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 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 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 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
