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SAM II Exam 1 > Head and Neck Tumors > Flashcards

Head and Neck Tumors Flashcards

focus on sinonasal and thyroid tumors// but more ?s on first two oncology lectures

1
Q 
What is the most common tumor of the nasal planum in animals exposed to UV rays?
A) Mast cell tumor
B) Squamous cell carcinoma
C) Sarcoma
D) Lymphosarcoma
A

B
Ddx:
Cats= LSA, MCT, eosinophilic granuloma
Dogs= MCT, sarcoma

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2
Q

T/F: In situ SCC is the pre-cancerous form, the basement membrane has been preserved.

A

True

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3
Q

T/F: Cytology is the most inexpensive and effective way to diagnose SCC on the nasal planum.

A

False- not likely to be effective!

must do an incisional biopsy= wedge or punch

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4
Q

A SCC lesion is said to be superficial if less than __ mm deep.

A

2 mm

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5
Q

You suspect the progressive lesion on an outside only cat’s nasal platum is SCC. Which of the following is the best way to diagnose this?
A) Fine needle aspirate while the pet is awake
B) Wedge or punch biopsy under general anesthesia
C) Wedge or punch biopsy under sedation
D) None of the above

A

B- will bleed!

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6
Q

T/F: SCC of the nasal planum are highly metastatic.

A

false- highly invasive, low metastasis

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7
Q

Cryoablation is minimally invasive, cheap, and widely available. This form of treatment works best for the ___ form of SCC.

A

superficial!! doesn’t allow for margin assessment= not sure if the whole tumor was removed

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8
Q

If the SCC lesion is greater than __cm (meaning it is infiltrative) then surgical removal is the treatment of choice.

A

1
surgery= nasal planectomy aka nosectomy
aggressive surgical removal= improves the prognosis!! can survive for almost 2 years after surgery

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9
Q 
What is the most common tumor of the ear canal?
A) SCC
B) Plasmocytomas
C) Sarcomas
D) Ceruminous gland adenocarcinoma
A

D

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10
Q

T/F: Dogs more often have malignant ear canal tumors that are a mixture of inflammatory, benign, and malignant lesions.

A

False- this is true of cats; dogs have a 50:50 split

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11
Q 
FNA is usually unrewarding/not recommended for all of the following tumors except:
A) Salivary  
B) Ear canal 
C) Sinonasal 
D) Nasal planum
A

A- do this! avoid doing a biopsy of the salivary gland

can also FNA thyroid tumors but be careful d/t vascularity!!

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12
Q

T/F: Ear canal tumors are similar to nasal planum tumors in that they are locally invasive but do not commonly metastasize.

A

true

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13
Q

What diagnostic modality is required if invasion of the tumor through the ear canal is suspected?

A

CT

suspect invasion if: cannot move the ear canal, they have jaw pain or swelling

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14
Q 
Which of the following surgeries has the best prognosis for ear canal tumors?
A) Lateral canal resection
B) TECA
C) TECA + BO
D) Radiation therapy
A

C!

if lesions on the pinna remove those as well

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15
Q 
Which of the following is not associated as being a negative prognostic factor for ear canal tumors?
A) Extension beyond the ear canal
B) SCC/undifferentiated carcinoma
C) Neurological signs
D) Ceruminous gland adenocarcinoma
E) invasion into the lymphatics
A

D

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16
Q

Which of the following is false regarding canine sinonasal tumors?
A) More common in older dogs
B) More common in dogs exposed to smoke and kerosene heaters
C) More common in mesocephalic breeds
D) more common in med-lg breeds
E) Associated with history of unilateral epistaxis

A

C- dolicocephalic

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17
Q 
Which tumors have been proven to be caused by environmental factors such as smoke or kerosene exposure?
A) Thyroid carcinomas
B) Sinonasal tumors
C) Ear canal tumors
D) All of the above
A

B

18
Q

T/F: Carcinomas are the most common cause of sinonasal tumors in dogs and cats.

A

False- they are in dogs, cats= LSA!!

19
Q

Name the radiographic view preferred for evaluating sinonasal tumors

A

Open mouth DV oblique

20
Q

Preferred method of evaluating sinonasal tumors?

A

CT

21
Q

T/F: FNA of sinonasal tumors is preferred to biopsy

A

False- do a biopsy, make sure to measure to medial canthus so you don’t enter the brain…want to make them bleed= means you got a good enough sample

22
Q 
What is the treatment of choice for sinonasal tumors in dogs?
A) NSAIDs 
B) Rhinotomy
C) Radiation
D) Chemotherapy
A

C
chemo= palliative…can try palladia which inhibits some growth factors
NSAIDs= decrease angiogenesis

23
Q

T/F: Dogs are often euthanized due to epistaxis associated with the tumor.

