Hepatobiliary tumors Flashcards
What is the incidence of hepatobiliary tumors in dogs and cats?
1.5% of canine and 1-2.9% of feline tumors
Is primary tumor or metastasis more common in dogs versus cats?
In dogs metastasis (liver, spleen, GI) 2.5X>primary tumors
Cats primary>metastasis
____ tumors are more common in cats, ___ in dogs
Benign, malignant
What are the 4 malignant categories for hepatobiliary tumors?
Hepatocellular
Bile duct
neuroendocrine
mesenchymal
3 morphological types of hepatobiliary tumors?
Massive (solitary, larger, 1 lobule)
nodular (multifocal, several lobes)
diffuse (effaced)
Reclassification according to hepatocytic or chalangiocytic lineages (based on keratin 19 IHC)
Well differentiated, poorly differentiated, and scirrhous
What are the 3 hepatocellular tumors?
HCC (77% and #1 tumor in dogs, #2 in cats)
Hepatocellular adenoma - more commmon in cats
hepatoblastoma - rare
Any etiology for hepatocellular tumors?
Morphologically, __% massive, ___ nodular, ___diffuse
Location in dogs and cats?
Metastatic rate
No viral or cirrhotic etiology, maybe like to vacuolar hepatopathy
34% scotties with VH had HCC
53-86% massive, 16-25% nodular, 19% diffuse
In dogs >2/3 left liver and anywhere in cats
0-37% for massive, 93-100% nodular or diffuse (LNs, peritoneum, lungs)
Bile duct tumors
Most common in cats? Sex?
Most common primary malignant tumor in cats? In dogs?
Dog breed predisposition and sex predilection?
Morphological apperance?
Behaivour?
Biliary cystadenomas, mostly in males
Carcinoma (cholangiocarcinoma) in cats and #2 in dogs
Labs, and female dogs
37-46% massive, 54% nodular, 17-54% diffuse
Aggressive bhaivour (in dogs 88% metastasize to LNs, lungs/ in cats 67-80% develop carcinomatosis)
Neuroendocrine tumors (carcinoids)
Age?
Location?
Morphologically?
Behaivour?
Rare tumors in dogs and cats (younger age)
Usually intrahepatic
67% diffuse and 33% nodular
Aggressive, diffue metastasize to regional LNs, pritoneum, lungs)
Sarcomas
Most common primary?
Morphologically?
Behaivour?
HSA (#1 in cats, and 5% in dogs), leiomyosarcomas (#1 dogs) and FSA
nodular 64%, massive 36%
Agressive 86% mets to spleen, 100% to lungs
Symptoms are reported in __ of cats and ___ of dogs
Clinical signs?
Most common signs?
50%, 75%
Related to mass effect and not hepatic insuficiency
inappetance, weight loss, lethagy, vomiting, PU/PD, and ascites
Type of liver enzyme elevation can differentiate between primary (___ and ___ increase) vs. metastatic __ and ___
HCC and bile duct carcinoma
ALP and ALT
AST, Tbili
AST:ALT<1
AST:ALT>1
Other chemistry abnormalities
hypoglycemia, hypoalbuminemia, hyperglobulinemia, increased BAs, azotemia in cats
a-fetoprotein in 75% HCC and 55% bile duct carcinomas in dogs
Therapy for HCC
__ sided tumors have higher intra-op death
liver lobectomy
right sided
Therapy for bile duct tumors
liver lobectomy for massive, none for nodular or diffuse forms
Therapy for sarcomas
liver lobectomy
MST for massic HCC treated with liver lobectomy?
MST with conservative management
1460-1836 days (4-5 yr) in dogs (2.4 years in cats)
270 days (9 mo) and 15.4x likelihood of tumor-related deaths
Complete histological resection of HCC
RR?
RR=0-13% for dogs after liver lobectomy
37 dogs with mHCC underwent liver lobectomy, RR=12%, DFI=1000 and MST 1836 days for complete resection vessus RR=58%, DFI 521 and MST 765 days for incomplete
Incompletely resected HCC treated with Gemzar had MST 1339 days
Prognosis for bile duct adenomas?
Very good after liver lobectomy
Prognosis for cats and dogs with massive bile duct carcinomas after liver lobectomy?
Poor and patients die in 6 months due to local recurrence or metastatic disease
Prognosis for neuroendocrine tumors
Metastasis
Poor not amenable to surgical resection
93%
Prognosis for liver sarcomas
poor due to metastatic disease being present at time of diagnosis
