Lecture 10 Flashcards
history suggestive of oral tumors
discharge or odor, lack of appetite,
rarely a mass
diagnostics to find oral tmors
– Biopsy / Cytology – LN aspiration – Thoracic radiographs – Tumor imaging (radiographic evidence of lysis requires that 40 % of bone is gone)
melanoma accounts for what percent of oral tumors?
30-40
chemotherapeutics used for melanoma in dogs
- Carboplatin
* Metronomic chemotherapy/ NSAIDs
therapy options for meloma
Surgery- 7-9 month survival historically, recent data 1 year
–Radiation- palliative (large fractions) 8 month historically, recent data 1year
–Chemotherapy
•Carboplatin
•Metronomic chemotherapy/ NSAIDs
–Immunotherapy- best when primary disease is controlled
best method to diagnose SSC
biopsy
treatment of squamous cell cercinoma
–Surgery- small, superficial, and rostral
–Radiation- small, superficial, and rostral (but we doing better with RT these days)
–Surgery + radiation occasionally necessary
characteristic of oral fibrosarcoma in the dog
–Flat boring mass to proliferative
–10-20% of canine oral tumors
–Average age 7
–M > F
description of melanoma
Fleshy friable mass, often black. Amelanotic
melanoma can be difficult to diagnose
staging melanoma
–Thoracic radiographs •> 10 % positive at time of diagnosis –LN aspiration or biopsy •> 10 % positive at time of diagnosis –Tumor biopsy •Amelanotic melanoma can be difficult –Tumor imaging •Important for surgery
biopsy info for oral fibrosarcs
–Grade, invasiveness, bone involvement
–High biologic grade with low pathologic grade (peculiarity)
staging for oral fibrosarcs
–Thoracic radiographs (sometime CT)
–CT / Radiographs- generally more bone involved than appreciated and visual inspection of soft tissue is deceiving
treatment for oral fibrosarcs
–Surgery- must have large margins
–Radiation alone- must dose higher than 50 Gy or large fraction size
–Surgery + Radiation is best approach, but still rarely curative (median survival 18 months)
two type of benign epuli
- Fibromatous epulis
* Ossifying epulis
malignant epulis
Acanthomatous ameloblastoma
methods to stage canthanthomatous ameloblastoma
•Staging
–Biopsy
–Thoracic radiographs
–Local radiographs / CT
treatment for acathomatous ameloblastoma
–Surgery- 90 % controlled (with small margins)
OR
–Radiation- 85 % controlled
•Slight possibility of future malignancy
canine oral tumors
–Osteosarcoma –Hemangiosarcoma –Plasma Cell Tumors –Lymphoma/ Epitheliotropic lymphoma (Mycosis fungoides) –Mast Cell Tumors –Transmissible Venereal Tumors
apperance of feline SSC
Inflamed proliferative mass, or ulcer, or facial distortion
SSC accounts for what percent of feline oral tumors
70
age affected with SSC
11-12 years
treatment for feline SSC
surgery + radiation for best (1 year) return
appearance of feline oral fibrosarc
–Diffuse proliferative tissue
–13 -17 % of feline oral tumors
age affected with feline oral fibrosarc
10 years
treatment for feline oral fibrosarc
–Surgery
•Rarely possible to achieve clean margins
–Radiation
•Curative rarely helpful
•Palliative can slow progression/ shrink tumor for ~ 6 months
other feline oral tumors
–Melanoma –Mast Cell Tumors –Lymphosarcoma –Osteosacoma –Acanthomatous epulis
SSC of the tonsils in dogs
cannot be cured; in cats, curable with radiation
biologic behavior in dogs with nasal tumors
– Locally aggressive
– Metastasis as high as 50 % at necropsy
nasal tumor types
– 2/3 Carcinoma- adenocarcinoma, squamous cell carcinoma, transitional cell carcinoma – Sarcomas less often- chondrosarcoma, osteosarcoma – Lymphosarcoma, and others – Anaplastic tumors
nasal tumor diagnosis
• Diagnosis requires histopathology • Imaging prior to biopsy – Plain Films – CT – MRI
diagnosis of nasal tumors
– Blind trans-nasal core biopsy is still best
– Nasal flushing, brushing, or aspiration cytology
rarely diagnostic ( ~50%)
– Biopsy with visualization difficult (~70%)
– Surgical biopsy at times necessary
treatment for nasal tumors
surgery, chemo, or CURATIVE radiation **
chemo protocol for nasal tumors
–LSA - standard chemotherapy is indicated
–Carcinomas- Cisplatin/Carboplatin will ameliorate signs but may not prolong survival
–Piroxicam or other NSAID
–Carboplatin and Piroxicam (or other NSAID)
–Tyrosine Kinase inhibitors
survival with surgery for nasal tumors
–Survival 3-7 mths (same as with no therapy)
–Debulking can be helpful for sarcomas
survival time for nasal tumors with curative radiation
–Survival 8-23 months
•Chondrosarcoma> Adenocarcinoma> Squamous cell carcinoma> Undifferentiated Carcinomas
signalment of dogs with thyroid tumors
•Presentation:
–Typically older dogs (9-11 years), boxer, golden retrievers, beagles at increased risk
•Incidence is low (1.2-3.8 % of all canine tumors) but seems common in Pacific Northwest
–Cause unknown
•Radiation
•Hypothyroidism (tumors retain TSH receptors)
•Breed- Huskies
biologic behavior of thyroid tumors
–30-50% are benign but we may not be detecting these
–Detectable tumors are malignant tumors
–Metastasis at time of diagnosis is less than 40%.
•Risk of metastasis is higher in dogs with tumor > 5cm in diameter or with bilateral tumors
•Wide variety of sites- usually retropharyngeal LN, cranial cervical, mandibular nodes, lungs
–Most canine thyroid carcinomas are non-functional (60% euthyroid, 30 % hypothyroid)
Diagnosis of thyroid tumors
•Diagnosis/Staging
–Fine needle aspirate
–Imaging- important- they may be better than you think
–Histopathology important, also surgical impression
•Invasiveness
•Vascular invasion
•Pleomorphisim
staging thyroid tumors
–Thoracic radiographs (or CT)
–Image the tumor
treatment of thyroid tumors
Surgery
–External beam radiation therapy
•Palliative treatment- overall median survival 22 months
–Radioactive Iodine 131I
•Doxorubicin or Cisplatin, Carboplatin, Metronomic therapy
–Tyrosine kinse inhibitors do seem to work
•Toceranib, Masitinib
Feline cutaneous squamous cell carcinoma signalment
–White cat disease, but also depends on geographic location
–Tumors appear on sparsely haired, poorly pigmented skin
–Median age 9-12 years
biologic behavior of feline cutaneous SSC
–Tumors typically progress slowly
•small carcinoma in situ lesions invasive ulcerative SCC
•Owners have often seen something wrong with the skin for as long as year
diagnosis of feline cutaneous SSC
–Biopsy
•requires full thickness to evaluate invasiveness
•very small skin biopsy punches work well
–Scraping is rarely diagnostic
treatment of feline SSC
surgical removal, radiation,
non traditional treatment of feline ssc
–Cryotherapy
•Should not be used for any tumor greater then 0.5 cm diameter
–Electrochemotherapy
•Response good but may require repeated treatments
–Photodynamic therapy
•Tumors less than 1.5cm in diameter and minimally invasive had 100% response and 100% tumor control at one year.
–Intralesional chemotherapy
•Cisplatin or Carboplatin,combined with sterile sesame oil injected directly into tumor.
