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Small Animal Medicine II > Neoplasia of Head and Neck > Flashcards

Neoplasia of Head and Neck Flashcards

1
Q

Oral Tumors

Presenting Complaints

A

Discharge
Odor (very stinky)
Lack of appetite
Rarely a mass

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2
Q

Oral Tumors

Diagnostics

A

Biopsy/Cytology
LN aspiration
Thoracic radiographs

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3
Q

Canine Oral Tumors
Melanoma
What is it?

A

Fleshy friable mass, often black
Amelanotic melanoma can be difficult to diagnose

HIGH probability of metastasis

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4
Q

Canine Oral Tumors
Melanoma
Signalment

A

30-40% of canine oral tumors

Average age: 12 years (older)

Male > Female

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5
Q

Oral Melanoma

Diagnosis

A

Thoracic radiographs; a must

LN aspiration or biopsy

Tumor biopsy; ideal but can be difficult (not needed if already seeing evidence of metastasis)

Tumor imaging; important for surgery

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6
Q

Oral Melanoma
Prognosis
Surgery

A

1 year

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7
Q

Oral Melanoma
Therapy/Prognosis
Radiation

A

Palliative

1 year

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8
Q

Oral Melanoma
Therapy/Prognosis
Chemotherapy

A

Not very effective

Carboplatin (works only in 10-20% of dogs)

Metronomic chemotherapy/NSAIDs (suppression of T-regs)

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9
Q

Oral Melanoma
Therapy/Prognosis
Immunotherapy

A

Merial melanoma vaccine; some cases tumor does shrink including the metted tumors

Cimetidine (ant-acid, also suppresses T-regs)

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10
Q

Canine Oral Tumors
Squamous Cell Carcinomas
Background

A

Ulcerated inflamed mass; infiltration of neutrophils

20-30% of oral tumors in dogs

Average age: 9-10 years (young-ish)

Site predilection for rostral mandible (good!)

Painful

Metastasis uncommon (except when on tongue or tonsil) -> usually spread via lymph node not lung

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11
Q

Canine Oral Squamous Cell Carcinoma

Staging

A

Thoracic radiographs
CT
May need to image to identify lymph node involvement

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12
Q

Canine Oral Squamous Cell Carcinoma

Surgery

A

Small, superficial, and rostral

Can be curative

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13
Q

Canine Oral Squamous Cell Carcinoma

Radiation

A

Small, superficial, and rostral

Aggressive protocol

About 50% get cured

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14
Q

Canine Oral Squamous Cell Carcinoma

Surgery + Radiation

A

If not rostral

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15
Q

Canine Oral Squamous Cell Carcinoma

Tongue

A

50% metastasize

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16
Q

Canine Oral Squamous Cell Carcinoma
Tongue
Treatment with Prognosis

A

Surgery: 8 months

Radiation: 4 months

Chemotherapy: Carboplatin, Toceranib (must do with Sx or Radiation)

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17
Q

Canine Oral Tumors

Fibrosarcoma

A

Flat mass; can look like many things

Average age: 7 years

Male > Females

Metastasis uncommon but may depend on grade and age of dog

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18
Q

Canine Oral Fibrosarcoma

Biopsy Info

A

Grade, invasiveness, bone involvement

High biologic grade with low pathologic grade; grows very fast but low chance to met (looks like granulation tissue)

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19
Q

Canine Oral Fibrosarcoma

Staging

A

Thoracic radiographs

CT/Radiographs; good for surgical planning, often more bone involvement than expected

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20
Q

Canine Oral Fibrosarcoma

Treatment (3)

A

Surgery; large margins which are almost impossible

Radiation alone

Surgery + Radiation; best approach but rarely curative (grows back fast and usually large by the time you see them)

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21
Q

Canine Oral Tumors
Epulides
What are these?

A

Tumors of the periodontal tissue

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22
Q

Canine Oral Tumors
Epulides
Benign

A

Fibromatous epulis

Ossifying epulis

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23
Q

Canine Oral Tumors
Epulides
Malignant

A

Aggressive locally, but almost never metastasize

Acanthomatous ameloblastoma

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24
Q

Acanthamotous Ameloblastoma

Staging/Diagnostics

A

Biopsy (must to diagnose)
Thoracic Radiographs
CT (see how deep erosion goes)

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25
Q

Acanthamotous Ameloblastoma

Treatment

A

Surgery; 90% controlled (with small margins)

Radiation: 85% controlled (slight possibility of future malignancy)

26
Q

Feline Oral Tumors

Most common

A

Squamous Cell Carcinoma

27
Q

Feline Oral Squamous Cell Carcinoma

Background

A

Inflamed proliferative mass, or ulcer, or facial distortion

70% of feline oral tumors

Average age: 11-12 years

28
Q

Feline Oral Squamous Cell Carcinoma

Locations

A 
Tongue
Maxilla
Mandible
Tonsil
Larynx
29
Q

Feline Oral Squamous Cell Carcinoma
Palliative Treatment
Prognosis

A

NSAIDs, pain meds, +/- feeding tube

2 months

30
Q

Feline Oral Squamous Cell Carcinoma

Surgery

A

Only if small and rostral

Cats do not do well with parts of jaw missing

31
Q

Feline Oral Squamous Cell Carcinoma

Radiation Prognosis

A

3-6 months

32
Q

Feline Oral Squamous Cell Carcinoma

Surgery + Radiation

A

12.5 months

33
Q

Feline Oral Fibrosarcoma

Background

A

Diffuse proliferative tissue

Average age: 10 years

Bone involvement common (almost always)

