Oncology

Question 1

Apocrine gland carcinoma px

Answer 1

1-2yrs if mass and LN excisions (and no adjunct treatment)

Highly malignant and metastatic potential

Question 2

Perianal adenoma px

Answer 2

Good - commonly benign

Question 3

Surgical margins required for a MCT

Answer 3

> 3cms + deep fascial plane

+ chemo/radiation

Question 4

Soft tissue sarcoma behaviour

Answer 4

locally invasive - slow to met but will

may need radical excision ie. amputation

Question 5

melanoma tx options

Answer 5

sx excision + vaccine + chemo

Question 6

FNA limitations

Answer 6

• fibrous/sarcomas do not exfoliate well
• cannot rule anything out - can only rule in
• cannot grade neoplasia

Question 7

A mass you suspect is malignant would you rather a excision or incisional biopsy?

Answer 7

• incisional (but do not extend margins!!)

- excisional makes potential re-resection difficult

Question 8

what dog breed is associated with apocrine gland carcinomas?

Answer 8

cocker spaniels

Question 9

why is minimal manipulation of the tumour important?

Answer 9

to prevent exfoliate of tumour cells + to not stimulate release of cytokines (MCT - histamine)

Question 10

give an example of a biologic margin

Answer 10

fascia, tendon, cartilage

– collagen rich, low vascularity = natural barrier

Question 11

what is a marginal excision?

Answer 11

en bloc removal of a tumour and pseudocapsule ‘shell out’ – for benign tumours (lipomas)

Question 12

what is considered a wide margin?

Answer 12

> 3cm

Question 13

what is considered a narrow margin?

Answer 13

<2-3cm

Question 14

what tumour types require wide excision?

Answer 14

• plasmacytoma
• mast cell tumour (G1-2)
• cutaneous melanoma

’ well contained malignant disease’

Question 15

which tumour types require radical excision?

Answer 15

infiltrative, highly malignant disease

Question 16

always submit excised tissue for histologic examination –> surgical site marking
Why?

Answer 16

to confirm the diagnosis and confirm complete excision (good margins)

Question 17

what are your options when you receive histo report that you have ‘dirty margins’?

Answer 17

• Revisit surgical options: en bloc excision/radical excision of previous site
• Adjunctive therapy - radiation/chemo

Question 18

a digital melanoma is more likely to be malignant or benign?

Answer 18

malignant

Question 19

what advise would you give an owner of a dog with perianal adenoma?

Answer 19

It is very commonly benign.
The malignant form is an adenocarcinoma and associated with hypercalcaemia.
Recommend - Biochem to assess calcium levels
+ surgical exicison
+ castration

Question 20

Ddx for non-neoplastic oral masses

Answer 20

• gingival hyperplasia
• eosinophilic granuloma complex
• osteomyelitis
• lymphocytic plasmacytic stomatitis
• nasopharyngeal polyps
• salivary mucoceles

Question 21

Malignant canine oral neoplasias

Answer 21

• malignant melanoma
• SCC
• fibrosarcoma
• osteosarcoma

Question 22

benign canine neoplasias

Answer 22

periodontal ligament tumours (odontogenic/epulides)

Question 23

Feline malignant oral neoplasias

Answer 23

SCC

Question 24

signalment canine oral malignant melanoma

Answer 24

older, male dogs w/ heavily pigmented mucosa

Question 25

behaviour of oral malignant melanoma

Answer 25

- firm, vascular, rapidly growing mass --> bone invasion and dental disruption common - early mets to LNs and lungs - poor prognosis +often necrosis + infection

Question 26

signalment canine oral SCC

Answer 26

older large breed dogs

Question 27

how does location affect behaviour of oral SCC?

Answer 27

1. Rostral = locally invasive, low mets 2. Caudal = invasive, high mets 3. Tonsils = aggressive, high mets 4. Lingual = aggressive

Question 28

appearance of oral SCC

Answer 28

red, friable, ulcerated +/- dental disruption and bony invasion

Question 29

prognosis of cat w/ sublingual SCC

Answer 29

grave (along w/ maxilla)

Question 30

prognosis of cat w/ mandibular SCC

Answer 30

fair prognosis w/ excision

Question 31

oral fibrosarcoma signalment

Answer 31

young dogs OR older 7-8yo large breed dogs OR older cats

Question 32

appearance of oral fibrosarcoma

Answer 32

pink/red, firm, fixed, multilobulated, smooth

Question 33

behaviour of oral fibrosarcomas

Answer 33

- locally invasive | - distant mets uncommon

Question 34

signalment of oral osteosarcomas

Answer 34

large breed dogs

Question 35

behaviour of oral osteosarcomas

Answer 35

- distant mets - locally invasive - -> poor prognosis

Question 36

appearance and behaviour of ameloblastomas/acanthomatous epulis

Answer 36

- gingiva and mucosa of tooth-bearing surface in medium to large breed dogs - benign - bony lysis/proliferation, alveolar bone resorption and tooth displacement

Question 37

appearance and behaviour of peripheral odontogenic fibromas

Answer 37

- pendunculated, firm, smooth, pink - benign, slow growing - broader base - various amounts of calcification w/in mass (ossifying epulis)

Question 38

appearance and behaviour of odontomas

Answer 38

- sharply defined mass of calcified material surrounded by narrow radiolucent band + variable tooth-like structures - benign

Question 39

treatment of dentigerous cysts

Answer 39

- cyst w/ tooth/teeth embedded in wall --> surgical removal of the unerupted tooth and removal of cyst lining

Question 40

what is a feline inductive odontogenic tumour?

Answer 40

seen in young cats <18mo, on rostral maxilla locally invasive fibroameloblastoma - no mets

Question 41

Tongue neoplasia ddx

Answer 41

SCC | others: malignant melanoma, fibrosarcoma, plasmacytoma, haemangiosarcoma

Question 42

gross margin for oral neoplasia resection

Answer 42

1cm - maintain oral function and minimise deformity

Question 43

Resection of what % of the body of the tongue is well tolerated?

Answer 43

40-60%

Question 44

Complications of maxillectomies

Answer 44

mandibular canine teeth --> ulceration on lips

Question 45

complications of mandibulectomies

Answer 45

- mandibular drift - mandibular instability, difficulty prehending food - ranula