Lecture 11 Flashcards
characteristics of carcinomas
–Epithelial tissues
–Spread to lymph nodes, less via blood
3 anal tumors
•Perianal adenoma –Benign –Intact male dogs •Perianal gland carcinomas –Malignant –Possible male predominance •Anal sac carcinomas –Malignant –Median age 10.5 years –Breeds - Springer spaniel, dachshund, malamute, cocker spaniel, German shepherd –Anal sac mass –Hypercalcemia
Important tool to stage anal sac carcinomas
–Image the abdomen- > 50 % have metastasized to lymph nodes at diagnosis
treatment for anal sac carcinomas
•Surgery –remove mass and nodes •Radiation therapy –mass and nodes •Chemotherapy –Carboplatin/ Cisplatin –Tyrosine Kinase inhibitors Survival can be long
other less common anal tumors
–Soft tissue sarcomas –Lymphosarcoma –Mast Cell tumors –Melanoma –Squamous cell carcinoma
limitations of treating internal tumors
–Surgery- but tissue has to be expendable
–Radiation- tumor tissue has to sit still and surrounding tissues must tolerate radiation
–Chemotherapy- often poorly responsive
Trends of internal tumors
–Most give rise to Carcinomas •GI tract including pancreas and liver •Kidney/Bladder •Ovaries/Uterus •Testicles/prostate •Adrenal glands –Some round cell or sarcomas •Spleen/lymph nodes •All supporting structures
Signalments of dogs with GI tumors
•Signalment- usually middle age or older
•Presentation
–Gastric- weight loss, vomiting, melena
–Small intestine- melena, diarrhea, weight loss
–Colon- diarrhea, weight loss, hemtochezia
–Hepatobilliary- weight loss, inappetance, vomiting, PU/PD
–Or may just palpate a mass in the abdomen
staging of GI tumors
•Staging –Abdominal imaging- usually ultrasound –Thoracic radiographs –+/- Cytology of mass and all other masses found –Exploratory
GI lymphoma treatment
chemo
treatment of GI adenocarcinoma
– Adenocarcinoma of intestines- prognosis depends
on surgical margins
• >44% metastasize but can be late
• Most chemotherapy ineffective
treatment of leiomyosarcoma
prognosis depends
on surgical margins
• Metastatic potential moderate
• Chemotherapy may help (doxorubicin)?
treatment of GI stromal tumors
• Low metastatic potential
• Traditional chemotherapy not be helpful but tyrosine
kinase inhibitors can be effective even with gross
disease present.
treatment and prognosis of hepatic tumors
• Felines- benign tumors common • Canine- malignant tumors more common but can be quite low grade – Surgical removal if possible – Chemotherapy ineffective
most common bladder tumor
TCC
signalment of dogs with bladder tumors
• Signalment – Usually small breed older dog – Scottish terriers and Shelties may be over re-presented • Presentation- Pollakiuria, stranguria, dysuria, urinary obstruction
biologic behavior of TCC
– generally cause signs locally and can cause the death or euthanasia of the animal – Transitional cell carcinoma can metastasize (30-60%) but generally not detected initially and often not the cause of death
staging of TCC
– generally cause signs locally and can cause the death or euthanasia of the animal – Transitional cell carcinoma can metastasize (30-60%) but generally not detected initially and often not the cause of death
treatment and prog of TCC
– Surgery alone- complete resection- 12-13 months
median survival
– Surgery plus RT intraoperatively- 15 months
– NSAID alone- 6 months
– Variety of chemotherapy drugs- Mitoxantrone,
Carboplatin, Vinblastine, metronomic chemotherapy.
– Chemotherapy plus NSAID (Piroxicam plus
Mitoxantrone)- 12 months
– Palliative radiation also effective but most commonly
used as rescue, or to un-obstruct.
signalment of animals with thoracic tumors
- Signalment
- Various, usually older animal
- May be from a smoking household
diagnosis and staging of thoracic tumors
Imaging is critical!
–Most thoracic problems would be difficult to identify without at least a thoracic radiograph
–Thoracic CT, or cardiac ultrasound, or trans-esophageal ultrasound often needed as well
–Biopsy can be difficult without surgical approach
–Needle aspirates as well can be difficult and ill-advised.
CT is useful in IDing what type of lesions of lung cancers
Thoracic CT very helpful in identifying the presence of metastasis to other lung lobes or lymph nodes
treatment of lung cancers
–Depends on size of tumor, type of tumor and presence or absence of metastasis
–Surgery is generally the treatment of choice
–Chemotherapy minimally effective but Vinorelbine may be better than most drugs
good prognostic indicators for lung cancers
–adenocarcinoma or papillary carcinoma, low grade tumors
–< 5cm diameter
–peripheral location
–negative node, no clinical signs
bad prognostic indicators for lung cancers
–squamous cell carcinoma, poorly differentiated tumors, high grade tumors –> 5cm diameter –pleural effusion –presence of clinical signs –positive nodes –evidence of metastasis •median survival 1-8 months
