Miscellaneous Tumors Flashcards

1
Q

List two malignant ddx for acute hemoabdomen in dogs

A
  1. mast cell tumor

2. lymphoma

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2
Q

List two benign ddx for acute hemoabdomen in dogs

A
  1. benign splenic nodules

2. hematoma

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3
Q

What is hemangiosarcoma?

A

a malignant neoplasm of vascular endothelium

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4
Q

What are the forms hemangiosarcoma can take?

A
  1. splenic (most common)
  2. cutaneous (second most common)
  3. hepatic
  4. right atrial
  5. soft tissue
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5
Q

What is the “double two-thirds) rule?

A

2/3 of dogs with splenic masses will have a malignant tumor, and 2/3 of splenic malignancies are HSA

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6
Q

What are some clinical signs associated with splenic HSA?

A
  • 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
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7
Q

What three things should be included in staging for splenic HSA? what are two others things you may or may not do?

A
  1. LABWORK
  2. THORACIC IMAGING
  3. ABDOMINAL IMAGING-liver, spleen, LNs
  4. +/- echocardiography
  5. +/- coagulation panel
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8
Q

What is the metastatic rate for splenic HSA?

A

> 90%

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9
Q

What is the MST for splenic HS treated with Sx + Dox-based chemo?

A

6 months

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10
Q

What is the MST for splenic HS treated with Sx + Dox-based chemo?

A

6 months

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11
Q

List two benign ddx for acute hemoabdomen in dogs

A
  1. benign splenic nodules

2. hematoma

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12
Q

What is hemangiosarcoma?

A

a malignant neoplasm of vascular endothelium

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13
Q

What are the forms hemangiosarcoma can take?

A
  1. splenic (most common)
  2. cutaneous (second most common)
  3. hepatic
  4. right atrial
  5. soft tissue
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14
Q

What is the “double two-thirds) rule?

A

2/3 of dogs with splenic masses will have a malignant tumor, and 2/3 of splenic malignancies are HSA

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15
Q

What are some clinical signs associated with splenic HSA?

A
  • 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
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16
Q

What three things should be included in staging for splenic HSA? what are two others things you may or may not do?

A
  1. LABWORK
  2. THORACIC IMAGING
  3. ABDOMINAL IMAGING-liver, spleen, LNs
  4. +/- echocardiography
  5. +/- coagulation panel
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17
Q

What is the metastatic rate for splenic HSA?

A

> 90%

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18
Q

What is the MST for splenic HS treated with Sx + Dox-based chemo?

A

6 months

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19
Q

How does the extent of cutaneous HSA affect prognosis?

A

Dermal: surgery may be curative-MST is 780 days with only surgery

Hypodermal: worse; similar to visceral. Surgery + adjuvant chemotherapy warranted

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20
Q

____% of dogs with OSA have gross metastasis at dx and _____% eventually die of metastasis

A

10, 90

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21
Q

What is osteosarcoma?

A

mesenchymal tumor of bone

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22
Q

85% of primary bone tumors are ____

A

osteosarcoma

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23
Q

What percent of OSA is appendicular?

A

75%

24
Q

Is OSA more common in forelimbs or hindlimbs?

A

forelimbs

25
Q

Conservative medical management of OSA might consist of________?

A

anti-inflammatories, analgesics

26
Q

Radiographic findings associated with Osteosarcoma

A
  • Codman triangle
  • Cortical lysis
  • Loss of trabecular pattern
  • Soft tissue extension
  • “Sunburst” appearance
27
Q

Describe the classic cytologic appearance of OSA

A

very peripheral nucleus; “yolk falling out of an egg”

28
Q

What is the most common ddx for a bone tumor?

A

fungal infection

29
Q

Osteosarcoma staging should include:

A
  1. Labwork (CBC, chem, UA)

2. 3 view thoracic rads or thoracic CT

30
Q

Definitive-intent therapy for osteosarcoma consists of:

A

Aggressive local therapy(e.g. amputation, limb-sparing surgery, or stereotactic RT) PLUS chemo

31
Q

Diagnosis of TCC should be done by ________

A
  • 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
32
Q

What are two examples of bisphosphonates?

A

pamidronate, zoledronate

33
Q

Appropriate steps for staging a TCC

A

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
34
Q

What is the MST for dogs with OSA treated with amputation alone?

A

~4 months

35
Q

Conservative medical management of OSA might consist of________?

A

anti-inflammatories, analgesics

36
Q

What is the breakdown of incidence of feline OSA between appendicular/axial/extraskeletal?

A

appendicular: 33-50%
axial: 33-40%
extraskeletal: 33%

37
Q

What is the prognosis for feline OSA that is treated with amputation alone?

A

24 months (2 years)

38
Q

Risk factors for TCC include:

A
  • Scottish terriers
  • neutered dogs
  • chemical exposure (topical flea/tick dips, lawn herbicides, pesticides)
39
Q

TCC of the urinary bladder is usually located where?

A

trigone

40
Q

Ddx for TCC (local)

A
  • other neoplasia
  • chronic cystitis
  • polyps
  • granulomatous urethritis
  • gossypiboma
  • calculi
41
Q

Diagnosis of TCC should be done by ________

A
  • 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
42
Q

Regional metastasis sites for TCC

A
  • Sublumbar, iliac LN

- bone(infrequently)

43
Q

Appropriate steps for staging a TCC

A

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
44
Q

What is the MST for a TCC treated with ureterocolonic anastomosis?

A

5 months

45
Q

Consequence of incomplete excisions and local recurrences of TCC

A

field carcinogenesis

46
Q

Name two oral tumors that have similar appearances

A

SCC & malignant melanoma

47
Q

What does “HiLo” fibrosarcoma mean?

A

histologically low-grade but biologically high-grade. these tumors don’t metastasize but are very locally aggressive

48
Q

What are two breeds that HiLo FSA is diagnosed in fairly commonly?

A

Golden Retriever

Poodle

49
Q

What are some ddx for oral tumors in dogs? (in order of most common)

A
  • SCC
  • melanoma (may be amelanotic)
  • fibrosarcoma
  • MCT
  • lymphoma
  • acanthomatous ameloblastoma (epulis)
  • granular cell tumors
  • TVT
  • osteosarcoma
  • multilobular osteochondrosarcoma
50
Q

How does the location of an oral tumor affect prognosis?

A
  1. Rostrally-located tumors=better prognosis
    - more amenable to surgery
    - lower metastatic rate (diagnosed earlier b/c noticed sooner?)
  2. Prognosis better for tumors:
    a. under 2 cm
    b. without regional LN metastasis
    c. without bony invasion
  3. for SCC in dogs: Oral has better prognosis than tonsillar
51
Q

What are some ddx for oral tumors in cats?

A

SCC!

52
Q

What is the prognosis for feline oral SCC?

A

very poor, even with aggressive treatment

53
Q

What factor determines whether you pursue systemic treatment for an oral tumor?

A

likelihood of metastasis

54
Q

Give an example of an oral tumor for which systemic treatment is not warranted

A

epulis

55
Q

Give an example of an oral tumor where systemic treatment would be warranted

A

melanoma-purpose is to slow metastases

56
Q

Six ways to maximize prognosis for oral tumors

A
  1. client education-toothbrushing, examination of mouth
  2. routine veterinary oral exams
  3. biopsy early
  4. stage for metastasis
  5. treat aggressively early
  6. supportive care; treatment of pain & secondary infections, nutritional support