Oncology Flashcards
1
Q
Oral tumors - most common epithelial (3), melanocitic (1), mesenchymal (5) and miscellaneous (3)
A
Epithelial: Squamous Cell Carcinoma, intraosseous carcinoma and invasive nasal carcinoma
Melanocytic: Malignant Melanoma
Mesenchymal: fibrosarcoma, hemangiosarcoma, osteosarcoma, chondrosarcoma, multilobular osteochondrosarcoma
Miscellaneous: TVT, MCT, lymphoma
2
Q
Odontogenic tumors - list one epithelial, one mesenchymal and three periodontal
A
odontogenic ameloblastoma (epithelial)
odontogenic fibroma (mesenchymal)
acanthomatous epulis (periodontal), ossifying epulis (periodontal), and fibromatous epulis (periodontal)
3
Q
Describe the TNM staging system for canine oral tumors as proposed by the WHO
A
“Stage Characteristics
T – Primary tumour
T0 No evidence of tumour
Tis Carcinoma in situ
T1 <2cm (1a = no bony invasion, 1b = bony invasion)
T2 2–4cm (2a, 2b)
T3 >4cm (3a, 3b)
N – Regional lymph nodes
N0 No regional lymph node (RLN) involvement
N1 Movable ipsilateral RLN (N1a = no tumour cells, N1b = tumour cells)
N2 Movable contralateral or bilateral RLN (N2a, N2b)
N3 Fixed RLN
M – Distant metastasis
M0 No distant metastasis
M1 Distant metastasis”
Excerpt From
Small Animal Oncology E-Book
Susan M. North BSc(Hons), PhD, DVM, DipACVIM(Med Onc), DipECVIM-CA(Int Med and Med Onc), MRCVS & Tania Ann Banks BVsc, FACVSc(Small Animal Surgery), MRCVS
https://books.apple.com/us/book/small-animal-oncology-e-book/id582697699
This material may be protected by copyright.
4
Q
Briefly explain stereotactic radiation therapy
A
“Stereotactic radiation therapy involves three-dimensional localization of the neoplasm with imaging following immobilization of the part of the patient to be radiated.90 Multiple beams of radiation are administered from different directions to deliver a high dose to a more localized area (small lesions), typically as one to a few treatments.”
Excerpt From
Veterinary Surgery: Small Animal Expert Consult
Spencer A. Johnston VMD, DACVS & Karen M. Tobias DVM, MS, DACVS
https://books.apple.com/us/book/veterinary-surgery-small-animal-expert-consult/id1250368401
This material may be protected by copyright.
5
Q
What are the four types of neoplasia affecting the central nervous system which are most likely to respond to chemotherapy?
A
“lymphoma, leukemias, multiple myeloma, and disseminated histiocytic sarcoma,”
Excerpt From
Veterinary Surgery: Small Animal Expert Consult
Spencer A. Johnston VMD, DACVS & Karen M. Tobias DVM, MS, DACVS
https://books.apple.com/us/book/veterinary-surgery-small-animal-expert-consult/id1250368401
This material may be protected by copyright.
6
Q
Discuss the primary use for bisphosphonates, mechanism of action and adverse effects
A
“Bisphosphonates may be useful in the treatment of neoplasms that cause bone lysis. These drugs inhibit bone resorption without inhibiting mineralization primarily through induction of osteoclast apoptosis, resulting in decreased osteolysis, stabilized or improved mineralization, and pain relief.48,110 In vitro studies of canine osteosarcoma have shown that bisphosphonates may have anticancer benefits as well.6,50,138 The most commonly used bisphosphonates in veterinary oncology are pamidronate (Aredia, Novartis Pharma) and zoledronate (Zometa, Novartis Pharma). Pamidronate is administered as an intravenous (IV) infusion every 4 weeks at a dose of 1 to 2 mg/kg. Pamidronate has been reported to cause both tubular and glomerular nephrotoxicity in people,133 and preclinical studies in dogs demonstrated a dose- and infusion-length–dependent nephropathy.”
Excerpt From
Veterinary Surgery: Small Animal Expert Consult
Spencer A. Johnston VMD, DACVS & Karen M. Tobias DVM, MS, DACVS
https://books.apple.com/us/book/veterinary-surgery-small-animal-expert-consult/id1250368401
This material may be protected by copyright.
7
Q
What kind of non-spinal neoplasia is most likely to cause spinal cord disfunction? What is the most common type of tumor?
A
Vertebral neoplasia; osteosarcoma
8
Q
Most vertebral tumors in dogs are primary tumors, with osteosarcoma (most common), fibrosarcoma and Chondrosarcoma comprising most cases.
What are the most common origins/types of secondary tumors that may affect the vertebral column?
A
“The most commonly identified metastatic neoplasms are either vascular in origin (e.g., hemangiosarcoma) or epithelial (thyroid, mammary, prostatic, and urinary [transitional cell]) in origin.58,114”
Excerpt From
Veterinary Surgery: Small Animal Expert Consult
Spencer A. Johnston VMD, DACVS & Karen M. Tobias DVM, MS, DACVS
https://books.apple.com/us/book/veterinary-surgery-small-animal-expert-consult/id1250368401
This material may be protected by copyright.
9
Q
What is the radiographic appearance of multiple myeloma affecting spinal vertebrae?
A
“Radiographically, multiple myeloma is characterized by multifocal well-circumscribed lytic lesions affecting multiple vertebrae (Figure 37.2).66,155”
Excerpt From
Veterinary Surgery: Small Animal Expert Consult
Spencer A. Johnston VMD, DACVS & Karen M. Tobias DVM, MS, DACVS
https://books.apple.com/us/book/veterinary-surgery-small-animal-expert-consult/id1250368401
This material may be protected by copyright.
10
Q
Typical MRI appearance of vertebral tumors on T1 and T2 weighed images
A
“In comparison to normal vertebrae, lesions are often hypointense on T1-weighted (T1W) images, hyperintense on T2-weighted (T2W) images, and demonstrate variability in enhancement after intravenous contrast administration.”
Excerpt From
Veterinary Surgery: Small Animal Expert Consult
Spencer A. Johnston VMD, DACVS & Karen M. Tobias DVM, MS, DACVS
https://books.apple.com/us/book/veterinary-surgery-small-animal-expert-consult/id1250368401
This material may be protected by copyright.
11
Q
Is spinal lymphoma in the dog and in the cat most likely to be extradural, intradural-extramedullary or intramedullary? How can a presumptive diagnosis usually be achieved in these cases?
A
Extradural
“A presumptive diagnosis of lymphoma may be reached by identifying circulating neoplastic lymphocytes with routine hematology or observing neoplastic lymphocytes with cytological evaluation of bone marrow, affected organs, cerebrospinal fluid, or lymph node specimens.”
Excerpt From
Veterinary Surgery: Small Animal Expert Consult
Spencer A. Johnston VMD, DACVS & Karen M. Tobias DVM, MS, DACVS
https://books.apple.com/us/book/veterinary-surgery-small-animal-expert-consult/id1250368401
This material may be protected by copyright.
12
Q
What is the etiology (cell line) of histiocytic sarcoma complex? Where are the cells typically found in where are they not naturally found?
A
“Histiocytic sarcoma is the neoplastic proliferation of cells of the dendritic or macrophage lineage. Because dendritic cells exist in all tissues and organs except the central nervous system (although found in the meninges), histiocytic sarcoma can arise in nearly every tissue and organ. ”
Excerpt From
Veterinary Surgery: Small Animal Expert Consult
Spencer A. Johnston VMD, DACVS & Karen M. Tobias DVM, MS, DACVS
https://books.apple.com/us/book/veterinary-surgery-small-animal-expert-consult/id1250368401
This material may be protected by copyright.
13
Q
From what tissue do myxomas (benign) and myxosarcomas (malignant) arrives?
A
Synovium
14
Q
Where do myxosarcomas typically arise from when affecting the spinal cord?
A
Zygapophyseal joints
15
Q
What are the three types of mineralization of soft tissues and their most common causes?
A
“Mineralization of the soft tissues can be classified into three types: metastatic, dystrophic, and idiopathic.
- Metastatic mineralization is secondary to abnormal calcium and/or phosphorous homeostasis; in general, mineralization of soft tissues is widespread.
- Dystrophic mineralization occurs in animals with normal calcium homeostasis in tissues that have been damaged by a pathological process (i.e., tissues devitalized by trauma, necrosis, inflammation/infection, or neoplasia).
- Idiopathic mineralization occurs in animals with normal calcium homeostasis in which mineralization occurs in normal tissues.
- Dystrophic and idiopathic mineralization occurs most commonly in animals. A fourth type, iatrogenic, has also been described in which the mineralization occurs secondary to a surgical procedure, suture material, or repeated injections at a single site. ”
16
Q
What is the most common primary nervous system neoplasm of the spinal cord of the dog? What tissues does it typically arise from?
A
“Meningiomas arise from the meningothelial cells of the arachnoid membrane or pia mater. Meningioma is the most common primary nervous system neoplasm of the spinal cord in the dog.”
Excerpt From
Veterinary Surgery: Small Animal Expert Consult
Spencer A. Johnston VMD, DACVS & Karen M. Tobias DVM, MS, DACVS
https://books.apple.com/us/book/veterinary-surgery-small-animal-expert-consult/id1250368401
This material may be protected by copyright.
17
Q
What is the typical biological behavior of nerve sheath neoplasms in the dog?
A
“In dogs, most nerve sheath neoplasms behave in a similar way to soft tissue sarcoma.85 Nerve sheath neoplasms are locally aggressive, infiltrating the nerve proximally and distally, but generally associated with a low rate of distant metastasis.16,19,24,84 Based on their biological behavior and histologic characteristics, most nerve sheath neoplasms in dogs are malignant.”
Excerpt From
Veterinary Surgery: Small Animal Expert Consult
Spencer A. Johnston VMD, DACVS & Karen M. Tobias DVM, MS, DACVS
https://books.apple.com/us/book/veterinary-surgery-small-animal-expert-consult/id1250368401
This material may be protected by copyright.
18
Q
What is the typical Signalment and presentation for dogs with nerve sheath neoplasms?
A
Large breed, middle age to early senior, no gender predisposition
Progressive and typically unilateral limb lameness over a long period (typically over 6 months). The degree of discomfort may be variable from mild to severe. Clinical signs may be initially bilateral and then progressed to unilateral. Paresis/plegia may eventually develop but is less common. Pain or manipulation of the affected limb is common.
Thoracic limbs are most commonly affected. Scapular muscle atrophy may be present. A mass may be palpable in the axillary region.
If the lesion affects the pelvic limb, a mass may be rectally palpable on ventrolateral aspect of the sacrum.
19
Q
What is the most commonly affected breed, age and location for Extrarenal nephroblastomas?
A
German Shepherd and retrievers, 6 to 18 months of age, T10-L2
20
Q
What is the theory for why extrarenal nephroblastoma‘s most commonly present in the T10 L2 region?
A
“Given the histologic resemblance to primitive nephrons, these neoplasms may arise from mesonephric or metanephric embryologic remnants that become entrapped in the developing dura and spinal cord.168 This explanation of the histogenesis helps account for the near exclusive occurrence of the lesion between the T10 and L2 vertebrae. ”
Excerpt From
Veterinary Surgery: Small Animal Expert Consult
Spencer A. Johnston VMD, DACVS & Karen M. Tobias DVM, MS, DACVS
https://books.apple.com/us/book/veterinary-surgery-small-animal-expert-consult/id1250368401
This material may be protected by copyright.
21
Q
What are the 6 types of round cell neoplasms
A
HLMMPT
Histiocytic tumors
lymphoma
mast cell tumor
melanoma
plasma cell tumor
transmissible venereal tumor
22
Q
Types of epithelial neoplasms
A
Carcinoma (nonglandular origin)
Adenocarcinoma (glandular)
23
Q
What are the three tumors which if arising from the nailbed tend to be particularly aggressive and sometimes metastatic?
A
Squamous cell carcinomas, mast cell tumors, and melanomas arising in the subungual epithelium are aggressive and sometimes metastatic.
24
Q
What kind of subungual tumor are black dogs predisposed to? What is the expected 1 year survival rate after digit amputation?
A
Squamous cells carcinoma, 45% to 100%
25
What is the median survival for patient diagnosed with subungual melanomas?
1 year
26
You are presented with a middle-age cat with digital tumors affecting two weight-bearing toes. What are the three most likely differential diagnosis? What is the prognosis?
Aside from squamous cell carcinoma and fibrosarcoma, digital tumors in cats can also be metastatic, most commonly from pulmonary adenocarcinoma. These tumors typically involve weight-bearing digits and can involve more than one toe. Cats with digital tumors should be carefully evaluated for primary disease. Prognosis for digital tumors in cats is guarded. Median survival in cats with digital squamous cell carcinoma is 73 days, whereas cats with metastatic lesions have similarly poor survival.
27
Canine eyelid neoplasms - from what structures do theytypically arise from? Are they most commonly benign or malignant? What is the most common benign tumor in the most common malignancies observed? Roughly what percentage of tumors are benign versus malignant?
Eyelid neoplasms in dogs are most often associated with the meibomian glands (see Figs. 16.1 and 16.5B), and 70% to 80% are benign. Sebaceous adenomas and epitheliomas are the most common eyelid tumor in dogs; they sometimes grow rapidly. Malignant eyelid tumors are less common and include squamous cell carcinoma, sebaceous adenocarcinoma, basal cell carcinoma, and fibrosarcoma. Of the eyelid melanomas, approximately 60% are benign and 40% are malignant.
28
Eyelid neoplasms in cats - most likely benign or malignant? What is the most common type in what are the other possibilities?
In cats, eyelid neoplasms tend to be malignant, and squamous cell carcinomas (~60% of cases) are the most common. Others include fibrosarcoma, adenocarcinoma, basal cell carcinoma, melanoma, and hemangiosarcoma.
29
What diagnostic technique should always be performed when evaluating a case of entropion? Why?
Topical anesthetic desensitization (proparacaine). This is important to evaluate for spastic entropion which resolves home tenuously and does not require surgery (Typically a result of discomfort).
30
What is a Leukoma?
A white corneal scar
31
Why should ketamine be avoided during ophthalmic procedures?
Because it may cause undesirable eye movements.
32
What are the two main indications for a third eyelid flap?
Bullous keratopathy and indolent corneal ulceration
33
What is Haw’s syndrome? What species does it affect and what is it typically associated with? How can you confirm it?
Bilateral exposure or protrusion of the nictitating membranes, only observed in cats. Associated with gastrointestinal disease although the mechanism is unknown. Confirmed via phenylephrine testing
34
Describe the Seidel test and it’s purpose
Perform a Seidel test to determine if a corneal ulcer has reached full-thickness and ruptured. Fill a 3-mL syringe with sterile eye wash or LRS after removing the plunger. Dip the stained tip of the fluorescein strip into the solution repeatedly until the solution is a dark, dense yellow. Have an assistant drip the fluorescein solution onto the cornea ulcer site while you watch the area with magnification and a cobalt light. Alternatively, moisten the tip of a fresh sterile fluorescein strip with a full drop of sterile eye wash, and allow this drop to fall onto the top of the globe; monitor the site in question under magnification with a cobalt light. Observe to see whether a clear rivulet of aqueous humor is seen running through the fluorescein stain. A positive Seidel test indicates aqueous humor leakage and that the corneal ulcer has ruptured. If a corneal perforation is leaking, referral to an ophthalmologist is indicated because accurate evaluation and repair requires use of specialized skills and an operating microscope.
35
The three bones that compose the orbit
frontal, lacrimal, and zygomatic bones
36
What is the typical clinical sign of severe extraocular muscles tearing as a result of ocular proptosis?
marked dorsolateral strabismus
37
Pupil size is not always considered a good predictor of vision in patients with globe proptosis. List three or more positive prognostic indicators
Positive prognostic indicators include a brachycephalic dog signalment, intact direct and consensual pupillary light reflexes, intact vision (indicated by tracking of a thrown cotton ball or head retraction when the eye is menaced), a normal fundus appearance, and short duration of proptosis before treatment.16
38
The prognosis for vision in proptosis globes is guarded to pour. Globe retention and acceptable cosmesis are quite possible depending on the degree of damage in the level of care provided. Approximately what percentage of dogs and cats become blind after proptosis?
Blindness occurs in approximately 60% to 70% of dogs and in 100% of cats.
39
In the order from the tympanic membrane to the semi circular canals, what are the names of the three otic ossicles?
Malleus, incus and stapes
40
Describe the surgical approach for a ventral bulla osteotomy
In dogs, make a 7- to 10-cm incision (3–5 cm in cats) parallel to the midline of the animal and centered 2 cm toward the affected side from where these imaginary lines intersect (see Fig. 17.14A). Incise the platysma muscle, retract the linguofacial vein if necessary, and deepen the incision by bluntly dissecting the digastricus muscle (lateral) from the hyoglossus and styloglossus muscles (medial). Avoid damaging the hypoglossal nerve, located on the lateral aspect of the hyoglossus muscle. Confirm the location of the bulla and use self-retaining retractors (e.g., Gelpi, Weitlaner)
41
What are the two most common tumors affecting the palatine tonsils in the dog?
Squamous cell carcinoma and lymphosarcoma
42
What are the four most common tumors affecting the tongue of the dog?
S-M-MYL-M
Squamous cell carcinoma
Malignant melanoma
Granular Cell myeloblastoma
Mast cell tumor
43
How much of the tongue can be amputated and still very well tolerated in dogs?
Nearly the entire free tongue can be amputated without major problems (40 to 60%).
44
What are the general epidemiological Facts regarding oral tumors in dogs and cats?
