Neoplasia of Head and Neck Flashcards
Oral Tumors
Presenting Complaints
Discharge
Odor (very stinky)
Lack of appetite
Rarely a mass
Oral Tumors
Diagnostics
Biopsy/Cytology
LN aspiration
Thoracic radiographs
Canine Oral Tumors
Melanoma
What is it?
Fleshy friable mass, often black
Amelanotic melanoma can be difficult to diagnose
HIGH probability of metastasis
Canine Oral Tumors
Melanoma
Signalment
30-40% of canine oral tumors
Average age: 12 years (older)
Male > Female
Oral Melanoma
Diagnosis
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
Oral Melanoma
Prognosis
Surgery
1 year
Oral Melanoma
Therapy/Prognosis
Radiation
Palliative
1 year
Oral Melanoma
Therapy/Prognosis
Chemotherapy
Not very effective
Carboplatin (works only in 10-20% of dogs)
Metronomic chemotherapy/NSAIDs (suppression of T-regs)
Oral Melanoma
Therapy/Prognosis
Immunotherapy
Merial melanoma vaccine; some cases tumor does shrink including the metted tumors
Cimetidine (ant-acid, also suppresses T-regs)
Canine Oral Tumors
Squamous Cell Carcinomas
Background
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
Canine Oral Squamous Cell Carcinoma
Staging
Thoracic radiographs
CT
May need to image to identify lymph node involvement
Canine Oral Squamous Cell Carcinoma
Surgery
Small, superficial, and rostral
Can be curative
Canine Oral Squamous Cell Carcinoma
Radiation
Small, superficial, and rostral
Aggressive protocol
About 50% get cured
Canine Oral Squamous Cell Carcinoma
Surgery + Radiation
If not rostral
Canine Oral Squamous Cell Carcinoma
Tongue
50% metastasize
Canine Oral Squamous Cell Carcinoma
Tongue
Treatment with Prognosis
Surgery: 8 months
Radiation: 4 months
Chemotherapy: Carboplatin, Toceranib (must do with Sx or Radiation)
Canine Oral Tumors
Fibrosarcoma
Flat mass; can look like many things
Average age: 7 years
Male > Females
Metastasis uncommon but may depend on grade and age of dog
Canine Oral Fibrosarcoma
Biopsy Info
Grade, invasiveness, bone involvement
High biologic grade with low pathologic grade; grows very fast but low chance to met (looks like granulation tissue)
Canine Oral Fibrosarcoma
Staging
Thoracic radiographs
CT/Radiographs; good for surgical planning, often more bone involvement than expected
Canine Oral Fibrosarcoma
Treatment (3)
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)
Canine Oral Tumors
Epulides
What are these?
Tumors of the periodontal tissue
Canine Oral Tumors
Epulides
Benign
Fibromatous epulis
Ossifying epulis
Canine Oral Tumors
Epulides
Malignant
Aggressive locally, but almost never metastasize
Acanthomatous ameloblastoma
Acanthamotous Ameloblastoma
Staging/Diagnostics
Biopsy (must to diagnose)
Thoracic Radiographs
CT (see how deep erosion goes)