Miscellaneous Tumors Flashcards
List two malignant ddx for acute hemoabdomen in dogs
- mast cell tumor
2. lymphoma
List two benign ddx for acute hemoabdomen in dogs
- benign splenic nodules
2. hematoma
What is hemangiosarcoma?
a malignant neoplasm of vascular endothelium
What are the forms hemangiosarcoma can take?
- splenic (most common)
- cutaneous (second most common)
- hepatic
- right atrial
- soft tissue
What is the “double two-thirds) rule?
2/3 of dogs with splenic masses will have a malignant tumor, and 2/3 of splenic malignancies are HSA
What are some clinical signs associated with splenic HSA?
- may be no signs or sudden death; possible signs include weakness, distended abdomen, increased RR/HR, pale mucus membranes; clinical signs may ebb and flow
- 50% reported to be in DIC at presentation; 50% of those are clinical for it
What three things should be included in staging for splenic HSA? what are two others things you may or may not do?
- LABWORK
- THORACIC IMAGING
- ABDOMINAL IMAGING-liver, spleen, LNs
- +/- echocardiography
- +/- coagulation panel
What is the metastatic rate for splenic HSA?
> 90%
What is the MST for splenic HS treated with Sx + Dox-based chemo?
6 months
What is the MST for splenic HS treated with Sx + Dox-based chemo?
6 months
List two benign ddx for acute hemoabdomen in dogs
- benign splenic nodules
2. hematoma
What is hemangiosarcoma?
a malignant neoplasm of vascular endothelium
What are the forms hemangiosarcoma can take?
- splenic (most common)
- cutaneous (second most common)
- hepatic
- right atrial
- soft tissue
What is the “double two-thirds) rule?
2/3 of dogs with splenic masses will have a malignant tumor, and 2/3 of splenic malignancies are HSA
What are some clinical signs associated with splenic HSA?
- may be no signs or sudden death; possible signs include weakness, distended abdomen, increased RR/HR, pale mucus membranes; clinical signs may ebb and flow
- 50% reported to be in DIC at presentation; 50% of those are clinical for it
What three things should be included in staging for splenic HSA? what are two others things you may or may not do?
- LABWORK
- THORACIC IMAGING
- ABDOMINAL IMAGING-liver, spleen, LNs
- +/- echocardiography
- +/- coagulation panel
What is the metastatic rate for splenic HSA?
> 90%
What is the MST for splenic HS treated with Sx + Dox-based chemo?
6 months
How does the extent of cutaneous HSA affect prognosis?
Dermal: surgery may be curative-MST is 780 days with only surgery
Hypodermal: worse; similar to visceral. Surgery + adjuvant chemotherapy warranted
____% of dogs with OSA have gross metastasis at dx and _____% eventually die of metastasis
10, 90
What is osteosarcoma?
mesenchymal tumor of bone
85% of primary bone tumors are ____
osteosarcoma
What percent of OSA is appendicular?
75%
Is OSA more common in forelimbs or hindlimbs?
forelimbs
Conservative medical management of OSA might consist of________?
anti-inflammatories, analgesics
Radiographic findings associated with Osteosarcoma
- Codman triangle
- Cortical lysis
- Loss of trabecular pattern
- Soft tissue extension
- “Sunburst” appearance
Describe the classic cytologic appearance of OSA
very peripheral nucleus; “yolk falling out of an egg”
What is the most common ddx for a bone tumor?
fungal infection
Osteosarcoma staging should include:
- Labwork (CBC, chem, UA)
2. 3 view thoracic rads or thoracic CT
Definitive-intent therapy for osteosarcoma consists of:
Aggressive local therapy(e.g. amputation, limb-sparing surgery, or stereotactic RT) PLUS chemo
Diagnosis of TCC should be done by ________
- Collection of urine by free catch or catheterization for cytology
- cystoscopy or traumatic catheterization for biopsy and histopathology
- NOT cystocentesis or transabdominal FNA-risk seeding
What are two examples of bisphosphonates?
pamidronate, zoledronate
Appropriate steps for staging a TCC
Regional metastasis:
- PE(rectal exam, bone palpation)
- abdominal US
- +/- abdominal rads
Distant metastasis:
- Thoracic rads or CT to look for lung mets
- abdominal ultrasound and labwork looking for liver mets
What is the MST for dogs with OSA treated with amputation alone?
~4 months
Conservative medical management of OSA might consist of________?
anti-inflammatories, analgesics
What is the breakdown of incidence of feline OSA between appendicular/axial/extraskeletal?
appendicular: 33-50%
axial: 33-40%
extraskeletal: 33%
What is the prognosis for feline OSA that is treated with amputation alone?
24 months (2 years)
Risk factors for TCC include:
- Scottish terriers
- neutered dogs
- chemical exposure (topical flea/tick dips, lawn herbicides, pesticides)
TCC of the urinary bladder is usually located where?
trigone
Ddx for TCC (local)
- other neoplasia
- chronic cystitis
- polyps
- granulomatous urethritis
- gossypiboma
- calculi
Diagnosis of TCC should be done by ________
- Collection of urine by free catch or catheterization for cytology
- cystoscopy or traumatic catheterization for biopsy and histopathology
- NOT cystocentesis or transabdominal FNA-risk seeding
Regional metastasis sites for TCC
- Sublumbar, iliac LN
- bone(infrequently)
Appropriate steps for staging a TCC
Regional metastasis:
- PE(rectal exam, bone palpation)
- abdominal US
- +/- abdominal rads
Distant metastasis:
- Thoracic rads or CT to look for lung mets
- abdominal ultrasound and labwork looking for liver mets
What is the MST for a TCC treated with ureterocolonic anastomosis?
5 months
Consequence of incomplete excisions and local recurrences of TCC
field carcinogenesis
Name two oral tumors that have similar appearances
SCC & malignant melanoma
What does “HiLo” fibrosarcoma mean?
histologically low-grade but biologically high-grade. these tumors don’t metastasize but are very locally aggressive
What are two breeds that HiLo FSA is diagnosed in fairly commonly?
Golden Retriever
Poodle
What are some ddx for oral tumors in dogs? (in order of most common)
- SCC
- melanoma (may be amelanotic)
- fibrosarcoma
- MCT
- lymphoma
- acanthomatous ameloblastoma (epulis)
- granular cell tumors
- TVT
- osteosarcoma
- multilobular osteochondrosarcoma
How does the location of an oral tumor affect prognosis?
- Rostrally-located tumors=better prognosis
- more amenable to surgery
- lower metastatic rate (diagnosed earlier b/c noticed sooner?) - Prognosis better for tumors:
a. under 2 cm
b. without regional LN metastasis
c. without bony invasion - for SCC in dogs: Oral has better prognosis than tonsillar
What are some ddx for oral tumors in cats?
SCC!
What is the prognosis for feline oral SCC?
very poor, even with aggressive treatment
What factor determines whether you pursue systemic treatment for an oral tumor?
likelihood of metastasis
Give an example of an oral tumor for which systemic treatment is not warranted
epulis
Give an example of an oral tumor where systemic treatment would be warranted
melanoma-purpose is to slow metastases
Six ways to maximize prognosis for oral tumors
- client education-toothbrushing, examination of mouth
- routine veterinary oral exams
- biopsy early
- stage for metastasis
- treat aggressively early
- supportive care; treatment of pain & secondary infections, nutritional support