Fourth most common site of neoplasia and dogs and cats
2.6 times more likely to occur in dogs than cats
Males more commonly affected than females
45
What are the three most common oral tumors of dogs (in the order of most common to least common)
Malignant melanomas, squamous cell carcinoma, fibrosarcoma
46
What is the most common malignant oral tumor in dogs? Does it occur often in cats? Where in the mouth does it typically arise and what is the typical Signalment of affected dogs?
Melanoma
“• Most common malignant oral tumor in dogs (approximately 20%)
• Rare in cats
• Most common on gingiva
• More common in male dogs
• Mean age of affected animals is 9–11 years (average, 10.3 years)
• Breeds with pigmented oral mucosa, cocker spaniels, and German shepherds”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
47
What is the most common oral tumor in cats? Does it happen in dogs? Where does it typically arise and what is the typical biological behavior?
“• Most common tumor in cats (approximately 70%)
• Second most common tumor in dogs (with fibrosarcoma) (approximately 15%)
• Occur on the gingiva, lip, tongue, or tonsil
• Biological behavior varies with location and species; regional lymph node involvement “is common with tongue and tonsillar squamous cell carcinomas”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
48
What are the main characteristics of oral fibrossarcomas in dogs?
“Second most common malignant oral tumors in dogs (with squamous cell carcinoma)
• Occur most commonly on the gingiva and hard palate
• More common in large breeds (>20 kg) and male dogs
• Younger dogs may be affected (mean age <7 years)
• Locally invasive; high metastatic potential in dogs <2 years of age”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
49
What are the main characteristics of the dog’s most common group of benign gingival tumor? What is the most common form?
“Most common oral tumor in dogs (approximately 30%)
• Mean age approximately 8.2 years
• More common in large-breed dogs (>20 kg)
• Do not metastasize
• Acanthomatous epulis is most common form”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
50
What population is most commonly affected by ameloblastoma‘s? What is the biological behavior?
“Ameloblastomas (adamantinoma) are benign tumors that arise from the dental lamina. They usually occur in younger dogs and involve the rostral mandible. Ameloblastomas develop as intraosseous tumors and are locally invasive and nonmetastasizing.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
51
What are dentigerous cysts and what is their biological behavior?
“Dentigerous cysts appear as closed cavities or sacs with one or more teeth embedded in the cyst wall. They arise within islands of odontogenic epithelium and are described as benign, nonneoplastic lesions; however, they may represent an early stage of malignant epithelial tumor development.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
52
What is the expected response to radiation therapy of SCC’s, fibrosarcoma and melanomas? What percentage of patients develop neoplasia secondary to radiation therapy?
“SCC’s are radiosensitive and are successfully treated by radiotherapy. Piroxicam is sometimes helpful in treating SCC. Fibrosarcomas are radioresistant. Melanomas may be sensitive to radiotherapy, but distant metastasis frequently renders it ineffective. Radiation-induced tumors occur in up to 20% of the irradiated sites.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
53
What is the prognosis for feline oral squamous cell carcinoma?
“Cats with oral SCC have a poor prognosis, with a median survival time of approximately 2 months regardless of the form of therapy. ”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
54
What is the prognosis for a canine oral melanoma? What percentage of dogs is still disease-free 1 year postop?
“Melanomas have the poorest prognosis because they metastasize early. Fewer than 20% of affected animals are disease-free 1 year after surgery. Median survival times vary from 8 to 10 months. Tumors arising from the tongue have a poor prognosis. They are controlled locally in only approximately one-fourth of animals 1 year after resection or radiation therapy. ”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
55
Esophageal tumors are generally rare Regards and cats. When observed, what are the three most common types of tumors? What non-neoplastic parasitic condition can mimic cancer?
Sarcomas, squamous cell carcinoma and Leiomyomas.
Spirocerca lupi
56
Regarding hiatal hernia’s:
Typically acquired or congenital?
Predisposed breeds?
Typical clinical signs?
Easy to diagnose via radiographs? Why?
What surgical steps are typically taken to correct the issue?
What patients are typically treated via surgery versus conservative management?
What preoperative step must be observed?
Is the prognosis good or bad after repair?
“Most are congenital rather than acquired
• Shar peis and English bulldogs are most commonly affected
• Some are asymptomatic
• Symptomatic animals often have regurgitation and esophagitis
• Herniation may be intermittent, making radiographic diagnosis challenging
• Herniorrhaphy includes hiatal reduction, esophagopexy, and left-sided gastropexy
• Surgery is usually most appropriate for younger symptomatic animals; older symptomatic animals are usually best treated medically
• Treat for esophagitis initially after surgery
• Prognosis is usually good after repair”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
57
What is the likelihood of metastasis for gastric neoplasm‘s at the time of diagnosis? How does this apply to leiomyomas and leyomyosarcomas?
“Most neoplasms in the gastric body, except for leiomyomas and leiomyosarcomas, have metastasized by the time they are diagnosed. ”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
58
G.I. adenocarcinoma in dogs and cats: Most common location for each species, three morphologic forms, most common clinical signs, mode of metastasis
“Adenocarcinomas are locally invasive and slow-growing. They most commonly arise in the duodenum and colon of dogs and in the distal jejunum and ileum of cats. These tumors have three main morphologic forms: (1) infiltrative adenocarcinomas cause a thickened stenotic area that obstructs the intestinal lumen; (2) ulcerative adenocarcinomas have a deep indurated mucosal ulcer with raised edges; and (3) proliferative adenocarcinomas are lobulated, expanding intraluminal masses. Mucosal ulceration may cause chronic bleeding, melena, and iron deficiency anemia. The tumors spread to adjacent serosal surfaces, mesentery, omentum, and regional lymph nodes by local invasion and may metastasize distally to the lungs and liver. Mucinous intestinal adenocarcinomas extend transmurally to the mesentery with accumulation of variable amounts of mucin.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
59
Intestinal lymphosarcoma in dogs and cats: typical etiology in cats; what are the two intestinal types?
“In cats, they may be caused by FeLV or feline immunodeficiency virus (FIV), but most are caused by unknown mechanisms. The etiology in dogs is unknown. Affected animals may have multicentric disease. Lymphomas have two intestinal types: diffuse and nodular. Diffuse infiltration of the lamina propria and submucosa with neoplastic lymphocytes causes malabsorption and occasional deep ulceration. Nodular lymphoma is an expanding intestinal mass that causes obstruction, often but not invariably in the ileocecocolic area. Involvement of regional lymph nodes and other organs is common. Cats in particular may have intestinal lymphoma and no gross or ultrasonographic evidence of intestinal disease. Dogs typically have lymphoblastic lymphoma, whereas there are multiple forms of lymphoma in cats including small cell lymphoma, lymphoblastic lymphoma, epitheliotropic lymphoma, and large granular lymphoma.42”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
60
What is the typical biological behavior of canine intestinal leiomyosarcoma’s? Where do they typically occur? How does the tumor spread? Is metastasis slow or fast? What is the expected median survival after surgical resection with or without metastasis?
“Intestinal leiomyosarcomas are slow-growing, malignant smooth muscle tumors of older dogs that usually occur in the cecum and jejunum. Neoplastic spread is by local invasion, and metastasis is slow. Metastasis occurs to the mesentery, mesenteric lymph nodes, peritoneum, and liver. Median survival of approximately 2 years is expected after resection of a localized lesion. This is also true of animals with metastasis at the time of surgery. ”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
61
name three breeds predisposed to lymphoma, adenocarcinoma and leiomyosarcoma’s of the G.I. tract
“Boxers, collies, and German shepherds”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
62
What are the three most common G.I. tumors of cats?
“lymphosarcomas are most common followed by adenocarcinomas and mast cell tumors”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
63
What is the prognosis for dogs with localized intestinal adenocarcinoma or leiomyosarcoma completely excised? Include median survival, one and two years post-op.
“The prognosis is good for patients with a localized intestinal adenocarcinoma or leiomyosarcoma if complete resection is possible. The median survival time is 10 months; the 1-year survival rate is 40.5%, and the 2-year survival rate is 33% for dogs with an adenocarcinoma or a leiomyosarcoma.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
64
What is the prognosis for cats with intestinal adenocarcinoma surgically removed?
Excellent, over two years
65
What is the prognosis for cats with intestinal lymphoblastic lymphoma versus those with small cell lymphoma?
 “The prognosis associated with lymphoblastic lymphoma is poor; however, cats with small cell lymphoma can have survival times of years.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
66
Where are intestinal tumors most likely in the dog versus the cat? What are the most commonly observed tumors?
Dogs: large intestines, adenocarcinoma
Cats: small intestines, lymphosarcoma
67
Adenocarcinoma’s are most commonly observed in the large intestine (mid rectum) of dogs and cats, although are overall rare. Where are the two most common locations within the anatomical structure of the colon?
Annular (intramural) and intraluminal
68
Most common type of cecal tumors in dogs and cats? What is the prognosis with early complete resection?
Leiomyosarcoma
Median survival with or without metastasis is approximately two years (excellent prognosis).
69
What is the most common surgical technique utilized in the treatment of Rectal adenocarcinoma ? What is the expected survival time?
“Adenocarcinoma was the tumor most commonly treated with rectal pull-through, and these dogs had a median survival time of 696 days (1006 days if the carcinoma was classified as in situ).
70
 Which canine epithelial tumor is frequently associated with hypercalcemia of malignancy? What clinical signs are typically associated with this syndrome?
Apocrine Gland Adenocarcinoma (anal sac)
Hypercalcemia is typically associated with polyuria, polydipsia, poor appetite and vomiting
71
Where do anal squamous cell carcinoma‘s typically arise? What is the typical clinical presentation and prognosis?
“Anal SCCs arise from the anocutaneous line. They are typically malignant and metastasize quickly. Extensive fistula or mucosal-cutaneous, ulcer-like lesions occur and are often covered with mucus. Anal function is impaired, and pain, tenesmus, and hemorrhage are typical. The prognosis is grave because of their malignant nature. Treatment is often discouraged.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
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72
Do cats develop perianal gland tumors?
No. “Cats do not have perianal or circumanal glands”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
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73
You are presented with an intact dog affected by multiple, large perianal Adenomas. What can be done to reduce the size of the tumors prior to excision?
Castration, wait six weeks and reevaluate.
74
What is the most important organ dysfunction associated with hypercalcemia of malignancy , such as caused by apocrine gland adenocarcinoma?
Renal dysfunction
75
Renal dysfunction secondary to hypercalcemia of malignancy (apocrine gland tumors) can be serious. What is the typical treatment and prognosis?
“Although the renal dysfunction is initially mild and reversible, it can become severe, oliguric, and irreversible if therapy is delayed. Therefore it is important to be sure the patient is not oliguric. Prednisolone may be given (Box 18.62) to help lower the serum calcium. Severely affected animals (total serum calcium concentration greater than 16 mg/dL) may also be treated with alkalinizing agents (e.g., sodium bicarbonate) and bone resorption inhibitors (i.e., pamidronate disodium). Pamidronate disodium (1–2 mg/kg IV) has been used in dogs that were hypercalcemic from different causes, and it quickly lowered serum calcium concentrations. However, pamidronate is expensive. Peritoneal dialysis may be performed in oliguric patients but is of uncertain value.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
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76
When is recurrence of perianal malignant tumors typically observed?
Three months post-surgery
77
Name 4 epithelial and 4 mesenchimal primary hepatic tumors
Epithelial
• Hepatocellular carcinoma
• Hepatocellular adenoma
• Cholangiocellular carcinoma
• Cholangiocellular adenoma
• Hepatic carcinoids
Mesenchymal
• Hemangiosarcoma
• Fibrosarcoma
• Extraskeletal osteosarcoma
• Leiomyosarcoma”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
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78
What is the typical metastatic behavior of epithelial Vs. mesenchymal hepatic tumors?
“Epithelial tumors most often metastasize to the regional lymph nodes and lungs. Mesenchymal tumors most often metastasize to the spleen.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
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79
What is the overall prognosis for he[atocellular carcinoma treated via surgical excision alone?
“Malignant primary hepatic tumors have typically been considered to be highly metastatic; however, long-term survival is common after lobectomy for hepatocellular carcinoma. The median survival time in cats undergoing surgery for hepatocellular carcinoma was 2.5 years in a 2016 study.2”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
80
What is the most common tumor to metastasize to the liver? What other tumors frequently metastasize to the liver?
Lymphosarcoma
“Other tumors that commonly metastasize to the liver are pancreatic adenocarcinomas, hemangiosarcomas, insulinomas, and tumors of the alimentary and urinary tracts.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
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81
Where are hepatic tumors most commonly observed? (Lobes)
“Hepatocellular tumors are most commonly found in the left medial and left lateral liver lobes.
”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
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82
What clinical signs are typically associated with pheochromocytomas?
“Pheochromocytomas may cause vague, intermittent signs of weakness or panting due to episodic hypertension and tachycardia.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
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83
 What drugs can be used as part of the medical management of hypertension caused by pheochromocytoma?
“Adrenergic blockage (e.g., phenoxybenzamine, phentolamine, prazosin)”
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Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
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84
What cardiovascular concerns could you expect in a patient with pheochromocytoma? How should this be addressed prior to surgery?
“Particular emphasis should be placed on preoperative examination of the cardiovascular system for evidence of arrhythmias or congestive heart failure in animals with pheochromocytomas. If cardiac arrhythmias are present, a β-blocker may be added, but only after the phenoxybenzamine dosage (see under Anesthesia) has been determined to be adequate and blood pressure has returned to normal. Both α- and β-blockade will allow the return of a normal fluid volume; however, they may unmask renal insufficiency and anemia. α-Adrenergic blockade has been shown to drastically reduce the incidence of severe perioperative hypertension, thereby reducing mortality (Table 22.1).”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
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85
Dogs with adrenocortical tumors are particularly predicposed to this life-threateninc post-op complication
Thromboembolism
86
What is the prognosis for dogs undergoing adrenalectomy for the removal of adrenal neoplasia? What factors affect prognosis and what is the median survival?
“Although there can be significant perioperative complications, median survival for dogs that survive to discharge exceeds 10 months. In a study of 52 dogs undergoing adrenalectomy, survival time was significantly shorter in dogs with carcinoma, tumors with a major axis length greater than 5 cm, thrombosis, metastasis, and when adrenalectomy was combined with another abdominal surgical procedure.9 Dogs in this study had a median survival of 953 days, with more than 65% living for more than 1 year.”
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Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
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87
What prognostic factors are considered favorable for survival in dogs undergoing adrenalectomy for removal pf pheochromocytomas?
“Prognostic factors for improved survival for pheochromocytoma include preoperative use of phenoxybenzamine, younger age, lack of intraoperative arrhythmias, and decreased surgical time.13”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
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88
What is the average perioperative mortality rate for dogs and cats undergoing adrenalectomy (regardless of cause)?
20%
89
What warning would you provide the owner of a dog with pheochromocytoma before and during surgery?
“Warn owners that animals with pheochromocytoma may die suddenly as a result of arrhythmias and hypertension.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
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90
Ptuitary tumors - stats…
% of functional vs non-functional
Correlation between size and neuro signs?
Most common tumor type
60% functional (main cause of HAC)
40 % non-functional
No correlation between size and neuro signs
Microadenoma (< 1cm) - 70% of tumors
91
Four breeds predisposed to PDH due to hypophyseal microadenoma
PMDB
“Poodles, Malteses, dachshunds, and boxers may be predisposed to PDH.”
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Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
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92
What structures can be compressed by hypophyseal tumors, leading to neurologic abnormalities?
“Large pituitary tumors often grow dorsally into the brain because the diaphragm of the sella is incomplete. Such tumors may cause clinical signs by impinging on adjacent brain tissue (e.g., optic chiasm, hypothalamus, thalamus, infundibular recess, and third ventricle). Size of the tumor and development of neurologic signs do not always correlate.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
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93
List the signalment and typical clinical signs presented by a dog with functional hypophyseal microadenoma growing beyond the sella turcica?
Poodle, Maltese, Dachshund, Boxer; Middle-age to senior;
“Most dogs are presented for evaluation of typical signs of HAC (polyuria, polydipsia, polyphagia, abdominal enlargement, endocrine alopecia, muscle wasting, weakness, lethargy, panting, and/or hyperpigmentation). Concurrent neurologic signs (e.g., seizures, visual deficits, ataxia, incoordination, facial hemiplegia, head tilt, somnolence, compulsive walking, depression)”
Mental depression/stupor are the most common abnormalities.
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
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94
Therapy for microadenoma Vs. Macroadenoma of the pituitary gland?
Microadenoma: hypophysectomy
Macroadenoma: external beam radiation
95
What consideration should be made prior to considering hypophysectomy for the therapy of PDH in a breeding dog?
“Hypophysectomy should not be considered in animals intended for breeding purposes because it renders them infertile. ”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
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96
Three drugs typically needed for the first two weeks post-hypophysectomy
Desmopressin Acetate
Hydrocortisone
Levothyroxine
97
What is the median survival for patients with insulinoma who are surgically treated?
“If metastasis is not apparent at surgery, survival of longer than 1 year may occur, even though cures are unlikely.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
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98
“Zollinger-Ellison syndrome refers specifically to gastrinomas arising in the pancreas (non–β-cell tumors). What is the expected biological behavior of these tumors?
 “Pancreatic gastrin-secreting tumors are usually locally invasive into adjacent parenchyma and frequently metastasize to regional lymph nodes or the liver or both.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
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99
List 6 differential diagnosis for a cystic ventral cervical mass in a dog
branchial cyst
thyroglossal cyst
thyroid cyst
thyroid cystadenoma
parathyroid cyst
parathyroid cystadenoma
thyroid carcinoma
salivary mucocele
abscess
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
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100
What is the most common thyroid tumor in dogs versus cats? biologic behavior?
Carcinomas are more common in dogs. “Carcinomas are generally rapidly growing, highly invasive tumors that frequently metastasize to the draining lymph nodes and lungs. ”
Functional adenomas are more common in cats
101
What is the prognosis for thyroid carcinomas treated via surgical excision or irradiation?
