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SAM II > Head & Neck Tumors > Flashcards

Head & Neck Tumors Flashcards

1
Q

what is the common signalment for nasal planum tumors?

A

cats, older and lightly pigmented getting lots of sun

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2
Q

what are the differential diagnoses for nasal planum tumors in a cat?

A

LSA, eosinophilic granuloma, MCT

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3
Q

what are the differential diagnoses for nasal planum tumors in a dog?

A

SCC (#1), MCT, sarcoma (fibro-most likely)

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4
Q

what are the three variations in SCC?

A
  • in situ (BM preserved “pre-cancerous”)
  • superficial (<2mm deep)
  • infiltrative
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5
Q

what is the best method for work-up and staging of nasal planum tumors?

A

wedge or punch biopsy (cytology not likely effected)

LN staging w/ FNA

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6
Q

do nasal planum tumors have a low or high metastatic rate?

A

LOW, LN staging

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7
Q

T/F: nasal planum tumors SLN tend to be submandibular

A

FALSE, SLN unpredictable (check PRESCAPS)

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8
Q

what is a popular minimally invasive, cheap, and available treatment option for superficial planum tumors?

A

cryoablation (if less than 1 cm)

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9
Q

what is the surgical procedure done to remove infiltrative nasal planum tumors?

A

nasal planectomy (nosectomy) +/- some removal of some of the maxilla

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10
Q

combined use of chemotherapeutic drugs (bleomycin or cisplatin) in combination with high-voltage electric pulses

A

electrochemotherapy

reversible permeabilization of cell membranes > enables more efficient entry of drugs into cells

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11
Q

what presenting complaints might you see with a patient with an ear canal tumor?

A

recurrent signs of infection with visible mass

  • pruritis
  • bleeding
  • pain or reluctance to open mouth
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12
Q

what is the typical signalment for ear canal tumors?

A

cocker spaniels, poodles, GSD, younger cats

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13
Q

what is your top differential diagnosis for ear canal tumors?

A

ceruminous gland adenocarcinoma

-carcinomas (SCC/undifferentiated), round cell tumors (plasmacytomas), sarcomas

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14
Q

T/F: dogs develop malignant dz > benign and cats are more of an even split when it comes to ceruminous gland tumors

A

FALSE, opposite

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15
Q

what is the best way to sample ear canal tumors?

A

pinch biopsy w/ alligator or clamp shell forceps

FNA usually unrewarding (friable or too deep)

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16
Q

is the metastatic yield high or low for ear canal tumors?

A

low, do thoracic met check anyways! may see osseous changes in bulla, don’t know SLN either

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17
Q

what surgery is necessary for ear canal tumors?

A

TECA-BO (need to be aggressive! NOT lateral canal resection which gives you a higher rate of recurrence)

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18
Q

what are the negative prognostic factors for ear canal tumors?

A
  • extension BEYOND ear canal (MST= 6m (dogs), 4m (cats))
  • SCC or undifferentiated carcinoma
  • neuro signs
  • PO histologic criteria (vascular or lymphatic invasion, high mitotic index)
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19
Q

what is the typical signalment for canine sinonasal tumors?

A

older dogs, medium to large breed, dolichocephalic

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20
Q

what can predispose a dog to sinonasal tumors?

A

environmental exposure (smoke, kerosene (heaters) indoors (2-4x) and urban environments

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21
Q

what is the typical presenting complaint for a dog with a sinonasal tumor?

A

2-3 month hx of UNILATERAL epistaxis, sneezing, open mouth breathing w/ partial response to empirical treatments

22
Q

what are the differential diagnoses for sinonasal tumors for dogs?

A

2/3rd = carcinomas (ACA, SCC & undifferentiated) = DOGS

-sarcomas (FIBRO-, osteo-, & chondro-), fungal (GSD > aspergillosis), polyps, epidermoid cyst (brachys), LSA, MCT, TVT

23
Q

what are the differential diagnoses for sinonasal tumors for cats?

A

LSA!!! (must rule out), ACA, idiopathic non-specific rhinitis

24
Q

what is a likely indication of neoplasia that would be seen on skull & chest radiographs in a dog with a suspect sinonasal tumor?

