFR expressed by carcinomas)
What curative treatment options are available for dogs with a sinonasal tumor?
- Intensity Modulated Radiation therapy
- Steriotactic Radiotherapy (large doses over a shorter duration, only hits tumor cells)
- External Beam Course Fractionated Radiation therapy (zaps huge area including normal tissue)
____% of the cortex must be destroyed to see evidence of turbinate lysis on radiographs, which is why CT/MRI is better at detection
40