“The prognosis is good following surgical treatment of mobile thyroid tumors and irradiation of fixed thyroid carcinomas, with median survival times greater than 3 years. Median survival time for dogs with local or regional tumors (i.e., stage II or III) was significantly longer (839 days) than median survival time for dogs with metastasis (366 days). ”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
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102
What are lymphangiomas?
“Lymphangiomas are rare, nonmalignant abnormalities originating from lymphatic capillaries that present as fluid-filled spaces or masses in the skin or deeper tissues.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
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103
What is the typical biological behavior of lymphangipsarcomas?
“Lymphangiosarcomas (Fig. 23.2) are malignant tumors that arise from lymphatic capillaries. They are locally aggressive, and metastasis to regional lymph nodes, lungs, spleen, kidneys, and bone marrow has been reported. Even without metastasis, the local invasiveness of this tumor may necessitate amputation or euthanasia.4”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
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104
What is the typical biological behavior of renal tumors? What are the four distinct origins (types) in what tumors are most commonly observed in dogs versus cats?
“Approximately 85% of renal tumors are malignant, and thoracic metastatic disease is common. Renal tumors are of four distinct origins (types): renal tubular, transitional cell, nephroblastic, and nonepithelial. In dogs, carcinomas (also known as renal tubular carcinoma and renal tubular adenocarcinoma) are most common, followed by sarcomas (Box 24.4). Lymphoma is the most common renal neoplasm in cats and may be primary or metastatic (associated with alimentary lymphoma).”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
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105
Generalized nodular Dermatofibrosis is a disorder seen in German Shepherd dogs in association with white malignant neoplasm?
“Generalized nodular dermatofibrosis, a skin disorder seen in German shepherd dogs, is associated with renal cystadenocarcinomas and other neoplasms.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
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106
Nephroblastomas – typical Signalment and associated musculoskeletal disorder
“Nephroblastomas are rare tumors of juvenile and adult dogs that are associated with hypertrophic osteopathy (see p. 1297). Most are malignant, and these tumors are thought to arise from embryonic tissue ”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
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107
List the 7 most common malignant tumors affecting the canine kidneys
“Carcinomas
Hemangiosarcomas
Fibrosarcomas
Leiomyosarcomas
Nephroblastomas
Squamous cell carcinomas
Undifferentiated carcinomas”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
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108
Ureteral tumors in dogs – how frequently do they occur? Typically benign or malignant?
“Ureteral tumors are very uncommon; only 17 cases have been documented in the veterinary literature. Most ureteral tumors are benign; however, there are three reports of ureteral sarcoma in dogs.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
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109
Dogs affected by renal tumors are typically geriatric. What’s the most likely exception to this rule?
“with the exception of hereditary multifocal renal cystadenocarcinomas in German shepherd dogs.”
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Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
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110
Rare benign neoplasm that affects the kidneys of young dogs
“Teratomas are rare but may occur in the kidneys of young dogs.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
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111
What kinds of renal tumors are most likely to cause gross hematuria?
“Gross hematuria may occur with mesenchymal tumors (e.g., anaplastic sarcomas, fibromas, hemangiosarcomas, lymphosarcomas) and transitional cell tumors; however, microscopic hematuria is more common.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
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112
Abdominal ultrasonography is the most useful diagnostic tool for renal neoplasia, in allows ultrasound guided biopsy. In what situations should this kind of biopsy not be pursued? Why?
“Abdominal ultrasonography is the most useful diagnostic tool for renal and ureteral neoplasia. Ultrasound-guided biopsy (see p. 654) can be performed if the kidney does not appear fluid filled; however, biopsy may cause peritonitis or uncontrollable hemorrhage, or it may seed the abdomen with tumor cells.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
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113
Briefly explain the pathophysiology of feline perirenal pseudocysts. How are they treated and what’s the prognosis?
“Perirenal pseudocysts have been reported in cats and are formed when fluid accumulates between the parenchyma of the kidney and the renal capsule owing to underlying parenchymal disease. Resection of the pseudocyst wall is effective in eliminating signs but does not necessarily stop the progression of renal disease. The prognosis for cats with pseudocysts is related to the degree of renal dysfunction at the time of diagnosis.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
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114
What is the median survival for dogs with renal carcinomas versus Sarcomas versus nephroblastomas? what is the effect of chemotherapy on overall survival? 
- renal carcinomas: 16 months (range, 0–59 months)
- sarcomas: 9 months (range, 0–70 months)
- nephroblastomas: 6 months (range, 0–6 months)
Although long-term survival (i.e., >2 years) with nephroblastoma is possible, dogs with renal tumors receiving adjunctive chemotherapy do not survive a significantly longer period than dogs not receiving chemotherapy. With benign neoplasia, nephrectomy is usually curative.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
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115
How does the diagnosis of a benign mammary tumor in a dog affect her chance of developing a malignant tumor?
“Dogs with benign mammary tumors have more than a threefold risk of developing malignant mammary tumors.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
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116
What is the recommended surgical therapy for feline inflammatory mammary carcinoma?
“Do not excise inflammatory carcinomas; the prognosis is too poor.”
“Inflammatory carcinomas are extremely aggressive, and surgery is of no value in controlling or palliating the disease. ”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
117
What is the biological behavior and overall prognosis for a cat with a mammary adenocarcinoma?
90% of feline mammary tumors are adenocarcinoma’s
Grow rapidly and metastasized to local lymph nodes and lungs early in the course of the disease
Not as well circumscribed as the canine counterpart
Often firm and ulcerated
Must be differentiated from lobular hyperplasia and fibroepithelial hyperplasia
Expected survival is less than one year
118
What are the two main benign differentials for a feline mammary tumor?
“Feline mammary tumors must be differentiated from lobular hyperplasia and fibroepithelial hyperplasia.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
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119
What is the published thoracic metastasis rate for dogs with malignant mammary tumors at the time of diagnosis?
“Thoracic metastasis occurs in 25% to 50% of dogs with malignant mammary tumors by the time of diagnosis.”
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Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
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120
Besides the lungs, what other area should be checked for metastatic lesions associated with caudal mammary tumors?
“Abdominal radiographs should be evaluated for iliac lymph node enlargement with caudal tumors. Abdominal ultrasonography may detect abdominal metastasis. CT and MRI imaging may facilitate evaluation of invasive tumors and metastasis.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
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121
Has postoperative adjunctive chemotherapy been shown to affect the survival of dogs and cats with mammary tumors (as an adjunctive to surgery)?
“Postoperative adjunctive chemotherapy has not been shown to improve outcomes or survival times in dogs or cats”
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Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
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122
What is the recommended surgical approach for a cat with unilateral mammary adenocarcinoma?
“local recurrence is decreased in cats when unilateral mastectomy is performed rather than lumpectomy.”
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Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
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123
What is the recommended surgical therapy for a dog with multiple mammary masses?
“Separate mammary masses on the same dog may be of different histologic types; therefore excise all masses and submit them for histologic examination. Be sure to mark them so that you can determine which mass originated from which site when the biopsy report returns.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
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124
Describe the major blood vessels supplying the mammary glands of dogs and cats
“Mammary Glands 1 and 2
Ventral and lateral branches of the intercostal, internal thoracic, and lateral thoracic vessels
Mammary Glands 2 and 3
Cranial superficial epigastric vessels
Mammary Glands 4 and 5
Caudal superficial epigastric vessels”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
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125
What is the reported local recurrence post surgery in dogs with mammary gland neoplasia?
“In dogs, local recurrence occurs within 2 years and varies from 20% to 73%. (Depends on various factors)
“The prognosis for dogs with malignant tumors is variable and depends on several factors, including tumor type, tumor stage, tumor size, OHE status, and the presence of metastasis.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
126
How does tumor size affect the prognosis for cats with mammary adenocarcinoma?
“Cats with mammary carcinoma greater than 3 cm have a median survival of 6 months, whereas those with tumors less than 2 cm have a median survival of approximately 3 years. ”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
127
How does spaying at the time of mastectomy affect the prognosis for dogs with mammary tumors?
“2016 study found dogs with grade 2 mammary carcinoma, ER-positive tumors, or perioperative increased serum E2 concentration had a decreased hazard of relapse when undergoing OHE at the time of mammary tumor removal compared with dogs not receiving OHE.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
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128
What are the most common types of vulvar/vaginal tumors in bitches?
“The most common types of vulvar-vaginal tumors are fibroleiomyoma, lipoma, leiomyosarcoma, squamous cell carcinoma, and transmissible venereal tumor (TVT).”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
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129
List five cytologic criteria of malignancy
“Variation in nuclear and nucleolar size
Variable and increased nuclear cytoplasmic ratio
Nuclear molding
Abnormal mitotic figures
Coarsely clumped chromatin”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
130
Discuss the medical management of prosthetic neoplasia in dogs. Are they responsive to chemotherapy? How about radio therapy? What other drug class has been shown to be helpful at improving clinical signs and why?
“Chemotherapeutic protocols are not successful in the management of prostatic neoplasia. Radiation therapy can be used to decrease prostate size but does not improve survival times. COX inhibitors (e.g., piroxicam 0.3 mg/kg PO [orally] q24–48h or carprofen 2.2 mg/kg PO q12h) have been shown to improve survival in dogs with prostatic carcinomas, probably because of their binding to COX receptors. Concurrent administration of omeprazole (1–2 mg/kg PO q12h), pantoprazole (1 mg/kg IV q12–24h) or misoprostol (2–5 µg/kg PO q8–12h) may help ameliorate adverse effects associated with chronic use of NSAIDs. Proton pump inhibitors have fewer side effects than misoprostol and are probably as effective.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
131
What active substances are present in the cytoplasmic granules of mast cells? What difference is typically observed in the cytoplasmic granule composition between low-grade versus high-grade MST?
“Cytoplasmic granules in mast cells contain heparin, histamine, platelet-activating factor, and eosinophilic chemotactic factor. The number and type of granules in MCTs depend on the degree of tumor differentiation. Well-differentiated MCTs contain more heparin, whereas undifferentiated tumors have more histamine. ”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
132
Regarding scrotal tumors, what is the most common type and biological behavior?
“In dogs, 50% of MCTs are malignant, especially those in the preputial, inguinal, and perineal areas. Regional lymph nodes, spleen, liver, and bone marrow are common metastatic sites. ”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
133
What is the most common distant adverse effect of cutaneous mast cell tumor’s? What is the potential impact of heparin and proteolytic enzyme release as it pertains to surgery and surgical healing?
“Gastroduodenal ulcers occur in up to 80% of dogs with MCTs because of histamine release. Ulcers may cause anorexia, vomiting, diarrhea, or melena (see p. 428). Heparin and proteolytic enzyme release may prolong coagulation and delay wound healing after resection.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
134
What is the typical biological behavior of skin melanomas?
“Tumors originating in the skin tend to be benign.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
135
List 5 commonly reported scrotal tumors in dogs
Mast cell tumor (54%)
Malignant melanoma
Hemangiosarcoma
Vascular hemartoma
Hemangioma

136
What is the biological behavior of neoplasia arising from normally positioned testicles (older dogs) versus cryptorchid testicles?
“Tumors involving scrotal testes are usually benign, whereas those in cryptorchid testes may be malignant. Metastases are slow-growing but are occasionally detected in lumbar, deep inguinal, and external iliac lymph nodes. ”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
137
What is the biological behavior of Sertoli cell tumors? Where are they most commonly observed?
“Dogs with Sertoli cell tumors often have signs of hyperestrogenism (Box 26.33), especially those with large tumors. Signs regress with castration and tumor removal. Persistence or recurrence of clinical signs suggests estrogen-producing metastasis. Sertoli cell tumors have a higher rate of metastasis than other testicular tumors.”
“They are more common in cryptorchid than scrotal testes. ”
“Sertoli cell tumors producing excess estrogens may cause squamous metaplasia of the prostate, feminization, and/or myelotoxicity.”
138
List 8 clinical signs associated with hyperestrogenism due to Sertoli cell tumors
“Bilateral symmetrical alopecia
Brittle hair
Poor hair regrowth
Thin skin
Hyperpigmentation
Nipple elongation
Mammary enlargement
Penile atrophy
Preputial swelling and sagging
Squatting micturition
Reduced libido
Male attraction
Testicular atrophy
Prostatic atrophy or cystic enlargement
Anemia
Thrombocytopenia or neutropenia”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
139
Interstitial cell tumors (Leydig) Are typically benign, soft encapsulated and rarely ever exceed 2 cm in diameter. What clinical signs / concomitant disorders are typically associated with these tumors?
“Dogs with interstitial cell tumors may be infertile. These tumors produce androgens or contribute to androgenic hormone imbalance. Perineal hernia, perianal adenomas and hyperplasia, and prostatic disease have been associated with interstitial cell tumors.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
140
What tumors are cryptorchid dogs predisposed to? How many more times are these dogs likely to develop testicular tumors as compared to non-cryptorchid dogs?
“Cryptorchidism predisposes to Sertoli cell tumors and seminomas. Cryptorchid dogs are 13.6 times more likely to develop testicular tumors than normal dogs. ”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
141
What dog breeds are particularly predisposed to scrotal mast cell tumors?
“Dogs predisposed to scrotal MCTs include English bulldogs, English bull terriers, boxers, Boston terriers, and American pit bull terriers.14”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
142
Sertoli cell tumors and seminoma‘s because hyperestrogenism. What clinical pathologic abnormalities can you expect as a result of this paraneoplastic syndrome?
“Hematology, serum biochemistry panel, and urinalysis are indicated in animals with scrotal or testicular tumors. Nonregenerative anemia, leukopenia, and thrombocytopenia may be associated with hyperestrogenism and myelotoxicosis. ”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
143
How is TVT treated?
“TVTs are treated with vincristine (0.5 mg/m2 IV or 0.025 mg/kg up to 1 mg IV) weekly for 3 to 6 weeks. Alternatively, radiation therapy is effective against TVTs resistant to chemotherapy and at metastatic sites.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
144
What CBC abnormalities are frequently associated with cardiac or splenic hemangiosarcoma?
“increased numbers of circulating nucleated red blood cells or large numbers of acanthocytes are suggestive of cardiac or splenic hemangiosarcoma. ”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
145
What is the biological behavior of canine chemodectomas? What is the prognosis with versus without pericardiectomy?
“Chemodectomas are slow-growing tumors, and long-term palliation with pericardiectomy and primary mass excision is possible. Regardless of the presence or absence of pericardial effusion at the time of surgery, dogs with aortic body tumors survive significantly longer if a pericardiectomy is performed (median survival, 730 days) than if one is not done (median survival, 42 days).”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
146
What are the two most common cardiac neoplasms in dogs?
“right atrial hemangiosarcoma and heart base chemodectoma”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
147
What are the two most common cardiac neoplasms in cats?
“Lymphosarcoma and metastatic neoplasia are the most frequent causes of cardiac neoplasia in cats.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
148
What is the most common clinical consequence of chemodectomas? Is there a risk factor known to predispose a patient the development of this condition? When are these tumors typically diagnosed?
“Residence at altitude and chronic hypoxia probably increase the risk for developing these tumors. Chemodectomas can cause pericardial effusion, which probably accounts for the most common clinical presentation of this disease. However, chemodectomas just as often are an incidental finding in older dogs undergoing thoracic radiography or echocardiography for other reasons.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
149
What is the reported median survival for dogs with right atrial hemangiosarcoma treated via surgery alone?
“Median survival after surgery alone is approximately 4 months.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
150
List 8 radiographic features of appendicular osteosarcomas
“Features of an aggressive bony lesion may include one or all of the following (see Figure 21.1A–D): a
- loss of fine trabecular detail of the metaphyseal bone due to lysis, - - discontinuity of the cortex, periosteal new bone formation
- Codman's triangle
- palisading mineralization perpendicular to the bone shaft ('sunburst effect’)
- extension of a mass into the adjacent soft tissues
- indistinct transitional zone between tumour and normal bone
- inappropriate areas of sclerosis
- pathological fracture
Excerpt From
Small Animal Oncology E-Book
Susan M. North BSc(Hons), PhD, DVM, DipACVIM(Med Onc), DipECVIM-CA(Int Med and Med Onc), MRCVS & Tania Ann Banks BVsc, FACVSc(Small Animal Surgery), MRCVS
https://books.apple.com/us/book/small-animal-oncology-e-book/id582697699
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151
Specificity and sensitivity of Jamshidi bone biopsy for appendicular osteosarcoma
92% specific
82% sensitive
152
What is the sensitivity and specificity of FNA cytology for osteosarcoma according to Britt et al 2007?
“sensitivity of 97% and a specificity of 100% in 32 of 36 cases. When a diagnosis of sarcoma was made on cytology (Figure 21.4), ALKP staining indicated OSA, with a sensitivity of 100% (Britt et al 2007).”
Excerpt From
Small Animal Oncology E-Book
Susan M. North BSc(Hons), PhD, DVM, DipACVIM(Med Onc), DipECVIM-CA(Int Med and Med Onc), MRCVS & Tania Ann Banks BVsc, FACVSc(Small Animal Surgery), MRCVS
https://books.apple.com/us/book/small-animal-oncology-e-book/id582697699
This material may be protected by copyright.
153
What is the reported response (improved limb function) for dogs with appendicular osteosarcoma treated via radiotherapy? What is the median duration of improvement?
“Response (improvement in limb function) occurs in 75–92%, for variable durations (Green et al 2002, Ramirez et al 1999). Reported response duration ranges from 17 to 288 days (median 130 days).”
Excerpt From
Small Animal Oncology E-Book
Susan M. North BSc(Hons), PhD, DVM, DipACVIM(Med Onc), DipECVIM-CA(Int Med and Med Onc), MRCVS & Tania Ann Banks BVsc, FACVSc(Small Animal Surgery), MRCVS
https://books.apple.com/us/book/small-animal-oncology-e-book/id582697699
This material may be protected by copyright.
