Hemangiosarcoma & Squamous Cell Carcinoma Flashcards
What is hemangiosarcoma? What dogs are over-represented?
tumor arising from vascular endothelium with a high metastatic rate (NOT dermal)
older (8-13 y/o), large breed dogs —> GSD
What is the most common primary site for HSA? What are 4 other common sites?
spleen —> mid-abdominal mass
- right atrium
- SQ - looks like soft tissue sarcoma
- dermal - solar-induced
- liver
(realistically, anywhere else blood vessels go)
What is the most common presentation of HSA? When it’s an incidental finding?
- weakness or collapse due to internal hemorrhage
- cardiac tamponade = decreased heart/respiratory sounds
- pallor, dyspnea
palpable mid-abdominal mass or found on U/S + mass effect seen on radiographs
What are some findings on CBC/chem/UA in patients with HSA? Radiographs?
- regenerative anemia (mild)
- thrombocytopenia
- normal chem panel
splenic mass + peritoneal/pleural effusion + rounded heart
What 2 diagnostics are preferred for splenic HSA?
- AFAST/TFAST - fluid in peritoneal/pleural/pericardial spaces
- evaluation of thoracic/abdominal fluid - may look bloody, PCV of fluid similar to peripheral PCV
What diagnostic is preferred for cutaneous/SQ HSA? What is avoided?
incisional/excisional* biopsy - less bleeding
FNA - will likely only see blood
If a patient seems to require emergency surgery in a case of HSA, what should be performed first? Why?
3-view thoracic radiographs —> ideal to get a full abdominal U/S too
surgery likely not worth it if there is diffuse metastasis to lungs
How does the anatomical placement of HSA alter surgeries performed?
SPLEEN/LIVER = splenectomy, liver lobectomy
SQ = excision with deep margins
CUTANEOUS = not invasive, excision
RIGHT ATRIUM = not amendable to surgery, pericardectomy?
What is recommended post-surgery in cases of HSA? What is the main exception?
chemotherapy - Doxorubicin, 5 doses
dermal
What are 2 herbal therapies that can be added to treatment of HSA? What is used for the dermal form?
- I’m-Yunity - turkey mushroom
- Yunnan Baiyao - slows/prevents hemorrhage (coagulant)
propanolol - beta-adrenergic receptor antagonist, enhances Doxorubicin
What is the prognosis of splenic/visceral forms of HSA depending on the treatment performed?
- sx alone = MST ~ 3 months
- sx + doxorubixin = MST ~ 6-7 months
- sx + metronomic = MST ~ 6-7 months
<10% live over a year
What is the prognosis of right atrial and SQ HSA like?
poor (1-3 months) —> improved with Doxorubicin
3-6 months with sx and possibly longer with post-surgical Doxorubicin
What is the prognosis of dermal HSA like?
surgery is usually curative for a single lesion
- multiple lesions —> often too many to remove, grows slowly over a few years
How does feline HSA compare to in dogs?
uncommon —> consider same testing, treatment, and prognosis
What is the most common oral tumor in cats? How does it act? Where is it specifically most commonly seen?
SCC - often mistaken for infection initially, becomes very invasive/erosive with low metastatic potential
sublingual and gingival
What is the most common cause of SCC in cats?
actinic (solar-induced) —> common in older, lightly pigmented cats
- UV light exposure + lack of protective pigment
What are the 4 most common locations of actinic SCC in cats?
- nasal planum
- ear pinna
- eyelid
- preauricular skin
What is the typical presentation of oral SCC in cats?
- difficulty eating - dropping food from one side of the mouth
- decreased appetite
- oral bleeding
- excessive drooling, halitosis
- mass seen on oral exam
- facial deformity
What is the typical presentation of actinic SCC in cats?
- crusting and erythema
- superficial erosions, ulcers
- carcinoma in situ
- deeply invasive and erosive lesion
stages progress over months to years
What diagnostic is used for oral/actinic SCC in cats? Why must it be done properly?
incisional biopsy of mass, too invasive for excisional
may only see inflammation if not done deep enough
What changes on CBC/chem/UA and radiographs indicative of oral/actinic SCC in cats?
typically normal, may see neutrophilia
bone invasion —> metastasis is rare, recommend FNA of any enlarged LNs seen
What 3 treatments are recommended for oral SCC in cats?
none very effective
- NSAIDs - careful of toxicity, Piroxicam a good option - can improve appetite and slow growth
- palliative radiation - improve appetite and odor
- surgery - masses on rostral mandible
What are 3 options for treating actinic SCC in cats? How can it be prevented?
- surgery - pinnectomy, nosectomy, cryosurgery or laser surgery of superficial lesions
- palliative radiation
- NSAIDs
limit sun exposure + sunblock
What is the prognosis of oral and actinic SCC in cats like?
ORAL - MST = 2-3 months with any treatment, mostly look for QoL
ACTINIC = slowly progressive, MST = 18 months to 2 yrs
Very few cats live more than a year with oral SCC. What is a major exception?
those on rostral mandible able to be removed with large margins
What is the most common locatino of SCC in dogs? How do they act?
digital, arising from subungal epithelium —> most common in older, dark-colored, large breeds
locally invasive with low metastatic potential
What dogs develop syndrome of multiple digital SCC? What are some other sites affected?
Standard Poodles and Giant Schnauzers —> develop tumors in multiple digits over several months to years
oral cavity, cutaneous
What is the typical presentation of SCC in dogs?
limping + swollen digit around the nail
- mistaken for nailbed infections
What 3 diagnostics are commonly used for SCC in dogs?
- FNA of mass - may only get inflammation
- biopsy of mass - may only get inflammtion
- radiograph* - bone lysis, digital amputation indicated
How is canine SCC staged?
- FNA of regional LNs if enlarged
- 3 view thoracic radiographs - pulmonary metastasis rare at time of diagnosis
What treatment plan is recommended for canine SCC?
amputation of affected digit + chemotherapy
- chemo not necessary needed
- consider Carboplatin with metastasis into LNs or high grade on biopsy report (high mitotic count, angiolymphatic invasion)
What is prognosis of canine SCC like?
MST > 2 years
- many are cured by amputation
- extended survival even after LN metastasis