A

ipsilateral turbinate loss, bone invasion, and sinus infiltration

25
what type of biopsy would you do for a suspected sinonasal tumor?
"bling" trans-nostril biopsy using cup forceps, nasal flushing
26
what is the incidence for regional LN for sinonasal tumors?
10-24%
27
T/F: paraneoplastic hypercalcemia and erythrocytosis in sinonasal tumors is rare
TRUE
28
why are NSAID's (i.e. peroxicam) helpful in dogs with sinonasal tumors?
COX-2 overexpression = 80% nasal carcinomas
29
what are the options for palliative treatment for sinonasal tumors?
NSAIDs, low dose (6-9 Gy week) RT, chemo (palladia > inhibits VEGFR)
30
what could you do to control hemorrhage in a dog with a sinonasal tumor?
unilateral/bilateral carotid aa. ligation (>3 months...extensive collaterals develop)
31
what is the MST for RT-external beam in dogs with sinonasal tumors?
1 year (50% 1 yr, 20% 20 yrs)
32
what type of RT is more successful than external beam?
curative intent imaging guided - IMRT (intensity-modulated)...MST same but avoids critical surrounding structures resulting in less SEs - SRT (sterotactic radiotherapy)...absolute precision, 1-5 procedures, MST=586 days (1 yr 69%, 2y 22%)
33
what late toxicities might you see with curative intent image guided RT in dogs with sinonasal tumors?
oronasal fistulas and fungal rhinitis
34
what are the negative prognostic factors for sinonasal tumors?
- age (>10 yr) - epistaxis - longer duration C.S. - tumor stage (cribriform involvement = bad, ST 7 m vs 23 m) - metastatic dz - histologic subtype (SCC/undifferentiated carcinomas) - failure to achieve resolution clinical symptoms after tx
35
what can be frustrating and therefore cause to get a good biopsy when you have a suspected sinonasal tumor in cats?
LSA vs. lymphoplasmocytic rhinitis
36
what is the typical signalment for salivary tumors?
older dogs (spaniels) and cats (siamese) cats more aggressive!!
37
what salivary gland is most commonly affected when it comes to salivary tumors?
MANDIBULAR and parotid
38
salivary tumors tend to be locally invasive. what local effects might you see?
FIRM, painless swelling at gland, dysphagia, halitosis
39
T/F: regional LN mets are common with salivary tumors
TRUE (distant mets uncommon)
40
what are your differential diagnoses for salivary tumors?
CARCINOMAS, saladenitis, mucocele, misdiagnosed LN that's enlarged
41
T/F: when working-up salivary tumors it is best to biopsy them as FNA are typically unsuccesful
FALSE, better to do a FNA/cytology as biopsies increase the risk of compromising surgery (don't want to disrupt regional anatomy)
42
T/F: surgery on salivary tumors alone is rarely curative
TRUE!! need adjuvant RT for margins, provides good local control
43
what are typical breeds seen when it comes to thyroid tumors?
goldens, beagles, boxers, huskies
44
what clinical signs might be seen with thyroid tumors?
signs of hyperT4 (if functional), coughing, dysphagia, dyspnea, horner's
45
what is the 90:10 rule and who does it apply to?
DOGS for thyroid tumors - 90% malignant, 10% benign - 90% NON-functional, 10% functional CARCINOMAS
46
what is the 10:90 rule and who does it apply to?
CATS for thyroid tumors - 10% malignant, 90% benign - 10% non-funtional, 90% FUNCTIONAL ADENOMAS
47
unique phenomenon
33% of dogs with thyroid tumors will have multiple distinct malignancies (often intra-abdominal) -do an abdominal US!!
48
what FNA technique is best for thyroid tumors?
needle off > can be very vascular
49
what is most important when it comes to working-up salivary tumors?
FIXED vs. NON-FIXED - fixed > MST 10 months, 1 yr (25%), 2 yr (10%) - non-fixed > MST 36 months, 1 yr (75%), 2 yr (70%)
50
T/F: patients with salivary tumors tend to have a shorter MST with mets
FALSE, live long w/ mets
51
what are the negative prognostic factors for thyroid tumors?
- size (>20 cm or diameter >5 cm = poor prognosis) - movability (invasion of adjacent tissue = poor prognosis) - bilateral thyroid carcinoma 16x greater risk for developing metastatic dz - non-medullary thyroid carcinomas more likely to develop metastatic dz - NO evidence progression= 15x decreased risk developing metastasis

SAM II (3 decks)

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