154
How does chemotherapy affect the MST of patients with appendicular OSA?
“irrespective of the protocol employed, the MST remains in the order of 300–365 days with 2-year survival times at 20–25% (Berg et al, 1992 and Berg, Gebhardt, Rand, 1997, Bergman et al 1996, Chun et al 2005, Kent et al 2004, Mauldin et al 1988). ”
Excerpt From
Small Animal Oncology E-Book
Susan M. North BSc(Hons), PhD, DVM, DipACVIM(Med Onc), DipECVIM-CA(Int Med and Med Onc), MRCVS & Tania Ann Banks BVsc, FACVSc(Small Animal Surgery), MRCVS
https://books.apple.com/us/book/small-animal-oncology-e-book/id582697699
This material may be protected by copyright.
155
Most common site of metastasis for nasal tumors
“The most common site of metastasis is the brain, followed in decreasing order of frequency by regional lymph nodes, lungs, and liver. ”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
156
What are the four basic radiographic projections required for the initial evaluation of nasal tumors?
“Lateral, dorsoventral, open-mouth ventrodorsal, and frontal sinus views are suggested. ”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
157
What precaution regarding airways should always be observed before obtaining nasal tumor biopsies?
“Finding a mass that is not fungal (e.g., cryptococcosis) is strongly suggestive of neoplasia. Biopsies of these masses are sometimes associated with hemorrhage, and a cuffed endotracheal tube is mandatory. Bleeding typically stops within 5 minutes, but the back of the pharynx should be manually cleaned out before the endotracheal tube is removed. Rare tumors (e.g., intravascular lymphoma) can bleed so severely as to be life-threatening.”
“If the hemorrhage is worrisome, insert a nasal tampon into the affected nostril for 10 to 15 minutes. Be sure that hemorrhage has stopped before waking the patient, and clean out the pharynx before removing the endotracheal tube.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
158
What is Feline lung-digit syndrome?
Caused by primary bronchial or bronchioalveolar adenocarcinomas. Metastasis found on the distal phalanges of multiple digits and in multiple limbs, particularly weight-bearing digits.
159
Common clinical signs associated with pulmonary neoplasia
Non-productive cough
Lameness (HO in dogs; lung-digit syndrome in cats)
Weight loss
Hemostysis
Exercise intolerance
160
From a diagnostic point of view, what are the recommended diagnostic modalities to diagnose primary and metastatic neoplasia in dogs and cats?
3-view radiography (VD, LR, LL)
CT (ideal)
FNA cytology (US or CT-guided)
161
Recommended surgical treatment for solitary lung tumor
Lung lobectomy with lymph node biopsy
Partial lobectomy only recommended when tumor located on the periphery of the lobe.
162
Prognosis for primary, well-differentiated, non metastasized lung tumors in dogs Vs cats
Dogs: favorable if no LN metastasis. Two year MST 50%
Cats: poor because most tumors are aggressive. MST 150 days of already exhibiting clinical signs at the time of diagnosis Vs 500-700 days if still asymptomatic.
163
What is the prognosis for dogs with rib osteosarcoma following wide surgical excision and adjuvant chemotherapy.
Guarded (MST 300 days)
164
Prognosis for dogs with rib chondrosarcoma treated with surgery alone
Good
165
What is the most common SECONDARY digital tumor of cats? Prognosis?
“Aside from squamous cell carcinoma and fibrosarcoma, digital tumors in cats can also be metastatic, most commonly from pulmonary adenocarcinoma. These tumors typically involve weight-bearing digits and can involve more than one toe. Cats with digital tumors should be carefully evaluated for primary disease. Prognosis for digital tumors in cats is guarded. Median survival in cats with digital squamous cell carcinoma is 73 days, whereas cats with metastatic lesions have similarly poor survival.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
166
Most common digital tumors of dogs and average MST
“Squamous cell carcinomas, malignant melanomas, soft tissue sarcomas, osteosarcomas, and mast cell tumors are common digital tumors. Squamous cell carcinomas, mast cell tumors, and melanomas arising in the subungual epithelium are aggressive and sometimes metastatic. Black dogs are predisposed to subungual squamous cell carcinomas. The 1-year survival rate after digital amputation varies from 45% to 100%, depending on the tumor type; digital melanomas have a median survival of 1 year.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
167
Overall prognosis and MST for canine mammary inflammatory carcinoma
“Inflammatory carcinomas warrant a very poor prognosis, with a median survival time (MST) of 25 days with palliative care ”
Excerpt From
Small Animal Oncology E-Book
Susan M. North BSc(Hons), PhD, DVM, DipACVIM(Med Onc), DipECVIM-CA(Int Med and Med Onc), MRCVS & Tania Ann Banks BVsc, FACVSc(Small Animal Surgery), MRCVS
https://books.apple.com/us/book/small-animal-oncology-e-book/id582697699
This material may be protected by copyright.
168
What is the percentage influence of spaying in the development of mammary neoplasia?
“The risk of developing mammary cancer if spayed prior to first heat is 0.05%, 8% after 1st, and 26% after 2nd, compared to intact dogs (Schneider et al 1969). OHE after four or more cycles or greater than 2.5 years of age has little or no protective effect on the development of malignant mammary tumours (Misdorp 1988, Schneider et al 1969)”
Excerpt From
Small Animal Oncology E-Book
Susan M. North BSc(Hons), PhD, DVM, DipACVIM(Med Onc), DipECVIM-CA(Int Med and Med Onc), MRCVS & Tania Ann Banks BVsc, FACVSc(Small Animal Surgery), MRCVS
https://books.apple.com/us/book/small-animal-oncology-e-book/id582697699
This material may be protected by copyright.
169
Tissue origin, biological behavior and prognosis for Lymphangiosarcoma
“Lymphangiosarcomas are malignant tumors that arise from lymphatic capillaries. They are locally aggressive, and metastasis to regional lymph nodes, lungs, spleen, kidneys, and bone marrow has been reported. Even without metastasis, the local invasiveness of this tumor may necessitate amputation or euthanasia.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
170
Origin and typical biological behavior of lymphangiomas
“Lymphangiomas are rare, nonmalignant abnormalities originating from lymphatic capillaries that present as fluid-filled spaces or masses in the skin or deeper tissues. In humans, they are generally diagnosed before the age of 2 years and are most commonly found on the head and neck. ”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
171
What is the overall prognosis for dogs with ovarian tumors?
“The prognosis of all types of ovarian tumors is very similar. When single, nonmetastasized tumors are completely excised, the prognosis is good. Chemotherapy may lengthen survival times in canine patients with metastatic disease”
Excerpt From
Veterinary Surgery: Small Animal Expert Consult
Spencer A. Johnston VMD, DACVS & Karen M. Tobias DVM, MS, DACVS
https://books.apple.com/us/book/veterinary-surgery-small-animal-expert-consult/id1250368401
This material may be protected by copyright.
172
Feline ovarian tumors - most common, typical biological behavior, prognosis
“As with dogs, feline ovarian tumors are of epithelial, germ cell, or sex cord stromal origin. Sex cord stromal tumors are most commonly reported, and more than 50% of granulosa cell tumors are malignant in cats.218,289,352 As in dogs, feline granulosa cell tumors are often large and unilateral and produce hormones. They metastasize to peritoneum, lumbar lymph nodes, omentum, diaphragm, kidney, spleen, liver, and lungs.9,154,289 Dysgerminomas constitute approximately 15% of feline ovarian tumors. They are not hormone producing and are slow to metastasize but do so in up to 33% of cases.154 Epithelial tumors are rare in cats.154,289 The prognosis in cats with ovarian tumors is unknown but is likely similar to other species.”
Excerpt From
Veterinary Surgery: Small Animal Expert Consult
Spencer A. Johnston VMD, DACVS & Karen M. Tobias DVM, MS, DACVS
https://books.apple.com/us/book/veterinary-surgery-small-animal-expert-consult/id1250368401
This material may be protected by copyright.
173
The reported incidence of uterine tumors among intact dogs is 0.4%. What are the most common benign and malignant uterine tumors in dogs? Approximate incidence of each and prognosis?
“The majority of canine uterine tumors are benign and of mesenchymal origin. Leiomyomas represent 90% of the mesenchymal tumors, and leiomyosarcomas represent most of the remaining 10%. Rarely, other mesenchymal or epithelial tumors are reported, including fibroma, lipoma, liposarcoma, primary lymphoma, uterine adenocarcinoma, and endometrial carcinoma.
“The prognosis for benign uterine tumors in dogs is excellent because ovariohysterectomy is curative. For malignant tumors the prognosis is good unless metastatic disease is present or the tumor is not completely excised, in which case the prognosis is grave.”
Excerpt From
Veterinary Surgery: Small Animal Expert Consult
Spencer A. Johnston VMD, DACVS & Karen M. Tobias DVM, MS, DACVS
https://books.apple.com/us/book/veterinary-surgery-small-animal-expert-consult/id1250368401
This material may be protected by copyright.
174
Most common uterine tumor of cats, including biological behavior and prognosis
“In contrast to those in dogs, uterine tumors in cats are generally adenocarcinomas or of endometrial origin. Benign and malignant mesenchymal and round cell tumors have also been reported.352 Clinical signs may include vaginal discharge and abnormal estrus. General signs such as polydipsia, polyuria, and vomiting have also been observed.218 Cats are more likely to have metastatic disease than dogs, and preoperative staging with thoracic radiographs and abdominal ultrasonography is indicated. Metastasis in cats has been reported to the brain, eyes, ovaries, adrenal glands, lungs, liver, kidneys, bladder, colon, diaphragm, and regional lymph nodes. Disease is often advanced at the time of diagnosis, and the prognosis in cats is guarded because of the risk for metastasis. Adjunctive treatment has not been evaluated.”
Excerpt From
Veterinary Surgery: Small Animal Expert Consult
Spencer A. Johnston VMD, DACVS & Karen M. Tobias DVM, MS, DACVS
https://books.apple.com/us/book/veterinary-surgery-small-animal-expert-consult/id1250368401
This material may be protected by copyright.
175
What precaution should be taken when biopsying oral masses?
“Avoid areas of superficial necrosis when obtaining biopsies; sample deeper, viable tissues instead.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
176
Most common tonsilar tumors of dogs and cats. Response to surgical resection as sole method of treatment?
“Squamous cell carcinoma (SCC) and lymphosarcoma are the most common tumors of the tonsils, and neither are generally cured.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
177
Most common lingual tumors of dogs (4)
“The most common lingual tumor is SCC (Fig. 18.14), but others include malignant melanoma, granular cell myeloblastoma, and mast cell tumor.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
178
Most common salivary gland tumors of dogs and cats. Glands most commonly affected
“Neoplasms (usually adenocarcinomas or carcinomas) occur most frequently in the parotid (~50% dogs, ~20% cats) and the mandibular (~30% dogs, ~60% cats) salivary glands. ”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
179
List 4 tumors frequently associated with HO
“HO can affect all four limbs. It can be a paraneoplastic syndrome (e.g., primary and metastatic lung tumors, esophageal carcinoma, rhabdomyosarcoma of the bladder, anal sac adenocarcinoma, renal transitional cell carcinoma, nephroblastoma)”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewBook?id=1367916984
This material may be protected by copyright.
180
Prognosis for Hypertrophic Osteopathy
“The prognosis depends on the possibility for complete resolution of the underlying disease process. If the primary disease can be resolved, the secondary HO often resolves. Although clinical signs often disappear within 1 to 2 weeks after treatment, bone lesions may take months to remodel.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewBook?id=1367916984
This material may be protected by copyright.
181
Physical examination and radiographic findings in patients with HO
“Physical Examination Findings
Affected limbs are warm and swollen. Because this condition occurs secondary to diseases elsewhere in the body, an effort should be made to identify the underlying causative factors. A thorough physical examination is essential when evaluating affected animals.
Diagnostic Imaging
Radiographs of the limbs reveal a uniform periosteal proliferation, which is seen initially on the phalanges and metacarpal and metatarsal bones (Fig. 36.3). As the disease progresses, periosteal proliferation progresses proximally (i.e., radius/ulna and tibia/fibula). Articular surfaces of long bones are usually spared and appear normal.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
182
Craniomandibular osteopathy - most commonly affected breeds and associations
“The cause of craniomandibular osteopathy is unknown. It is most often recognized in West Highland white terriers, Cairn terriers, and Scottish terriers. A genetic predisposition is suspected in many breeds; in West Highland white terriers, it is thought to have an autosomal recessive inheritance pattern. A similar syndrome (calvarial hyperostotic syndrome) has been reported in bullmastiffs. Craniomandibular osteopathy has been associated with canine leukocyte adhesion deficiency in Irish setters. A link to canine distemper virus has been postulated but is not supported by epidemiologic studies.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
183
Multiple cartilaginous exostosis (MCE or osteochondromatosis) - when is it typically observed in cats Vs dogs?
“Multiple cartilaginous exostosis (MCE, or osteochondromatosis) is a histologically benign disease of cats that occurs after skeletal maturity, in contrast to dogs, in which the disease occurs before growth plate closure ”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
184
OSA accounts for what percentage of all bone tumors?
“75% of all bone tumors”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
185
Name 4 benign bone tumors of dogs and cats
osteoma
ossifying fibroma
multilobular osteomas
Chondromas
osteochondromas
enchondromas
chondromas
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
186
Axial OSA -
- biological behavior
- site where it tends to be less metastatic
- typical recommended therapy
- prognosis (median survival and one year MST)
- Highly metastatic, local recurrence except for mandible, which is slower to metastasize
- Local resection of tumor (i.e., mandible and rib) + Carboplatin, local radiation as adjunct to surgery to reduce local recurrence
- Median survival time is ~22 wk, 1-y survival is ~25%, rate of tumor recurrence is ~67%”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
187
What is the biological behavior, overall prognosis and recommended therapy of chondrosarcoma and fibrosarcoma?
Accounts for 5 to 10% of skeletal tumors
Slow to metastasize
Treatment typically involves amputation or limb sparing procedures. Chemotherapy (doxorubicin) may be a benefit after metastatic fibrosarcoma
Prognosis fibrosarcoma is poor, but may be fair for a low-grade tumors
Prognosis chondrosarcoma is good with surgical treatment
188
Most common primary bone tumor of cats, recommended therapy and prognosis
Osteosarcoma (70-80% of primary bone tumors)
Amputation
MST 12-50 months
189
Multiple cartilaginous exostosis (osteochondromatosis) in cats - causes, typical signalment, presentation, prognosis
Cause: Uncommon, usually feline leukemia virus (FeLV) positive (benign physeal lesion in dogs)
Presentation: Multiple sites common; scapula, vertebra, mandible in cats, (physeal in dogs). Affects adult cats (juvenile in dogs)
Treatment: Palliative removal of painful lesions
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
190
Canine appendicular OSA - % of patients with pulmonary metastasis at diagnosis Vs at time of euthanasia at 1 year
“Although fewer than 15% of affected dogs have radiographically detectable thoracic metastases at presentation, 90% die or are euthanized within 1 year of diagnosis because of complications associated with pulmonary metastasis.4,6 Improved chances for survival are possible with amputation (see p. 1303) or limb-sparing procedures (see p. 1305) combined with chemotherapy.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
191
Typical signalment for dogs with OSA
Large- and giant-breed dogs have the greatest incidence of appendicular bone neoplasia. The median age of dogs with osteosarcoma is 7 years; however, a small, early peak is seen in dogs 18 to 24 months of age.
Large size is a greater determinant of risk than breed, although greyhounds, Rottweilers, and Great Danes have been shown to be at increased risk.
Males may be slightly more commonly affected than females. Primary bone tumors of the axial skeleton are more common than appendicular tumors in small breed dogs; the median age of affected animals is 8 to 9 years.
The mean age of osteosarcoma in cats is 8 to 10 years.
No apparent breed or sex predilection has been identified in either species for tumors of the axial skeleton.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
192
Common clinical presentation and sites for MCE in cats
“MCE may result in pain and rapidly progressive swelling. Common sites for MCE include the spine, scapula, and mandible.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
193
Radiographic abnormalities associated with appendicular OSA
“Radiographic signs of osteosarcoma include cortical and trabecular bone lysis, periosteal bone proliferation, and soft tissue swelling”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
194
What us the sensitivity of radiographs for pulmonary nodules in patients with OSA? What other diagnostic modality is considered more sensitive if available?
“Systemic staging is critical for proper decision making in animals with skeletal neoplasia. Thoracic radiography or CT is indicated. Pulmonary nodules must be 6 to 8 mm in diameter to be detected by radiography; CT is more sensitive in the detection of pulmonary disease ”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
195
Canine appendicular OSA - is regional LN sampling considered part of standard clinical staging?
“Spread to regional lymph nodes is rare, and fine-needle aspiration is not indicated unless an enlarged lymph node is recognized clinically.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
196
List 6 differential diagnosis for suspected primary bone cancer like OSA
bacterial osteomyelitis
fungal osteomyelitis
metastatic bone tumor (e.g., prostatic carcinoma)
direct extension of soft tissue tumors (e.g., nail bed carcinomas)
hypertrophic pulmonary osteopathy
bone infarcts
hypervitaminosis A
periosteal response to trauma
aneurysmal bone cysts
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
197
What condition is radiographically indistinguishable from OSA? What diagnostic should be performed before considering amputation?
“Perform fine-needle aspiration or another biopsy technique before amputating a leg because fungal and neoplastic lesions can be radiographically indistinguishable.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
198
List 5 important principles pertaining to bone biopsies
• Obtain samples from the radiographic center of tumors
• Obtain multiple samples
• Take radiographs after biopsy to confirm biopsy site.
• Using Jamshidi needles may reduce the risk of pathologic fracture.
