Mast Cell Tumors

Question 1

what is the mean age at presentation for mast cell tumors?

Answer 1

8-9 years

Question 2

which breeds are at risk for low grade mast cell tumors?

Answer 2

bulldog descent

Question 3

are most mast cell tumors easy to diagnose by cytology?

Answer 3

yes

Question 4

do mast cell tumors spread to lungs in a nodular fashion?

Answer 4

no

Question 5

what is surgery like for mast cell tumors?

Answer 5

2 cm margins
one fascial plane deep

Question 6

what are some indicators of likely high-grade behavior?

Answer 6

rapid growth
ulceration
mucucutaneous location
inguinal or perineal location

Question 7

where are H1 receptors located?

Answer 7

in the skin

Question 8

what are chemotherapy drug options?

Answer 8

palladia
vinblastine
prednisone

Question 9

what is the treatment of choice for feline cutaneous mast cell tumors?

Answer 9

surgery

Question 10

what are mast cells like when they leave bone marrow?

Answer 10

immature

Question 11

how long do mast cells live in the tissues?

Answer 11

40 days

Question 12

what do mast cells contain that mediate local and systemic hypersensitivity?

Answer 12

histamine
heparin
cytokines: IL-6, TNF-alpha
chemokines
growth factors: VEGF, bFGF

Question 13

what is the most common skin tumor of the dog?

Answer 13

cutaneous mast cell tumor

Question 14

which dogs are at risk for high grade cutaneous mast cell tumors?

Answer 14

shar-pei

Question 15

where do most mast cell tumors occur?

Answer 15

skin and subcutaneous

Question 16

what is the treatment of choice for mast cell tumors?

Answer 16

surgery: 2 cm margins and one fascial plane deep

Question 17

can mast cell tumors spread to the lymph nodes in the thorax?

Answer 17

yes

Question 18

when should you do an abdominal ultrasound for mast cell tumors?

Answer 18

high grade
usually done after surgery, can be done before if suspect high grade

Question 19

how should incisions be oriented?

Answer 19

follow along the tension lines of the skin
to decrease risk of dehiscence and prevent raised tissue at end of incision

Question 20

tumors greater than _______ should use 2-cm skin margins on either side of the tumor with one fascial plane deep

Answer 20

1cm

Question 21

should you mark margins of a tumor removal?

Answer 21

yes
not orange or red dye

Question 22

what is the most consistent indicator of prognosis?

Answer 22

grade

Question 23

what makes a tumor high grade with the kiupel grading system?

Answer 23

mitotic count >7
multinucleated cells >3
bizarre nuclei >3
karyomegaly >10%

Question 24

is the kiupel or patnaik grading system more clear?

Answer 24

kiupel

Question 25

what is survival for grade III/high cutaneous mast cell tumors?

Answer 25

3.5-7 months

Question 26

when is camus cytologic grading not relevant?

Answer 26

low grade

Question 27

is grade highly correlated with survival?

Answer 27

yes

Question 28

is follow-up chemotherapy needed for high grade mast cell tumors?

Answer 28

yes

Question 29

should you do an ultrasound with aspiration of the liver and spleen prior to surgery for a high grade mast cell tumor?

Answer 29

yes

Question 30

where is tyrosine kinase receptor expressed?

Answer 30

surface of normal mast cells: high levels KIT mutation

Question 31

what should you use instead of diphenhydramine (low oral bioavailability)?

Answer 31

hydroxyzine cetirizine loratadine

Question 32

what can you give for H2 receptors?

Answer 32

famotidine omeprazole

Question 33

what is radiation most useful for?

Answer 33

incompletely excised low-grade tumors palliation of high-grade tumors

Question 34

when is chemotherapy useful?

Answer 34

high grade tumors visible metastatic disease

Question 35

what does palladia do?

Answer 35

inhibits tyrosine kinase specifically targets KIT mutation

Question 36

what is stelfonta/tigilanol tiglate for?

Answer 36

treatment of cutaneous non-metastatic mast cell tumors <10 cubic cm

Question 37

what is intralesional triamcinolone?

Answer 37

long-acting corticosteroid injected directly into mast cell tumor

Question 38

what is intralesional triamcinolone recommended for?

Answer 38

low grade tumors

Question 39

who is overrepresented with feline mast cell tumors?

Answer 39

siamese breed

Question 40

what usually happens with histiocytic feline cutaneous mast cell tumors?

Answer 40

spontaneously regress

Question 41

when is there a poor prognosis with feline cutaneous mast cell tumors?

Answer 41

multiple lesions pleomorphic phenotype high mitotic count survival still 500 days

Question 42

do you need wide margins for surgery for feline cutaneous mast cell tumors?

Answer 42

no

Question 43

how common is abdominal effusion with feline splenic mast cell tumors?

Answer 43

30%

Question 44

how common are circulating mast cells with feline splenic mast cell tumors?

Answer 44

35%

Question 45

what is survival for feline splenic mast cell tumors?

Answer 45

1600 days with splenectomy 780 days without

Question 46

who usually gets feline intestinal mast cell tumors?

Answer 46

older cats