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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
Acanthamotous Ameloblastoma | Treatment
Surgery; 90% controlled (with small margins) Radiation: 85% controlled (slight possibility of future malignancy)
26
Feline Oral Tumors | Most common
Squamous Cell Carcinoma
27
Feline Oral Squamous Cell Carcinoma | Background
Inflamed proliferative mass, or ulcer, or facial distortion 70% of feline oral tumors Average age: 11-12 years
28
Feline Oral Squamous Cell Carcinoma | Locations
``` Tongue Maxilla Mandible Tonsil Larynx ```
29
Feline Oral Squamous Cell Carcinoma Palliative Treatment Prognosis
NSAIDs, pain meds, +/- feeding tube 2 months
30
Feline Oral Squamous Cell Carcinoma | Surgery
Only if small and rostral Cats do not do well with parts of jaw missing
31
Feline Oral Squamous Cell Carcinoma | Radiation Prognosis
3-6 months
32
Feline Oral Squamous Cell Carcinoma | Surgery + Radiation
12.5 months
33
Feline Oral Fibrosarcoma | Background
Diffuse proliferative tissue Average age: 10 years Bone involvement common (almost always) Metastasis rare
34
Feline Oral Fibrosarcoma | Surgery
Rarely possible to achieve clean margins
35
Feline Oral Fibrosarcoma | Radiation
Curative rarely helpful Palliative can slow progression/shrink tumor for 6 months (comes right back)
36
``` Tonsils Common Tumors (3) ```
Squamous Cell Carcinomas Lymphosarcoma (T-cell) Metastasis from other oral lesion (Melanoma)
37
Squamous Cell Carcinoma Tonsil Dog
BAD Metastasis common Often present for cervical mass Chemotherapy likely helpful
38
Squamous Cell Carcinoma Tonsil Cat
Curable with radiation
39
Nasal Tumors | History
``` Noisy breathing Sneezing Reverse sneezing Nasal discharge Nasal bleeding ``` Second hand smoke exposure
40
Nasal Tumors | Cat Clinical Sign
Cats often get deformed faces
41
Nasal Tumors | Biologic Behavior
Locally aggressive Metastasis as high as 50%
42
Nasal Tumors | Types (4)
Carcinoma (2/3) Sarcoma Lymphosarcoma (usually cats) Anaplastic (highly invasive and highly metastatic)
43
Nasal Tumors | Carcinoma Examples
Adenocarcinoma SCC TCC
44
Nasal Tumors | Sarcomas Types
Chondrosarcoma > Osteosarcoma
45
Nasal Tumors | Diagnostics
Rule out other causes of nasal pathology/bleeding Diagnosis: histopathology Imaging Prior: Radiographs CT
46
Nasal Tumors | Biopsy
Blind trans-nasal biopsy = best Nasal flushing, brushing, or aspiration cytology rarely diagnostic May have to go in surgically Can use catheter sleeves
47
Nasal Tumors | Surgery
Not very helpful for sarcomas Live 3-7 months with or without surgery
48
Nasal Tumors | Chemotherapy
Lymphoma protocol Carcinomas-Cisplatin Piroxicam or other NSAIDs Tyrosine Kinase Inhibitors Do with Radiation
49
Nasal Tumors Curative Radiation Survival
Usually best treatment option 8-23 months
50
Nasal Tumors Curative Radiation Cancer types
Chondrosarcoma > Adenocarcinoma > SCC
51
Nasal Tumors Curative Radiation Side effects
Close to eyes and mouth so can cause damage to these areas Sometimes severe damage
52
Thyroid Tumors | Signalment
Older dogs (9-11) Boxer Golden Retrievers Beagles Neck mass of various size
53
Thyroid Tumors | Cause
Unknown but suspect: Radiation (ingestion) Hypothyroidism Breed: Husky
54
Thyroid Tumor | Biologic Behavior
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
Thyroid Tumor | Functional or Non-Functional? Kinds?
Non-functional Euthyroid Hypothyroid: might be getting stimulated too much by TSH
56
Thyroid Tumor | Diagnosis
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
Thyroid Tumor | Surgery
Mobile thyroid carcinomas with complete surgical resection 24-36+ months Only 25-50% are movable
58
Thyroid Tumor | Radiation
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
Thyroid Tumor | Rx Treatment
Long term thyroid supplementation advised to suppress TSH (stop stimulating thyroid gland) Even if thyroid levels are normal
60
Thyroid Tumor | Chemotherapy
Not likely to work
61
Thyroid Tumor | Tyrosine Kinase Inhibitors
Do seem to work Anti-VGEF function

Small Animal Medicine II (17 decks)

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