• Have pathologists with expertise in evaluating bone biopsies perform histology.
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
199
Eyelid tumors in dogs - usually malignant or benign? List 4 of the most common eyelid tumors in dogs, overall percentage of malignancies and most common types.
“Roberts et al (1986) reported that 88% of eyelid neoplasms in dogs were sebaceous tarsal gland adenomas, benign melanomas or papillomas, and that malignant tumours (melanoma, adenocarcinoma, basal cell carcinoma, mast cell tumour, squamous cell carcinoma, haemangiosarcoma and myoblastoma) comprised only 8.2%. Other malignant eyelid tumours in dogs include lymphoma (LSA) and fibrosarcoma (FSA).”
Excerpt From
Small Animal Oncology E-Book
Susan M. North BSc(Hons), PhD, DVM, DipACVIM(Med Onc), DipECVIM-CA(Int Med and Med Onc), MRCVS & Tania Ann Banks BVsc, FACVSc(Small Animal Surgery), MRCVS
https://books.apple.com/us/book/small-animal-oncology-e-book/id582697699
This material may be protected by copyright.
200
Adrenal tumors in cats - most common clinical presentation and tumor types; prognosis (MST) with surgery is operable
Clinical signs typically derive from hyperaldosteronism, leading to severe hypokalemia and hypernatremia. Most common clinical signs include weakness, cervical ventroflexion, dysphagia, hyphema, retinal hemorrhages and blindness (due to hypertension caused by hypernatremia)
Most commonly adenomas or carcinomas
MST w/surgery for adenoma: 45 months
MST w/surgery for carcinoma: 7 months
201
Name five common BENIGN lip neoplasms of dogs
• benign ceruminous gland adenoma
• basal cell tumor
• hemangioma
• histiocytoma
• cornifying epithelioma.
202
Name four common MALIGNANT lip neoplasms of dogs
• melanoma
• quamous cell carcinoma
• mast cell tumor
• various types of sarcomas.
203
Oral tumors - most common epithelial (3), melanocitic (1), mesenchymal (5) and miscellaneous (3)
Epithelial: Squamous Cell Carcinoma, intraosseous carcinoma and invasive nasal carcinoma
Melanocytic: Malignant Melanoma
Mesenchymal: fibrosarcoma, hemangiosarcoma, osteosarcoma, chondrosarcoma, multilobular osteochondrosarcoma
Miscellaneous: TVT, MCT, lymphoma
204
Odontogenic tumors - list one epithelial, one mesenchymal and three periodontal
odontogenic ameloblastoma (epithelial)
odontogenic fibroma (mesenchymal)
acanthomatous epulis (periodontal), ossifying epulis (periodontal), and fibromatous epulis (periodontal)
205
Describe the TNM staging system for canine oral tumors as proposed by the WHO
“Stage Characteristics
T – Primary tumour
T0 No evidence of tumour
Tis Carcinoma in situ
T1 <2 cm (1a = no bony invasion, 1b = bony invasion)
T2 2–4 cm (2a, 2b)
T3 >4 cm (3a, 3b)
N – Regional lymph nodes
N0 No regional lymph node (RLN) involvement
N1 Movable ipsilateral RLN (N1a = no tumour cells, N1b = tumour cells)
N2 Movable contralateral or bilateral RLN (N2a, N2b)
N3 Fixed RLN
M – Distant metastasis
M0 No distant metastasis
M1 Distant metastasis”
Excerpt From
Small Animal Oncology E-Book
Susan M. North BSc(Hons), PhD, DVM, DipACVIM(Med Onc), DipECVIM-CA(Int Med and Med Onc), MRCVS & Tania Ann Banks BVsc, FACVSc(Small Animal Surgery), MRCVS
https://books.apple.com/us/book/small-animal-oncology-e-book/id582697699
This material may be protected by copyright.
206
Briefly explain stereotactic radiation therapy
“Stereotactic radiation therapy involves three-dimensional localization of the neoplasm with imaging following immobilization of the part of the patient to be radiated.90 Multiple beams of radiation are administered from different directions to deliver a high dose to a more localized area (small lesions), typically as one to a few treatments.”
Excerpt From
Veterinary Surgery: Small Animal Expert Consult
Spencer A. Johnston VMD, DACVS & Karen M. Tobias DVM, MS, DACVS
https://books.apple.com/us/book/veterinary-surgery-small-animal-expert-consult/id1250368401
This material may be protected by copyright.
207
What are the four types of neoplasia affecting the central nervous system which are most likely to respond to chemotherapy?
“lymphoma, leukemias, multiple myeloma, and disseminated histiocytic sarcoma,”
Excerpt From
Veterinary Surgery: Small Animal Expert Consult
Spencer A. Johnston VMD, DACVS & Karen M. Tobias DVM, MS, DACVS
https://books.apple.com/us/book/veterinary-surgery-small-animal-expert-consult/id1250368401
This material may be protected by copyright.
208
Discuss the primary use for bisphosphonates, mechanism of action and adverse effects
“Bisphosphonates may be useful in the treatment of neoplasms that cause bone lysis. These drugs inhibit bone resorption without inhibiting mineralization primarily through induction of osteoclast apoptosis, resulting in decreased osteolysis, stabilized or improved mineralization, and pain relief.48,110 In vitro studies of canine osteosarcoma have shown that bisphosphonates may have anticancer benefits as well.6,50,138 The most commonly used bisphosphonates in veterinary oncology are pamidronate (Aredia, Novartis Pharma) and zoledronate (Zometa, Novartis Pharma). Pamidronate is administered as an intravenous (IV) infusion every 4 weeks at a dose of 1 to 2 mg/kg. Pamidronate has been reported to cause both tubular and glomerular nephrotoxicity in people,133 and preclinical studies in dogs demonstrated a dose- and infusion-length–dependent nephropathy.”
Excerpt From
Veterinary Surgery: Small Animal Expert Consult
Spencer A. Johnston VMD, DACVS & Karen M. Tobias DVM, MS, DACVS
https://books.apple.com/us/book/veterinary-surgery-small-animal-expert-consult/id1250368401
This material may be protected by copyright.
209
What kind of non-spinal neoplasia is most likely to cause spinal cord disfunction? What is the most common type of tumor?
Vertebral neoplasia; osteosarcoma
210
Most vertebral tumors in dogs are primary tumors, with osteosarcoma (most common), fibrosarcoma and Chondrosarcoma comprising most cases.
What are the most common origins/types of secondary tumors that may affect the vertebral column?
“The most commonly identified metastatic neoplasms are either vascular in origin (e.g., hemangiosarcoma) or epithelial (thyroid, mammary, prostatic, and urinary [transitional cell]) in origin.58,114”
Excerpt From
Veterinary Surgery: Small Animal Expert Consult
Spencer A. Johnston VMD, DACVS & Karen M. Tobias DVM, MS, DACVS
https://books.apple.com/us/book/veterinary-surgery-small-animal-expert-consult/id1250368401
This material may be protected by copyright.
211
What is the radiographic appearance of multiple myeloma affecting spinal vertebrae?
“Radiographically, multiple myeloma is characterized by multifocal well-circumscribed lytic lesions affecting multiple vertebrae (Figure 37.2).66,155”
Excerpt From
Veterinary Surgery: Small Animal Expert Consult
Spencer A. Johnston VMD, DACVS & Karen M. Tobias DVM, MS, DACVS
https://books.apple.com/us/book/veterinary-surgery-small-animal-expert-consult/id1250368401
This material may be protected by copyright.
212
Typical MRI appearance of vertebral tumors on T1 and T2 weighed images
“In comparison to normal vertebrae, lesions are often hypointense on T1-weighted (T1W) images, hyperintense on T2-weighted (T2W) images, and demonstrate variability in enhancement after intravenous contrast administration.”
Excerpt From
Veterinary Surgery: Small Animal Expert Consult
Spencer A. Johnston VMD, DACVS & Karen M. Tobias DVM, MS, DACVS
https://books.apple.com/us/book/veterinary-surgery-small-animal-expert-consult/id1250368401
This material may be protected by copyright.
213
Is spinal lymphoma in the dog and in the cat most likely to be extradural, intradural-extramedullary or intramedullary? How can a presumptive diagnosis usually be achieved in these cases?
Extradural
“A presumptive diagnosis of lymphoma may be reached by identifying circulating neoplastic lymphocytes with routine hematology or observing neoplastic lymphocytes with cytological evaluation of bone marrow, affected organs, cerebrospinal fluid, or lymph node specimens.”
Excerpt From
Veterinary Surgery: Small Animal Expert Consult
Spencer A. Johnston VMD, DACVS & Karen M. Tobias DVM, MS, DACVS
https://books.apple.com/us/book/veterinary-surgery-small-animal-expert-consult/id1250368401
This material may be protected by copyright.
214
What is the etiology (cell line) of histiocytic sarcoma complex? Where are the cells typically found and where are they not naturally found?
“Histiocytic sarcoma is the neoplastic proliferation of cells of the dendritic or macrophage lineage. Because dendritic cells exist in all tissues and organs except the central nervous system (although found in the meninges), histiocytic sarcoma can arise in nearly every tissue and organ. ”
Excerpt From
Veterinary Surgery: Small Animal Expert Consult
Spencer A. Johnston VMD, DACVS & Karen M. Tobias DVM, MS, DACVS
https://books.apple.com/us/book/veterinary-surgery-small-animal-expert-consult/id1250368401
This material may be protected by copyright.
215
From what tissue do myxomas (benign) and myxosarcomas (malignant) arrives?
Synovium
216
Where do myxosarcomas typically arise from when affecting the spinal cord?
Zygapophyseal joints
217
What are the three types of mineralization of soft tissues and their most common causes?
“Mineralization of the soft tissues can be classified into three types: metastatic, dystrophic, and idiopathic.
- Metastatic mineralization is secondary to abnormal calcium and/or phosphorous homeostasis; in general, mineralization of soft tissues is widespread.
- Dystrophic mineralization occurs in animals with normal calcium homeostasis in tissues that have been damaged by a pathological process (i.e., tissues devitalized by trauma, necrosis, inflammation/infection, or neoplasia).
- Idiopathic mineralization occurs in animals with normal calcium homeostasis in which mineralization occurs in normal tissues.
* Dystrophic and idiopathic mineralization occurs most commonly in animals. A fourth type, iatrogenic, has also been described in which the mineralization occurs secondary to a surgical procedure, suture material, or repeated injections at a single site. ”
218
What is the most common primary nervous system neoplasm of the spinal cord of the dog? What tissues does it typically arise from?
“Meningiomas arise from the meningothelial cells of the arachnoid membrane or pia mater. Meningioma is the most common primary nervous system neoplasm of the spinal cord in the dog.”
Excerpt From
Veterinary Surgery: Small Animal Expert Consult
Spencer A. Johnston VMD, DACVS & Karen M. Tobias DVM, MS, DACVS
https://books.apple.com/us/book/veterinary-surgery-small-animal-expert-consult/id1250368401
This material may be protected by copyright.
219
What is the typical biological behavior of nerve sheath neoplasms in the dog?
“In dogs, most nerve sheath neoplasms behave in a similar way to soft tissue sarcoma.85 Nerve sheath neoplasms are locally aggressive, infiltrating the nerve proximally and distally, but generally associated with a low rate of distant metastasis.16,19,24,84 Based on their biological behavior and histologic characteristics, most nerve sheath neoplasms in dogs are malignant.”
Excerpt From
Veterinary Surgery: Small Animal Expert Consult
Spencer A. Johnston VMD, DACVS & Karen M. Tobias DVM, MS, DACVS
https://books.apple.com/us/book/veterinary-surgery-small-animal-expert-consult/id1250368401
This material may be protected by copyright.
220
What is the typical Signalment and presentation for dogs with nerve sheath neoplasms?
Large breed, middle age to early senior, no gender predisposition
Progressive and typically unilateral limb lameness over a long period (typically over 6 months). The degree of discomfort may be variable from mild to severe. Clinical signs may be initially bilateral and then progressed to unilateral. Paresis/plegia may eventually develop but is less common. Pain or manipulation of the affected limb is common.
Thoracic limbs are most commonly affected. Scapular muscle atrophy may be present. A mass may be palpable in the axillary region.
If the lesion affects the pelvic limb, a mass may be rectally palpable on ventrolateral aspect of the sacrum.
221
What is the most commonly affected breed, age and location for Extrarenal nephroblastomas?
German Shepherd and retrievers, 6 to 18 months of age, T10-L2
222
What is the theory for why extrarenal nephroblastoma‘s most commonly present in the T10 L2 region?
“Given the histologic resemblance to primitive nephrons, these neoplasms may arise from mesonephric or metanephric embryologic remnants that become entrapped in the developing dura and spinal cord.168 This explanation of the histogenesis helps account for the near exclusive occurrence of the lesion between the T10 and L2 vertebrae. ”
Excerpt From
Veterinary Surgery: Small Animal Expert Consult
Spencer A. Johnston VMD, DACVS & Karen M. Tobias DVM, MS, DACVS
https://books.apple.com/us/book/veterinary-surgery-small-animal-expert-consult/id1250368401
This material may be protected by copyright.
223
What are the 6 types of round cell neoplasms
HLMMPT
Histiocytic tumors
lymphoma
mast cell tumor
melanoma
plasma cell tumor
transmissible venereal tumor
224
Types of epithelial neoplasms
Carcinoma (nonglandular origin)
Adenocarcinoma (glandular)
225
What are the three tumors which if arising from the nailbed tend to be particularly aggressive and sometimes metastatic?
Squamous cell carcinomas, mast cell tumors, and melanomas arising in the subungual epithelium are aggressive and sometimes metastatic.
226
What kind of subungual tumor are black dogs predisposed to? What is the expected 1 year survival rate after digit amputation?
Squamous cells carcinoma, 45% to 100%
227
What is the median survival for patient diagnosed with subungual melanomas?
1 year
228
You are presented with a middle-age cat with digital tumors affecting two weight-bearing toes. What are the three most likely differential diagnosis? What is the prognosis?
Aside from squamous cell carcinoma and fibrosarcoma, digital tumors in cats can also be metastatic, most commonly from pulmonary adenocarcinoma. These tumors typically involve weight-bearing digits and can involve more than one toe. Cats with digital tumors should be carefully evaluated for primary disease. Prognosis for digital tumors in cats is guarded. Median survival in cats with digital squamous cell carcinoma is 73 days, whereas cats with metastatic lesions have similarly poor survival.
229
Canine eyelid neoplasms: what structures today typically arise from? Are they most commonly benign or malignant? What is the most common benign tumor in the most common malignancies observed? Roughly what percentage of tumors are benign versus malignant?
Eyelid neoplasms in dogs are most often associated with the meibomian glands (see Figs. 16.1 and 16.5B), and 70% to 80% are benign. Sebaceous adenomas and epitheliomas are the most common eyelid tumor in dogs; they sometimes grow rapidly. Malignant eyelid tumors are less common and include squamous cell carcinoma, sebaceous adenocarcinoma, basal cell carcinoma, and fibrosarcoma. Of the eyelid melanomas, approximately 60% are benign and 40% are malignant.
230
Eyelid neoplasms in cats - most likely benign or malignant? What is the most common type in what are the other possibilities?
In cats, eyelid neoplasms tend to be malignant, and squamous cell carcinomas (~60% of cases) are the most common. Others include fibrosarcoma, adenocarcinoma, basal cell carcinoma, melanoma, and hemangiosarcoma.
231
What diagnostic technique should always be performed when evaluating a case of entropion? Why?
Topical anesthetic desensitization (proparacaine). This is important to evaluate for spastic entropion which resolves spontaneously and does not require surgery (Typically a result of discomfort).
232
What is a Leukoma?
A white corneal scar
233
Why should ketamine be avoided during ophthalmic procedures?
Because it may cause undesirable eye movements.
234
What are the two main indications for a third eyelid flap?
Bullous keratopathy and indolent corneal ulceration
235
What is Haw’s syndrome? What species does it affect and what is it typically associated with? How can you confirm it?
Bilateral exposure or protrusion of the nictitating membranes, only observed in cats. Associated with gastrointestinal disease although the mechanism is unknown. Confirmed via phenylephrine testing
236
Describe the Seidel test and it’s purpose
Perform a Seidel test to determine if a corneal ulcer has reached full-thickness and ruptured. Fill a 3-mL syringe with sterile eye wash or LRS after removing the plunger. Dip the stained tip of the fluorescein strip into the solution repeatedly until the solution is a dark, dense yellow. Have an assistant drip the fluorescein solution onto the cornea ulcer site while you watch the area with magnification and a cobalt light. Alternatively, moisten the tip of a fresh sterile fluorescein strip with a full drop of sterile eye wash, and allow this drop to fall onto the top of the globe; monitor the site in question under magnification with a cobalt light. Observe to see whether a clear rivulet of aqueous humor is seen running through the fluorescein stain. A positive Seidel test indicates aqueous humor leakage and that the corneal ulcer has ruptured. If a corneal perforation is leaking, referral to an ophthalmologist is indicated because accurate evaluation and repair requires use of specialized skills and an operating microscope.
237
The three bones that compose the orbit
frontal, lacrimal, and zygomatic bones
238
What is the typical clinical sign of severe extraocular muscles tearing as a result of ocular proptosis?
marked dorsolateral strabismus
239
Pupil size is not always considered a good predictor of vision in patients with globe proptosis. List three or more positive prognostic indicators
Positive prognostic indicators include a brachycephalic dog signalment, intact direct and consensual pupillary light reflexes, intact vision (indicated by tracking of a thrown cotton ball or head retraction when the eye is menaced), a normal fundus appearance, and short duration of proptosis before treatment.16
240
The prognosis for vision in proptosis globes is guarded to pour. Globe retention and acceptable cosmesis are quite possible depending on the degree of damage in the level of care provided. Approximately what percentage of dogs and cats become blind after proptosis?