Metastasis rare

34
Q

Feline Oral Fibrosarcoma

Surgery

A

Rarely possible to achieve clean margins

35
Q

Feline Oral Fibrosarcoma

Radiation

A

Curative rarely helpful

Palliative can slow progression/shrink tumor for 6 months (comes right back)

36
Q 
Tonsils
Common Tumors (3)
A

Squamous Cell Carcinomas

Lymphosarcoma (T-cell)

Metastasis from other oral lesion (Melanoma)

37
Q

Squamous Cell Carcinoma
Tonsil
Dog

A

BAD

Metastasis common
Often present for cervical mass
Chemotherapy likely helpful

38
Q

Squamous Cell Carcinoma
Tonsil
Cat

A

Curable with radiation

39
Q

Nasal Tumors

History

A 
Noisy breathing
Sneezing
Reverse sneezing
Nasal discharge
Nasal bleeding

Second hand smoke exposure

40
Q

Nasal Tumors

Cat Clinical Sign

A

Cats often get deformed faces

41
Q

Nasal Tumors

Biologic Behavior

A

Locally aggressive

Metastasis as high as 50%

42
Q

Nasal Tumors

Types (4)

A

Carcinoma (2/3)

Sarcoma

Lymphosarcoma (usually cats)

Anaplastic (highly invasive and highly metastatic)

43
Q

Nasal Tumors

Carcinoma Examples

A

Adenocarcinoma
SCC
TCC

44
Q

Nasal Tumors

Sarcomas Types

A

Chondrosarcoma > Osteosarcoma

45
Q

Nasal Tumors

Diagnostics

A

Rule out other causes of nasal pathology/bleeding

Diagnosis: histopathology
Imaging Prior:
Radiographs
CT

46
Q

Nasal Tumors

Biopsy

A

Blind trans-nasal biopsy = best

Nasal flushing, brushing, or aspiration cytology rarely diagnostic

May have to go in surgically
Can use catheter sleeves

47
Q

Nasal Tumors

Surgery

A

Not very helpful for sarcomas

Live 3-7 months with or without surgery

48
Q

Nasal Tumors

Chemotherapy

A

Lymphoma protocol
Carcinomas-Cisplatin
Piroxicam or other NSAIDs
Tyrosine Kinase Inhibitors

Do with Radiation

49
Q

Nasal Tumors
Curative Radiation
Survival

A

Usually best treatment option

8-23 months

50
Q

Nasal Tumors
Curative Radiation
Cancer types

A

Chondrosarcoma > Adenocarcinoma > SCC

51
Q

Nasal Tumors
Curative Radiation
Side effects

A

Close to eyes and mouth so can cause damage to these areas

Sometimes severe damage

52
Q

Thyroid Tumors

Signalment

A

Older dogs (9-11)

Boxer
Golden Retrievers
Beagles

Neck mass of various size

53
Q

Thyroid Tumors

Cause

A

Unknown but suspect:
Radiation (ingestion)
Hypothyroidism
Breed: Husky

54
Q

Thyroid Tumor

Biologic Behavior

A

30-50% benign (incidental finding)

Detectable tumor = malignant tumor

Metastasis at time of diagnosis is less than 40%

Met locations: retropharyngeal LN, cranial cervical, mandibular node, lungs

55
Q

Thyroid Tumor

Functional or Non-Functional? Kinds?

A

Non-functional

Euthyroid
Hypothyroid: might be getting stimulated too much by TSH

56
Q

Thyroid Tumor

Diagnosis

A

FNA; usually just get blood but send that in

Imaging; CT (can tell you size and extent of mass), radiographs of thorax

Histopathology; send in mass you take out tells you: invasiveness, vascular invation, pleomorphism (aggressive)

57
Q

Thyroid Tumor

Surgery

A

Mobile thyroid carcinomas with complete surgical resection 24-36+ months

Only 25-50% are movable

58
Q

Thyroid Tumor

Radiation

A

If too big or invasive for surgery:

External beam: 1+ year survival

Radioactive Iodine (131)
Expensive, 30 months for median survival (if tumor takes up the iodine; need functional tumor)
59
Q

Thyroid Tumor

Rx Treatment

A

Long term thyroid supplementation advised to suppress TSH (stop stimulating thyroid gland)

Even if thyroid levels are normal

60
Q

Thyroid Tumor

Chemotherapy

A

Not likely to work

61
Q

Thyroid Tumor

Tyrosine Kinase Inhibitors

A

Do seem to work

Anti-VGEF function

Small Animal Medicine II (17 decks)

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