A

true- want to treat this!
can cryoablate, or embolize terminal brr of maxillary artery; can also do uni/bilateral carotid ligation - works better in dogs, only unilateral can be done in cats

24
Q 
What type of radiation therapy is used for sinonasal tumors?
A) External beam- course fractionated
B) External beam- high, one time dose
C) Radiation therapy is not indicated
D) None of the above
A

A- begin with smaller doses and increase

prognosis with doing nothing= 3 month survival; with radiation= at least 1 year survival

25
Q

T/F: IMRT(computer aided) and SRT(3D) result in the same outcome as 2D fractionated but allow for fewer treatments and result in fewer side effects.

A

true- allow for more targeted therapy, not as much damage to surrounding tissue

26
Q 
What is the TOC for sinonasal tumors in cats?
A) Rhinotomy
B) Chemotherapy
C) Radiation
D) Radiation/chemo
A

C/D (radiation!) not sure if chemo makes a diff

must differentiate LSA form lymphoplasmocytic rhinitis= need a good biopsy

27
Q

Which is false regarding salivary tumors?
A) More aggressive in cats
B) Predilection in spaniels and siamese cats
C) Most commonly effects zygomatic and sublingual glands
D) Most commonly carcinomas
E) FNA preferred to bisopy

A

C mandibular and parotid

other facts, locally invasive- not metastatic, firm, painless swelling at gland

28
Q

T/F: Surgery is commonly curative for salivary tumors.

A

false- need adjuvant RT (not sure if chemo helps)

29
Q

Can you list 4 dog breeds that are predisposed to thyroid tumors?

A

Goldens, Beagles, Boxers, Huskies

30
Q

T/F: Siamese/himalayan cats are at increased risk for thyroid tumors.

A

false- decreased

31
Q

T/F: Most thyroid tumors are unilateral.

A

true

32
Q

Which of the following is true regarding thyroid tumors in cats and dogs?
A) Dogs get mostly malignant, functional tumors; cats are the opposite
B) Cats mainly get malignant, functional tumors; dogs are the opposite
C) Dogs and cats tend to get benign, non-functional tumors
D) Dogs tend to have malignant, non-functional tumors; cats are opposite

A

D
Dogs= thyroid carcinomas!!
Cats= thyroid adenomas

33
Q 
What part of the body should be at the top of your list to ultrasound for another tumor if you find a thyroid carcinoma in a dog?
A) Lungs
B) Abdomen
C) Urogenital tract
D) None of the above
A

B! they often have concurrent abdominal tumors although it hasn’t been proven to be linked to the thyroid carcinomas

34
Q

T/F: Metastasis of thyroid carcinomas is rare in the dog.

A

false- common but they can still live long even with mets

35
Q

T/F: FNA of the thyroid gland is contraindicated d/t the vascularity.

A

false- just be careful> US guided, needle OFF technique

36
Q

T/F: If you can slip your fingers around the thyroid mass and move it this is a better prognosis for surgical removal.

A

true

37
Q

T/F: The MST for a tumor that is moveable and surgically removed is similar to that if the tumor is fixed.

A

false- longer MST in moveable tumor cases; most survive up to two years, fixed tumors= usually only survive less than or up to 1 year > can use RT to down-stage invasive tumors before surgical removal

38
Q

T/F: Use of radiation delays the progression of malignant thyroid tumors for up to 3 years in many dogs.

A

true! better prognosis compared to not doing RT …biggest issue is that if the dog is clinically sick RT can take time to shrink the tumor (8-22m) …increased MST using fractionated vs hypofractionated

39
Q

If you have to remove both thyroid glands what is often required to be supplemented?

A

Calcium! b/c parathyroids are also gone….give calcitriol// also T4 since thyroid is gone

40
Q

T/F: I131 therapy has been shown to work well in treating non-resectable thyroid tumors in dogs.

A

false- can die from unpredictable myelosuppression!

41
Q

Which is false regarding negative prognostic factors with thyroid tumors?
A) Lack of mobility is probably the most important negative prognostic factor
B) Increased risk of developing metastasis related to no evidence of tumor growth progressing
C) Bilateral vs unilateral, bilateral has 16X greater risk for metastasizing
D) Poor prognosis if >5 cm in diameter

A

B- decreased risk of metastasis if no evidence of tumor progression

SAM II Exam 1 (5 decks)

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