Blindness occurs in approximately 60% to 70% of dogs and in 100% of cats.
241
In the order from the tympanic membrane to the semi circular canals, what are the names of the three otic ossicles?
Malleus, incus and stapes
242
Describe the surgical approach for a ventral bulla osteotomy
In dogs, make a 7- to 10-cm incision (3–5 cm in cats) parallel to the midline of the animal and centered 2 cm toward the affected side from where these imaginary lines intersect (see Fig. 17.14A). Incise the platysma muscle, retract the linguofacial vein if necessary, and deepen the incision by bluntly dissecting the digastricus muscle (lateral) from the hyoglossus and styloglossus muscles (medial). Avoid damaging the hypoglossal nerve, located on the lateral aspect of the hyoglossus muscle. Confirm the location of the bulla and use self-retaining retractors (e.g., Gelpi, Weitlaner)
243
What are the two most common tumors affecting the palatine tonsils in the dog?
Squamous cell carcinoma and lymphosarcoma
244
What are the four most common tumors affecting the tongue of the dog?
Squamous cell carcinoma
Malignant melanoma
Granular Cell myeloblastoma
Mast cell tumor
245
How much of the tongue can be amputated and still very well tolerated in dogs?
Nearly the entire free tongue can be amputated without major problems (40 to 60%).
246
What are the general epidemiological facts regarding oral tumors in dogs and cats?
Fourth most common site of neoplasia and dogs and cats
2.6 times more likely to occur in dogs than cats
Males more commonly affected than females
247
What are the three most common oral tumors of dogs (in the order of most common to least common)
Malignant melanomas, squamous cell carcinoma, fibrosarcoma
248
 what is the most common oral tumor in dogs? Does it occur often in cats? Where in the mouth does it typically arise and what is the typical Signalment of affected dogs?
“• Melanoma is the most common malignant oral tumor in dogs (approximately 20%)
• Rare in cats
• Most common on gingiva
• More common in male dogs
• Mean age of affected animals is 9–11 years (average, 10.3 years)
• Breeds with pigmented oral mucosa, cocker spaniels, and German shepherds”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
249
What is the most common oral tumor in cats? Does it happen in dogs? Where does it typically arise and what is the typical biological behavior?
“• SCC Most common tumor in cats (approximately 70%)
• Second most common tumor in dogs (with fibrosarcoma) (approximately 15%)
• Occur on the gingiva, lip, tongue, or tonsil
• Biological behavior varies with location and species; regional lymph node involvement “is common with tongue and tonsillar squamous cell carcinomas”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
250
What are the main characteristics of oral fibrossarcomas in dogs?
“Second most common malignant oral tumors in dogs (with squamous cell carcinoma)
• Occur most commonly on the gingiva and hard palate
• More common in large breeds (>20 kg) and male dogs
• Younger dogs may be affected (mean age <7 years)
• Locally invasive; high metastatic potential in dogs <2 years of age”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
251
What are the main characteristics of the dog’s most common group of benign gingival tumor? What is the most common form?
“Most common oral tumor in dogs (approximately 30%)
• Mean age approximately 8.2 years
• More common in large-breed dogs (>20 kg)
• Do not metastasize
• Acanthomatous epulis is most common form”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
252
What population is most commonly affected by ameloblastoma‘s? What is the biological behavior?
“Ameloblastomas (adamantinoma) are benign tumors that arise from the dental lamina. They usually occur in younger dogs and involve the rostral mandible. Ameloblastomas develop as intraosseous tumors and are locally invasive and nonmetastasizing.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
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253
What are dentigerous cysts and what is their biological behavior?
“Dentigerous cysts appear as closed cavities or sacs with one or more teeth embedded in the cyst wall. They arise within islands of odontogenic epithelium and are described as benign, nonneoplastic lesions; however, they may represent an early stage of malignant epithelial tumor development.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
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254
What is the expected response to radiation therapy of SCC’s, fibrosarcoma and melanomas? What percentage of patients develop neoplasia secondary to radiation therapy?
“SCC’s are radiosensitive and are successfully treated by radiotherapy. Piroxicam is sometimes helpful in treating SCC. Fibrosarcomas are radioresistant. Melanomas may be sensitive to radiotherapy, but distant metastasis frequently renders it ineffective. Radiation-induced tumors occur in up to 20% of the irradiated sites.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
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255
What is the prognosis for feline oral squamous cell carcinoma?
“Cats with oral SCC have a poor prognosis, with a median survival time of approximately 2 months regardless of the form of therapy. ”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
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256
What is the prognosis for a canine oral melanoma? What percentage of dogs is still disease-free 1 year postop?
“Melanomas have the poorest prognosis because they metastasize early. Fewer than 20% of affected animals are disease-free 1 year after surgery. Median survival times vary from 8 to 10 months. Tumors arising from the tongue have a poor prognosis. They are controlled locally in only approximately one-fourth of animals 1 year after resection or radiation therapy. ”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
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257
Esophageal tumors are generally rare Regards and cats. When observed, what are the three most common types of tumors? What non-neoplastic parasitic condition can mimic cancer?
Sarcomas, squamous cell carcinoma and Leiomyomas.
Spirocerca lupi
258
Regarding hiatal hernia’s:
Typically acquired or congenital?
Predisposed breeds?
Typical clinical signs?
Easy to diagnose via radiographs? Why?
What surgical steps are typically taken to correct the issue?
What patients are typically treated via surgery versus conservative management?
What preoperative step must be observed?
Is the prognosis good or bad after repair?
“Most are congenital rather than acquired
• Shar peis and English bulldogs are most commonly affected
• Some are asymptomatic
• Symptomatic animals often have regurgitation and esophagitis
• Herniation may be intermittent, making radiographic diagnosis challenging
• Herniorrhaphy includes hiatal reduction, esophagopexy, and left-sided gastropexy
• Surgery is usually most appropriate for younger symptomatic animals; older symptomatic animals are usually best treated medically
• Treat for esophagitis initially after surgery
• Prognosis is usually good after repair”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
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259
What is the likelihood of metastasis for gastric neoplasm‘s at the time of diagnosis? How does this apply to leiomyomas and leyomyosarcomas?
“Most neoplasms in the gastric body, except for leiomyomas and leiomyosarcomas, have metastasized by the time they are diagnosed. ”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
260
G.I. adenocarcinoma in dogs and cats: Most common location for each species, three morphologic forms, most common clinical signs, mode of metastasis
“Adenocarcinomas are locally invasive and slow-growing. They most commonly arise in the duodenum and colon of dogs and in the distal jejunum and ileum of cats. These tumors have three main morphologic forms: (1) infiltrative adenocarcinomas cause a thickened stenotic area that obstructs the intestinal lumen; (2) ulcerative adenocarcinomas have a deep indurated mucosal ulcer with raised edges; and (3) proliferative adenocarcinomas are lobulated, expanding intraluminal masses. Mucosal ulceration may cause chronic bleeding, melena, and iron deficiency anemia. The tumors spread to adjacent serosal surfaces, mesentery, omentum, and regional lymph nodes by local invasion and may metastasize distally to the lungs and liver. Mucinous intestinal adenocarcinomas extend transmurally to the mesentery with accumulation of variable amounts of mucin.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
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261
Intestinal lymphosarcoma in dogs and cats: typical etiology in cats; what are the two intestinal types?
“In cats, they may be caused by FeLV or feline immunodeficiency virus (FIV), but most are caused by unknown mechanisms. The etiology in dogs is unknown. Affected animals may have multicentric disease. Lymphomas have two intestinal types: diffuse and nodular. Diffuse infiltration of the lamina propria and submucosa with neoplastic lymphocytes causes malabsorption and occasional deep ulceration. Nodular lymphoma is an expanding intestinal mass that causes obstruction, often but not invariably in the ileocecocolic area. Involvement of regional lymph nodes and other organs is common. Cats in particular may have intestinal lymphoma and no gross or ultrasonographic evidence of intestinal disease. Dogs typically have lymphoblastic lymphoma, whereas there are multiple forms of lymphoma in cats including small cell lymphoma, lymphoblastic lymphoma, epitheliotropic lymphoma, and large granular lymphoma.42”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
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262
What is the typical biological behavior of canine intestinal leiomyosarcoma’s? Where do they typically occur? How does the tumor spread? Is metastasis slow or fast? What is the expected median survival after surgical resection with or without metastasis?
“Intestinal leiomyosarcomas are slow-growing, malignant smooth muscle tumors of older dogs that usually occur in the cecum and jejunum. Neoplastic spread is by local invasion, and metastasis is slow. Metastasis occurs to the mesentery, mesenteric lymph nodes, peritoneum, and liver. Median survival of approximately 2 years is expected after resection of a localized lesion. This is also true of animals with metastasis at the time of surgery. ”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
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263
Breeds predisposed to lymphoma, adenocarcinoma and leiomyosarcoma’s of the G.I. tract
“Boxers, collies, and German shepherds”
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Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
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264
What are the three most common G.I. tumors of cats?
“lymphosarcomas are most common followed by adenocarcinomas and mast cell tumors”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
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265
What is the prognosis for dogs with localized intestinal adenocarcinoma or leiomyosarcoma completely excised? Include median survival, one and two years post-op.
“The prognosis is good for patients with a localized intestinal adenocarcinoma or leiomyosarcoma if complete resection is possible. The median survival time is 10 months; the 1-year survival rate is 40.5%, and the 2-year survival rate is 33% for dogs with an adenocarcinoma or a leiomyosarcoma.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
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266
What is the prognosis for cats with intestinal adenocarcinoma surgically removed?
Excellent, over two years
267
What is the prognosis for cats with intestinal lymphoblastic lymphoma versus those with small cell lymphoma?
 “The prognosis associated with lymphoblastic lymphoma is poor; however, cats with small cell lymphoma can have survival times of years.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
268
Where are intestinal tumors most likely in the dog versus the cat? What are the most commonly observed tumors?
Dogs: large intestines, adenocarcinoma
Cats: small intestines, lymphosarcoma
269
Adenocarcinoma’s are most commonly observed in the large intestine (mid rectum) of dogs and cats, although are overall rare. Where are the two most common locations within the anatomical structure of the colon?
Annular (intramural) and intraluminal
270
Most common type of cecal tumors in dogs and cats? What is the prognosis with early complete resection?
Leiomyosarcoma
Median survival with or without metastasis is approximately two years (excellent prognosis).
271
What is the most common surgical technique utilized in the treatment of Rectal adenocarcinoma ? What is the expected survival time?
“Adenocarcinoma was the tumor most commonly treated with rectal pull-through, and these dogs had a median survival time of 696 days (1006 days if the carcinoma was classified as in situ).
272
 Which canine epithelial tumor is frequently associated with hypercalcemia of malignancy? What clinical signs are typically associated with this syndrome?
AGASACA - Apocrine Gland Adenocarcinoma (anal sac)
Hypercalcemia is typically associated with polyuria, polydipsia, poor appetite and vomiting
273
Where do anal squamous cell carcinoma‘s typically arise? What is the typical clinical presentation and prognosis?
“Anal SCCs arise from the anocutaneous line. They are typically malignant and metastasize quickly. Extensive fistula or mucosal-cutaneous, ulcer-like lesions occur and are often covered with mucus. Anal function is impaired, and pain, tenesmus, and hemorrhage are typical. The prognosis is grave because of their malignant nature. Treatment is often discouraged.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
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274
Do cats develop perianal gland tumors?
No. “Cats do not have perianal or circumanal glands”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
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275
You are presented with an intact dog affected by multiple, large perianal Adenomas. What can be done to reduce the size of the tumors prior to excision?
Castration, wait six weeks and reevaluate.
276
What is the most important organ dysfunction associated with hypercalcemia of malignancy , such as caused by apocrine gland adenocarcinoma?
Renal dysfunction
277
Renal dysfunction secondary to hypercalcemia of malignancy (apocrine gland tumors) can be serious. What is the typical treatment and prognosis?
“Although the renal dysfunction is initially mild and reversible, it can become severe, oliguric, and irreversible if therapy is delayed. Therefore it is important to be sure the patient is not oliguric. Prednisolone may be given (Box 18.62) to help lower the serum calcium. Severely affected animals (total serum calcium concentration greater than 16 mg/dL) may also be treated with alkalinizing agents (e.g., sodium bicarbonate) and bone resorption inhibitors (i.e., pamidronate disodium). Pamidronate disodium (1–2 mg/kg IV) has been used in dogs that were hypercalcemic from different causes, and it quickly lowered serum calcium concentrations. However, pamidronate is expensive. Peritoneal dialysis may be performed in oliguric patients but is of uncertain value.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
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278
When is recurrence of perianal malignant tumors typically observed?
Three months post-surgery
279
Name 4 epithelial and 4 mesenchimal primary hepatic tumors
Epithelial
• Hepatocellular carcinoma
• Hepatocellular adenoma
• Cholangiocellular carcinoma
• Cholangiocellular adenoma
• Hepatic carcinoids
Mesenchymal
• Hemangiosarcoma
• Fibrosarcoma
• Extraskeletal osteosarcoma
• Leiomyosarcoma”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
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280
What is the typical metastatic behavior of epithelial Vs. mesenchymal hepatic tumors?
“Epithelial tumors most often metastasize to the regional lymph nodes and lungs. Mesenchymal tumors most often metastasize to the spleen.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
281
What is the overall prognosis for he[atocellular carcinoma treated via surgical excision alone?
“Malignant primary hepatic tumors have typically been considered to be highly metastatic; however, long-term survival is common after lobectomy for hepatocellular carcinoma. The median survival time in cats undergoing surgery for hepatocellular carcinoma was 2.5 years in a 2016 study.2”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
282
What is the most common tumor to metastasize to the liver? What other tumors frequently metastasize to the liver?
Lymphosarcoma
“Other tumors that commonly metastasize to the liver are pancreatic adenocarcinomas, hemangiosarcomas, insulinomas, and tumors of the alimentary and urinary tracts.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
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283
Where are hepatic tumors most commonly observed? (Lobes)
“Hepatocellular tumors are most commonly found in the left medial and left lateral liver lobes.
”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
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284
What clinical signs are typically associated with pheochromocytomas?
“Pheochromocytomas may cause vague, intermittent signs of weakness or panting due to episodic hypertension and tachycardia.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
285
 What drugs can be used as part of the medical management of hypertension caused by pheochromocytoma?
“Adrenergic blockage (e.g., phenoxybenzamine, phentolamine, prazosin)”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
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286
What cardiovascular concerns could you expect in a patient with pheochromocytoma? How should this be addressed prior to surgery?
“Particular emphasis should be placed on preoperative examination of the cardiovascular system for evidence of arrhythmias or congestive heart failure in animals with pheochromocytomas. If cardiac arrhythmias are present, a β-blocker may be added, but only after the phenoxybenzamine dosage (see under Anesthesia) has been determined to be adequate and blood pressure has returned to normal. Both α- and β-blockade will allow the return of a normal fluid volume; however, they may unmask renal insufficiency and anemia. α-Adrenergic blockade has been shown to drastically reduce the incidence of severe perioperative hypertension, thereby reducing mortality (Table 22.1).”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
287
Dogs with adrenocortical tumors are particularly predicposed to this life-threateninc post-op complication
Thromboembolism
288
What is the prognosis for dogs undergoing adrenalectomy for the removal of adrenal neoplasia? What factors affect prognosis and what is the median survival?
“Although there can be significant perioperative complications, median survival for dogs that survive to discharge exceeds 10 months. In a study of 52 dogs undergoing adrenalectomy, survival time was significantly shorter in dogs with carcinoma, tumors with a major axis length greater than 5 cm, thrombosis, metastasis, and when adrenalectomy was combined with another abdominal surgical procedure.9 Dogs in this study had a median survival of 953 days, with more than 65% living for more than 1 year.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
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289
What prognostic factors are considered favorable for survival in dogs undergoing adrenalectomy for removal pf pheochromocytomas?
“Prognostic factors for improved survival for pheochromocytoma include preoperative use of phenoxybenzamine, younger age, lack of intraoperative arrhythmias, and decreased surgical time.13”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
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290
What is the average perioperative mortality rate for dogs and cats undergoing adrenalectomy (regardless of cause)?
20%
291
What warning would you provide the owner of a dog with pheochromocytoma before and during surgery?
“Warn owners that animals with pheochromocytoma may die suddenly as a result of arrhythmias and hypertension.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
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292
Ptuitary tumors - stats…
% of functional vs non-functional
Correlation between size and neuro signs?
Most common tumor type
60% functional (main cause of HAC)
40 % non-functional
No correlation between size and neuro signs
Microadenoma (< 1cm) - 70% of tumors
293
Four breeds predisposed to PDH due to hypophyseal microadenoma
PMDB
“Poodles, Malteses, dachshunds, and boxers may be predisposed to PDH.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
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294
What structures can be compressed by hypophyseal tumors, leading to neurologic abnormalities?
“Large pituitary tumors often grow dorsally into the brain because the diaphragm of the sella is incomplete. Such tumors may cause clinical signs by impinging on adjacent brain tissue (e.g., optic chiasm, hypothalamus, thalamus, infundibular recess, and third ventricle). Size of the tumor and development of neurologic signs do not always correlate.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
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295
List the signalment and typical clinical signs presented by a dog with functional hypophyseal microadenoma growing beyond the sella turcica?
Poodle, Maltese, Dachshund, Boxer; Middle-age to senior;
“Most dogs are presented for evaluation of typical signs of HAC (polyuria, polydipsia, polyphagia, abdominal enlargement, endocrine alopecia, muscle wasting, weakness, lethargy, panting, and/or hyperpigmentation). Concurrent neurologic signs (e.g., seizures, visual deficits, ataxia, incoordination, facial hemiplegia, head tilt, somnolence, compulsive walking, depression)”
Mental depression/stupor are the most common abnormalities.
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
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296
Therapy for microadenoma Vs. Macroadenoma of the pituitary gland?
Microadenoma: hypophysectomy
Macroadenoma: external beam radiation
297
What consideration should be made prior to considering hypophysectomy for the therapy of PDH in a breeding dog?
“Hypophysectomy should not be considered in animals intended for breeding purposes because it renders them infertile. ”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
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298
Three drugs typically needed for the first two weeks post-hypophysectomy
Desmopressin Acetate
Hydrocortisone
Levothyroxine
299
What is the median survival for patients with insulinoma who are surgically treated?
“If metastasis is not apparent at surgery, survival of longer than 1 year may occur, even though cures are unlikely.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
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300
“Zollinger-Ellison syndrome refers specifically to gastrinomas arising in the pancreas (non–β-cell tumors). What is the expected biological behavior of these tumors?
 “Pancreatic gastrin-secreting tumors are usually locally invasive into adjacent parenchyma and frequently metastasize to regional lymph nodes or the liver or both.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
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301
List 6 differential diagnosis for a cystic ventral cervical mass in a dog
branchial cyst
thyroglossal cyst
thyroid cyst
thyroid cystadenoma
parathyroid cyst
parathyroid cystadenoma
thyroid carcinoma
salivary mucocele
abscess
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
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302
What is the most common thyroid tumor in dogs versus cats? biologic behavior?
Carcinomas are more common in dogs. “Carcinomas are generally rapidly growing, highly invasive tumors that frequently metastasize to the draining lymph nodes and lungs. ”
Functional adenomas are more common in cats
303
What is the prognosis for thyroid carcinomas treated via surgical excision or irradiation?
“The prognosis is good following surgical treatment of mobile thyroid tumors and irradiation of fixed thyroid carcinomas, with median survival times greater than 3 years. Median survival time for dogs with local or regional tumors (i.e., stage II or III) was significantly longer (839 days) than median survival time for dogs with metastasis (366 days). ”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
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304
What are lymphangiomas?
“Lymphangiomas are rare, nonmalignant abnormalities originating from lymphatic capillaries that present as fluid-filled spaces or masses in the skin or deeper tissues.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
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305
What is the typical biological behavior of lymphangipsarcomas?
“Lymphangiosarcomas (Fig. 23.2) are malignant tumors that arise from lymphatic capillaries. They are locally aggressive, and metastasis to regional lymph nodes, lungs, spleen, kidneys, and bone marrow has been reported. Even without metastasis, the local invasiveness of this tumor may necessitate amputation or euthanasia.4”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
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306
What is the typical biological behavior of renal tumors? What are the four distinct origins (types) in what tumors are most commonly observed in dogs versus cats?
“Approximately 85% of renal tumors are malignant, and thoracic metastatic disease is common. Renal tumors are of four distinct origins (types): TTNN - renal tubular, transitional cell, nephroblastic, and nonepithelial. In dogs, carcinomas (also known as renal tubular carcinoma and renal tubular adenocarcinoma) are most common, followed by sarcomas (Box 24.4). Lymphoma is the most common renal neoplasm in cats and may be primary or metastatic (associated with alimentary lymphoma).”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
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307
Generalized nodular Dermatofibrosis is a disorder seen in German Shepherd dogs in association with white malignant neoplasm?
“Generalized nodular dermatofibrosis, a skin disorder seen in German shepherd dogs, is associated with renal cystadenocarcinomas and other neoplasms.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
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308
Nephroblastomas – typical Signalment and associated musculoskeletal disorder
“Nephroblastomas are rare tumors of juvenile and adult dogs that are associated with hypertrophic osteopathy (see p. 1297). Most are malignant, and these tumors are thought to arise from embryonic tissue ”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
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309
List the 7 most common malignant tumors affecting the canine kidneys
“Carcinomas
Hemangiosarcomas
Fibrosarcomas
Leiomyosarcomas
Nephroblastomas
Squamous cell carcinomas
Undifferentiated carcinomas”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
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310
Ureteral tumors in dogs – how frequently do they occur? Typically benign or malignant?
“Ureteral tumors are very uncommon; only 17 cases have been documented in the veterinary literature. Most ureteral tumors are benign; however, there are three reports of ureteral sarcoma in dogs.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
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311
Dogs affected by renal tumors are typically geriatric. What’s the most likely exception to this rule?
“with the exception of hereditary multifocal renal cystadenocarcinomas in German shepherd dogs.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
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312
Rare benign neoplasm that affects the kidneys of young dogs
“Teratomas are rare but may occur in the kidneys of young dogs.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
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313
What kinds of renal tumors are most likely to cause gross hematuria?
“Gross hematuria may occur with mesenchymal tumors (e.g., anaplastic sarcomas, fibromas, hemangiosarcomas, lymphosarcomas) and transitional cell tumors; however, microscopic hematuria is more common.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
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314
Abdominal ultrasonography is the most useful diagnostic tool for renal neoplasia, in allows ultrasound guided biopsy. In what situations should this kind of biopsy not be pursued? Why?
“Abdominal ultrasonography is the most useful diagnostic tool for renal and ureteral neoplasia. Ultrasound-guided biopsy (see p. 654) can be performed if the kidney does not appear fluid filled; however, biopsy may cause peritonitis or uncontrollable hemorrhage, or it may seed the abdomen with tumor cells.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
315
Briefly explain the pathophysiology of feline perirenal pseudocysts. How are they treated and what’s the prognosis?
“Perirenal pseudocysts have been reported in cats and are formed when fluid accumulates between the parenchyma of the kidney and the renal capsule owing to underlying parenchymal disease. Resection of the pseudocyst wall is effective in eliminating signs but does not necessarily stop the progression of renal disease. The prognosis for cats with pseudocysts is related to the degree of renal dysfunction at the time of diagnosis.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
316
What is the median survival for dogs with renal carcinomas versus Sarcomas versus nephroblastomas? what is the effect of chemotherapy on overall survival? 
- renal carcinomas: 16 months (range, 0–59 months)
- sarcomas: 9 months (range, 0–70 months)
- nephroblastomas: 6 months (range, 0–6 months)
Although long-term survival (i.e., >2 years) with nephroblastoma is possible, dogs with renal tumors receiving adjunctive chemotherapy do not survive a significantly longer period than dogs not receiving chemotherapy. With benign neoplasia, nephrectomy is usually curative.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
317
How does the diagnosis of a benign mammary tumor in a dog affect her chance of developing a malignant tumor?
“Dogs with benign mammary tumors have more than a threefold risk of developing malignant mammary tumors.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
318
What is the recommended surgical therapy for feline inflammatory mammary carcinoma?
“Do not excise inflammatory carcinomas; the prognosis is too poor.”
“Inflammatory carcinomas are extremely aggressive, and surgery is of no value in controlling or palliating the disease. ”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
319
What is the biological behavior and overall prognosis for a cat with a mammary adenocarcinoma?
90% of feline mammary tumors are adenocarcinoma’s
Grow rapidly and metastasized to local lymph nodes and lungs early in the course of the disease
Not as well circumscribed as the canine counterpart
Often firm and ulcerated
Must be differentiated from lobular hyperplasia and fibroepithelial hyperplasia
Expected survival is less than one year
320
What are the two main benign differentials for a feline mammary tumor?
“Feline mammary tumors must be differentiated from lobular hyperplasia and fibroepithelial hyperplasia.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
321
What is the published thoracic metastasis rate for dogs with malignant mammary tumors at the time of diagnosis?
“Thoracic metastasis occurs in 25% to 50% of dogs with malignant mammary tumors by the time of diagnosis.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
322
Besides the lungs, what other area should be checked for metastatic lesions associated with caudal mammary tumors?
“Abdominal radiographs should be evaluated for iliac lymph node enlargement with caudal tumors. Abdominal ultrasonography may detect abdominal metastasis. CT and MRI imaging may facilitate evaluation of invasive tumors and metastasis.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
323
Has postoperative adjunctive chemotherapy been shown to affect the survival of dogs and cats with mammary tumors (as an adjunctive to surgery)?
“Postoperative adjunctive chemotherapy has not been shown to improve outcomes or survival times in dogs or cats”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
324
What is the recommended surgical approach for a cat with unilateral mammary adenocarcinoma?
“local recurrence is decreased in cats when unilateral mastectomy is performed rather than lumpectomy.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
325
What is the recommended surgical therapy for a dog with multiple mammary masses?
“Separate mammary masses on the same dog may be of different histologic types; therefore excise all masses and submit them for histologic examination. Be sure to mark them so that you can determine which mass originated from which site when the biopsy report returns.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
326
Describe the major blood vessels supplying the mammary glands of dogs and cats
“Mammary Glands 1 and 2
Ventral and lateral branches of the intercostal, internal thoracic, and lateral thoracic vessels
Mammary Glands 2 and 3
Cranial superficial epigastric vessels
Mammary Glands 4 and 5
Caudal superficial epigastric vessels”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
327
What is the reported local recurrence post surgery in dogs with mammary gland neoplasia?
“In dogs, local recurrence occurs within 2 years and varies from 20% to 73%. (Depends on various factors)
“The prognosis for dogs with malignant tumors is variable and depends on several factors, including tumor type, tumor stage, tumor size, OHE status, and the presence of metastasis.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
328
How does tumor size affect the prognosis for cats with mammary adenocarcinoma?
“Cats with mammary carcinoma greater than 3 cm have a median survival of 6 months, whereas those with tumors less than 2 cm have a median survival of approximately 3 years. ”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
329
How does spaying at the time of mastectomy affect the prognosis for dogs with mammary tumors?
“2016 study found dogs with grade 2 mammary carcinoma, ER-positive tumors, or perioperative increased serum E2 concentration had a decreased hazard of relapse when undergoing OHE at the time of mammary tumor removal compared with dogs not receiving OHE.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
330
What are the most common types of vulvar/vaginal tumors in bitches?
“The most common types of vulvar-vaginal tumors are fibroleiomyoma, lipoma, leiomyosarcoma, squamous cell carcinoma, and transmissible venereal tumor (TVT).”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
331
List five cytologic criteria of malignancy
“Variation in nuclear and nucleolar size
Variable and increased nuclear cytoplasmic ratio
Nuclear molding
Abnormal mitotic figures
Coarsely clumped chromatin”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
332
Discuss the medical management of prosthetic neoplasia in dogs. Are they responsive to chemotherapy? How about radio therapy? What other drug class has been shown to be helpful at improving clinical signs and why?
“Chemotherapeutic protocols are not successful in the management of prostatic neoplasia. Radiation therapy can be used to decrease prostate size but does not improve survival times. COX inhibitors (e.g., piroxicam 0.3 mg/kg PO [orally] q24–48h or carprofen 2.2 mg/kg PO q12h) have been shown to improve survival in dogs with prostatic carcinomas, probably because of their binding to COX receptors. Concurrent administration of omeprazole (1–2 mg/kg PO q12h), pantoprazole (1 mg/kg IV q12–24h) or misoprostol (2–5 µg/kg PO q8–12h) may help ameliorate adverse effects associated with chronic use of NSAIDs. Proton pump inhibitors have fewer side effects than misoprostol and are probably as effective.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
333
What active substances are present in the cytoplasmic granules of mast cells? What difference is typically observed in the cytoplasmic granule composition between low-grade versus high-grade MST?
“Cytoplasmic granules in mast cells contain heparin, histamine, platelet-activating factor, and eosinophilic chemotactic factor. The number and type of granules in MCTs depend on the degree of tumor differentiation. Well-differentiated MCTs contain more heparin, whereas undifferentiated tumors have more histamine. ”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
334
Regarding scrotal tumors, what is the most common type and biological behavior?
“In dogs, 50% of MCTs are malignant, especially those in the preputial, inguinal, and perineal areas. Regional lymph nodes, spleen, liver, and bone marrow are common metastatic sites. ”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
335
What is the most common distant adverse effect of cutaneous mast cell tumor’s? What is the potential impact of heparin and proteolytic enzyme release as it pertains to surgery and surgical healing?
“Gastroduodenal ulcers occur in up to 80% of dogs with MCTs because of histamine release. Ulcers may cause anorexia, vomiting, diarrhea, or melena (see p. 428). Heparin and proteolytic enzyme release may prolong coagulation and delay wound healing after resection.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
336
What is the typical biological behavior of skin melanomas?
“Tumors originating in the skin tend to be benign.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
337
List 5 commonly reported scrotal tumors in dogs
Mast cell tumor (54%)
Malignant melanoma
Hemangiosarcoma
Vascular hemartoma
Hemangioma

338
What is the biological behavior of neoplasia arising from normally positioned testicles (older dogs) versus cryptorchid testicles?
“Tumors involving scrotal testes are usually benign, whereas those in cryptorchid testes may be malignant. Metastases are slow-growing but are occasionally detected in lumbar, deep inguinal, and external iliac lymph nodes. ”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
339
What is the biological behavior of Sertoli cell tumors? Where are they most commonly observed?
“Dogs with Sertoli cell tumors often have signs of hyperestrogenism (Box 26.33), especially those with large tumors. Signs regress with castration and tumor removal. Persistence or recurrence of clinical signs suggests estrogen-producing metastasis. Sertoli cell tumors have a higher rate of metastasis than other testicular tumors.”
“They are more common in cryptorchid than scrotal testes. ”
“Sertoli cell tumors producing excess estrogens may cause squamous metaplasia of the prostate, feminization, and/or myelotoxicity.”
340
List 8 clinical signs associated with hyperestrogenism due to Sertoli cell tumors
“Bilateral symmetrical alopecia
Brittle hair
Poor hair regrowth
Thin skin
Hyperpigmentation
Nipple elongation
Mammary enlargement
Penile atrophy
Preputial swelling and sagging
Squatting micturition
Reduced libido
Male attraction
Testicular atrophy
Prostatic atrophy or cystic enlargement
Anemia
Thrombocytopenia or neutropenia”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
341
Interstitial cell tumors (Leydig) Are typically benign, soft encapsulated and rarely ever exceed 2 cm in diameter. What clinical signs / concomitant disorders are typically associated with these tumors?
“Dogs with interstitial cell tumors may be infertile. These tumors produce androgens or contribute to androgenic hormone imbalance. Perineal hernia, perianal adenomas and hyperplasia, and prostatic disease have been associated with interstitial cell tumors.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
342
What tumors are cryptorchid dogs predisposed to? How many more times are these dogs likely to develop testicular tumors as compared to non-cryptorchid dogs?
“Cryptorchidism predisposes to Sertoli cell tumors and seminomas. Cryptorchid dogs are 13.6 times more likely to develop testicular tumors than normal dogs. ”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
343
What dog breeds are particularly predisposed to scrotal mast cell tumors?
“Dogs predisposed to scrotal MCTs include English bulldogs, English bull terriers, boxers, Boston terriers, and American pit bull terriers.14”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
344
Sertoli cell tumors and seminoma‘s may cause hyperestrogenism. What clinical pathologic abnormalities can you expect as a result of this paraneoplastic syndrome?
“Hematology, serum biochemistry panel, and urinalysis are indicated in animals with scrotal or testicular tumors. Nonregenerative anemia, leukopenia, and thrombocytopenia may be associated with hyperestrogenism and myelotoxicosis. ”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
345
How is TVT treated?
“TVTs are treated with vincristine (0.5 mg/m2 IV or 0.025 mg/kg up to 1 mg IV) weekly for 3 to 6 weeks. Alternatively, radiation therapy is effective against TVTs resistant to chemotherapy and at metastatic sites.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
346
What CBC abnormalities are frequently associated with cardiac or splenic hemangiosarcoma?
“increased numbers of circulating nucleated red blood cells or large numbers of acanthocytes are suggestive of cardiac or splenic hemangiosarcoma. ”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
347
What is the biological behavior of canine chemodectomas? What is the prognosis with versus without pericardiectomy?
“Chemodectomas are slow-growing tumors, and long-term palliation with pericardiectomy and primary mass excision is possible. Regardless of the presence or absence of pericardial effusion at the time of surgery, dogs with aortic body tumors survive significantly longer if a pericardiectomy is performed (median survival, 730 days) than if one is not done (median survival, 42 days).”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
348
What are the two most common cardiac neoplasms in dogs?
“right atrial hemangiosarcoma and heart base chemodectoma”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
349
What are the two most common cardiac neoplasms in cats?
“Lymphosarcoma and metastatic neoplasia are the most frequent causes of cardiac neoplasia in cats.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
350
What is the most common clinical consequence of chemodectomas? Is there a risk factor known to predispose a patient the development of this condition? When are these tumors typically diagnosed?
“Residence at altitude and chronic hypoxia probably increase the risk for developing these tumors. Chemodectomas can cause pericardial effusion, which probably accounts for the most common clinical presentation of this disease. However, chemodectomas just as often are an incidental finding in older dogs undergoing thoracic radiography or echocardiography for other reasons.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
351
What is the reported median survival for dogs with right atrial hemangiosarcoma treated via surgery alone?
“Median survival after surgery alone is approximately 4 months.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
352
List 8 radiographic features of appendicular osteosarcomas
“Features of an aggressive bony lesion may include one or all of the following (see Figure 21.1A–D): a
- loss of fine trabecular detail of the metaphyseal bone due to lysis, - - discontinuity of the cortex, periosteal new bone formation
- Codman's triangle
- palisading mineralization perpendicular to the bone shaft ('sunburst effect’)
- extension of a mass into the adjacent soft tissues
- indistinct transitional zone between tumour and normal bone
- inappropriate areas of sclerosis
- pathological fracture
Excerpt From
Small Animal Oncology E-Book
Susan M. North BSc(Hons), PhD, DVM, DipACVIM(Med Onc), DipECVIM-CA(Int Med and Med Onc), MRCVS & Tania Ann Banks BVsc, FACVSc(Small Animal Surgery), MRCVS
https://books.apple.com/us/book/small-animal-oncology-e-book/id582697699
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353
Specificity and sensitivity of Jamshidi bone biopsy for appendicular osteosarcoma
82% sensitive
92% specific
354
What is the sensitivity and specificity of FNA cytology for osteosarcoma according to Britt et al 2007?
“sensitivity of 97% and a specificity of 100% in 32 of 36 cases. When a diagnosis of sarcoma was made on cytology (Figure 21.4), ALKP staining indicated OSA, with a sensitivity of 100% (Britt et al 2007).”
Excerpt From
Small Animal Oncology E-Book
Susan M. North BSc(Hons), PhD, DVM, DipACVIM(Med Onc), DipECVIM-CA(Int Med and Med Onc), MRCVS & Tania Ann Banks BVsc, FACVSc(Small Animal Surgery), MRCVS
https://books.apple.com/us/book/small-animal-oncology-e-book/id582697699
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355
What is the reported response (improved limb function) for dogs with appendicular osteosarcoma treated via radiotherapy? What is the median duration of improvement?
“Response (improvement in limb function) occurs in 75–92%, for variable durations (Green et al 2002, Ramirez et al 1999). Reported response duration ranges from 17 to 288 days (median 130 days).”
Excerpt From
Small Animal Oncology E-Book
Susan M. North BSc(Hons), PhD, DVM, DipACVIM(Med Onc), DipECVIM-CA(Int Med and Med Onc), MRCVS & Tania Ann Banks BVsc, FACVSc(Small Animal Surgery), MRCVS
https://books.apple.com/us/book/small-animal-oncology-e-book/id582697699
This material may be protected by copyright.
356
How does chemotherapy affect the MST of patients with appendicular OSA?
“irrespective of the protocol employed, the MST remains in the order of 300–365 days with 2-year survival times at 20–25% (Berg et al, 1992 and Berg, Gebhardt, Rand, 1997, Bergman et al 1996, Chun et al 2005, Kent et al 2004, Mauldin et al 1988). ”
Excerpt From
Small Animal Oncology E-Book
Susan M. North BSc(Hons), PhD, DVM, DipACVIM(Med Onc), DipECVIM-CA(Int Med and Med Onc), MRCVS & Tania Ann Banks BVsc, FACVSc(Small Animal Surgery), MRCVS
https://books.apple.com/us/book/small-animal-oncology-e-book/id582697699
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357
Most common site of metastasis for nasal tumors
“The most common site of metastasis is the brain, followed in decreasing order of frequency by regional lymph nodes, lungs, and liver. ”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
358
What are the four basic radiographic projections required for the initial evaluation of nasal tumors?
“Lateral, dorsoventral, open-mouth ventrodorsal, and frontal sinus views are suggested. ”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
359
What precaution regarding airways should always be observed before obtaining nasal tumor biopsies?
“Finding a mass that is not fungal (e.g., cryptococcosis) is strongly suggestive of neoplasia. Biopsies of these masses are sometimes associated with hemorrhage, and a cuffed endotracheal tube is mandatory. Bleeding typically stops within 5 minutes, but the back of the pharynx should be manually cleaned out before the endotracheal tube is removed. Rare tumors (e.g., intravascular lymphoma) can bleed so severely as to be life-threatening.”
“If the hemorrhage is worrisome, insert a nasal tampon into the affected nostril for 10 to 15 minutes. Be sure that hemorrhage has stopped before waking the patient, and clean out the pharynx before removing the endotracheal tube.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
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360
What is Feline lung-digit syndrome?
Caused by primary bronchial or bronchioalveolar adenocarcinomas. Metastasis found on the distal phalanges of multiple digits and in multiple limbs, particularly weight-bearing digits.
361
Common clinical signs associated with pulmonary neoplasia
Non-productive cough
Lameness (HO in dogs; lung-digit syndrome in cats)
Weight loss
Hemostysis
Exercise intolerance
362
From a diagnostic point of view, what are the recommended diagnostic modalities to diagnose primary and metastatic neoplasia in dogs and cats?
3-view radiography (VD, LR, LL)
CT (ideal)
FNA cytology (US or CT-guided)
363
Recommended surgical treatment for solitary lung tumor
Lung lobectomy with lymph node biopsy
Partial lobectomy only recommended when tumor located on the periphery of the lobe.
364
Prognosis for primary, well-differentiated, non metastasized lung tumors in dogs Vs cats
Dogs: favorable if no LN metastasis. Two year MST 50%
Cats: poor because most tumors are aggressive. MST 150 days of already exhibiting clinical signs at the time of diagnosis Vs 500-700 days if still asymptomatic.
365
What is the prognosis for dogs with rib osteosarcoma following wide surgical excision and adjuvant chemotherapy.
Guarded (MST 300 days)
366
Prognosis for dogs with rib chondrosarcoma treated with surgery alone
Good
367
What is the most common SECONDARY digital tumor of cats? Prognosis?
“Aside from squamous cell carcinoma and fibrosarcoma, digital tumors in cats can also be metastatic, most commonly from pulmonary adenocarcinoma. These tumors typically involve weight-bearing digits and can involve more than one toe. Cats with digital tumors should be carefully evaluated for primary disease. Prognosis for digital tumors in cats is guarded. Median survival in cats with digital squamous cell carcinoma is 73 days, whereas cats with metastatic lesions have similarly poor survival.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
368
Most common digital tumors of dogs and average MST
“Squamous cell carcinomas, malignant melanomas, soft tissue sarcomas, osteosarcomas, and mast cell tumors are common digital tumors. Squamous cell carcinomas, mast cell tumors, and melanomas arising in the subungual epithelium are aggressive and sometimes metastatic. Black dogs are predisposed to subungual squamous cell carcinomas. The 1-year survival rate after digital amputation varies from 45% to 100%, depending on the tumor type; digital melanomas have a median survival of 1 year.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
369
Overall prognosis and MST for canine mammary inflammatory carcinoma
“Inflammatory carcinomas warrant a very poor prognosis, with a median survival time (MST) of 25 days with palliative care ”
Excerpt From
Small Animal Oncology E-Book
Susan M. North BSc(Hons), PhD, DVM, DipACVIM(Med Onc), DipECVIM-CA(Int Med and Med Onc), MRCVS & Tania Ann Banks BVsc, FACVSc(Small Animal Surgery), MRCVS
https://books.apple.com/us/book/small-animal-oncology-e-book/id582697699
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370
What is the percentage influence of spaying in the development of mammary neoplasia?
“The risk of developing mammary cancer if spayed prior to first heat is 0.05%, 8% after 1st, and 26% after 2nd, compared to intact dogs (Schneider et al 1969). OHE after four or more cycles or greater than 2.5 years of age has little or no protective effect on the development of malignant mammary tumours (Misdorp 1988, Schneider et al 1969)”
Excerpt From
Small Animal Oncology E-Book
Susan M. North BSc(Hons), PhD, DVM, DipACVIM(Med Onc), DipECVIM-CA(Int Med and Med Onc), MRCVS & Tania Ann Banks BVsc, FACVSc(Small Animal Surgery), MRCVS
https://books.apple.com/us/book/small-animal-oncology-e-book/id582697699
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371
Tissue origin, biological behavior and prognosis for Lymphangiosarcoma
“Lymphangiosarcomas are malignant tumors that arise from lymphatic capillaries. They are locally aggressive, and metastasis to regional lymph nodes, lungs, spleen, kidneys, and bone marrow has been reported. Even without metastasis, the local invasiveness of this tumor may necessitate amputation or euthanasia.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
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372
Origin and typical biological behavior of lymphangiomas
“Lymphangiomas are rare, nonmalignant abnormalities originating from lymphatic capillaries that present as fluid-filled spaces or masses in the skin or deeper tissues. In humans, they are generally diagnosed before the age of 2 years and are most commonly found on the head and neck. ”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
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373
What is the overall prognosis for dogs with ovarian tumors?
“The prognosis of all types of ovarian tumors is very similar. When single, nonmetastasized tumors are completely excised, the prognosis is good. Chemotherapy may lengthen survival times in canine patients with metastatic disease”
Excerpt From
Veterinary Surgery: Small Animal Expert Consult
Spencer A. Johnston VMD, DACVS & Karen M. Tobias DVM, MS, DACVS
https://books.apple.com/us/book/veterinary-surgery-small-animal-expert-consult/id1250368401
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374
Feline ovarian tumors - most common, typical biological behavior, prognosis
“As with dogs, feline ovarian tumors are of epithelial, germ cell, or sex cord stromal origin. Sex cord stromal tumors are most commonly reported, and more than 50% of granulosa cell tumors are malignant in cats.218,289,352 As in dogs, feline granulosa cell tumors are often large and unilateral and produce hormones. They metastasize to peritoneum, lumbar lymph nodes, omentum, diaphragm, kidney, spleen, liver, and lungs.9,154,289 Dysgerminomas constitute approximately 15% of feline ovarian tumors. They are not hormone producing and are slow to metastasize but do so in up to 33% of cases.154 Epithelial tumors are rare in cats.154,289 The prognosis in cats with ovarian tumors is unknown but is likely similar to other species.”
Excerpt From
Veterinary Surgery: Small Animal Expert Consult
Spencer A. Johnston VMD, DACVS & Karen M. Tobias DVM, MS, DACVS
https://books.apple.com/us/book/veterinary-surgery-small-animal-expert-consult/id1250368401
This material may be protected by copyright.
375
The reported incidence of uterine tumors among intact dogs is 0.4%. What are the most common benign and malignant uterine tumors in dogs? Approximate incidence of each and prognosis?
“The majority of canine uterine tumors are benign and of mesenchymal origin. Leiomyomas represent 90% of the mesenchymal tumors, and leiomyosarcomas represent most of the remaining 10%. Rarely, other mesenchymal or epithelial tumors are reported, including fibroma, lipoma, liposarcoma, primary lymphoma, uterine adenocarcinoma, and endometrial carcinoma.
“The prognosis for benign uterine tumors in dogs is excellent because ovariohysterectomy is curative. For malignant tumors the prognosis is good unless metastatic disease is present or the tumor is not completely excised, in which case the prognosis is grave.”
Excerpt From
Veterinary Surgery: Small Animal Expert Consult
Spencer A. Johnston VMD, DACVS & Karen M. Tobias DVM, MS, DACVS
https://books.apple.com/us/book/veterinary-surgery-small-animal-expert-consult/id1250368401
This material may be protected by copyright.
376
Most common uterine tumor of cats, including biological behavior and prognosis
“In contrast to those in dogs, uterine tumors in cats are generally adenocarcinomas or of endometrial origin. Benign and malignant mesenchymal and round cell tumors have also been reported.352 Clinical signs may include vaginal discharge and abnormal estrus. General signs such as polydipsia, polyuria, and vomiting have also been observed.218 Cats are more likely to have metastatic disease than dogs, and preoperative staging with thoracic radiographs and abdominal ultrasonography is indicated. Metastasis in cats has been reported to the brain, eyes, ovaries, adrenal glands, lungs, liver, kidneys, bladder, colon, diaphragm, and regional lymph nodes. Disease is often advanced at the time of diagnosis, and the prognosis in cats is guarded because of the risk for metastasis. Adjunctive treatment has not been evaluated.”
Excerpt From
Veterinary Surgery: Small Animal Expert Consult
Spencer A. Johnston VMD, DACVS & Karen M. Tobias DVM, MS, DACVS
https://books.apple.com/us/book/veterinary-surgery-small-animal-expert-consult/id1250368401
This material may be protected by copyright.
377
What precaution should be taken when biopsying oral masses?
“Avoid areas of superficial necrosis when obtaining biopsies; sample deeper, viable tissues instead.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
378
Most common tonsilar tumors of dogs and cats. Response to surgical resection as sole method of treatment?
“Squamous cell carcinoma (SCC) and lymphosarcoma are the most common tumors of the tonsils, and neither are generally cured.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
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379
Most common lingual tumors of dogs (4)
“The most common lingual tumor is SCC (Fig. 18.14), but others include malignant melanoma, granular cell myeloblastoma, and mast cell tumor.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
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380
Most common salivary gland tumors of dogs and cats. Glands most commonly affected
“Neoplasms (usually adenocarcinomas or carcinomas) occur most frequently in the parotid (~50% dogs, ~20% cats) and the mandibular (~30% dogs, ~60% cats) salivary glands. ”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
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381
List 4 tumors frequently associated with HO
“HO can affect all four limbs. It can be a paraneoplastic syndrome (e.g., primary and metastatic lung tumors, esophageal carcinoma, rhabdomyosarcoma of the bladder, anal sac adenocarcinoma, renal transitional cell carcinoma, nephroblastoma)”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewBook?id=1367916984
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382
Prognosis for Hypertrophic Osteopathy
“The prognosis depends on the possibility for complete resolution of the underlying disease process. If the primary disease can be resolved, the secondary HO often resolves. Although clinical signs often disappear within 1 to 2 weeks after treatment, bone lesions may take months to remodel.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewBook?id=1367916984
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383
Physical examination and radiographic findings in patients with HO
“Physical Examination Findings
Affected limbs are warm and swollen. Because this condition occurs secondary to diseases elsewhere in the body, an effort should be made to identify the underlying causative factors. A thorough physical examination is essential when evaluating affected animals.
Diagnostic Imaging
Radiographs of the limbs reveal a uniform periosteal proliferation, which is seen initially on the phalanges and metacarpal and metatarsal bones (Fig. 36.3). As the disease progresses, periosteal proliferation progresses proximally (i.e., radius/ulna and tibia/fibula). Articular surfaces of long bones are usually spared and appear normal.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
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384
Craniomandibular osteopathy - most commonly affected breeds and associations
“The cause of craniomandibular osteopathy is unknown. It is most often recognized in West Highland white terriers, Cairn terriers, and Scottish terriers. A genetic predisposition is suspected in many breeds; in West Highland white terriers, it is thought to have an autosomal recessive inheritance pattern. A similar syndrome (calvarial hyperostotic syndrome) has been reported in bullmastiffs. Craniomandibular osteopathy has been associated with canine leukocyte adhesion deficiency in Irish setters. A link to canine distemper virus has been postulated but is not supported by epidemiologic studies.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
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385
Multiple cartilaginous exostosis (MCE or osteochondromatosis) - when is it typically observed in cats Vs dogs?
“Multiple cartilaginous exostosis (MCE, or osteochondromatosis) is a histologically benign disease of cats that occurs after skeletal maturity, in contrast to dogs, in which the disease occurs before growth plate closure ”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
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386
OSA accounts for what percentage of all bone tumors?
“75% of all bone tumors”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
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387
Name 4 benign bone tumors of dogs and cats
osteoma
ossifying fibroma
multilobular osteomas
Chondromas
osteochondromas
enchondromas
chondromas
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
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388
Axial OSA -
- biological behavior
- site where it tends to be less metastatic
- typical recommended therapy
- prognosis (median survival and one year MST)
- Highly metastatic, local recurrence except for mandible, which is slower to metastasize
- Local resection of tumor (i.e., mandible and rib) + Carboplatin, local radiation as adjunct to surgery to reduce local recurrence
- Median survival time is ~22 wk, 1-y survival is ~25%, rate of tumor recurrence is ~67%”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
389
What is the biological behavior, overall prognosis and recommended therapy of chondrosarcoma and fibrosarcoma?
Accounts for 5 to 10% of skeletal tumors
Slow to metastasize
Treatment typically involves amputation or limb sparing procedures. Chemotherapy (doxorubicin) may be a benefit after metastatic fibrosarcoma
Prognosis fibrosarcoma is poor, but may be fair for a low-grade tumors
Prognosis chondrosarcoma is good with surgical treatment
390
Most common primary bone tumor of cats, recommended therapy and prognosis
Osteosarcoma (70-80% of primary bone tumors)
Amputation
MST 12-50 months
391
Multiple cartilaginous exostosis (osteochondromatosis) in cats - causes, typical signalment, presentation, prognosis
Cause: Uncommon, usually feline leukemia virus (FeLV) positive (benign physeal lesion in dogs)
Presentation: Multiple sites common; scapula, vertebra, mandible in cats, (physeal in dogs). Affects adult cats (juvenile in dogs)
Treatment: Palliative removal of painful lesions
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
392
Canine appendicular OSA - % of patients with pulmonary metastasis at diagnosis Vs at time of euthanasia at 1 year
“Although fewer than 15% of affected dogs have radiographically detectable thoracic metastases at presentation, 90% die or are euthanized within 1 year of diagnosis because of complications associated with pulmonary metastasis.4,6 Improved chances for survival are possible with amputation (see p. 1303) or limb-sparing procedures (see p. 1305) combined with chemotherapy.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
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393
Typical signalment for dogs with OSA
Large- and giant-breed dogs have the greatest incidence of appendicular bone neoplasia. The median age of dogs with osteosarcoma is 7 years; however, a small, early peak is seen in dogs 18 to 24 months of age.
Large size is a greater determinant of risk than breed, although greyhounds, Rottweilers, and Great Danes have been shown to be at increased risk.
Males may be slightly more commonly affected than females. Primary bone tumors of the axial skeleton are more common than appendicular tumors in small breed dogs; the median age of affected animals is 8 to 9 years.
The mean age of osteosarcoma in cats is 8 to 10 years.
No apparent breed or sex predilection has been identified in either species for tumors of the axial skeleton.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
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394
Common clinical presentation and sites for MCE in cats
“MCE may result in pain and rapidly progressive swelling. Common sites for MCE include the spine, scapula, and mandible.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
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395
Radiographic abnormalities associated with appendicular OSA
“Radiographic signs of osteosarcoma include cortical and trabecular bone lysis, periosteal bone proliferation, and soft tissue swelling”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
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396
What us the sensitivity of radiographs for pulmonary nodules in patients with OSA? What other diagnostic modality is considered more sensitive if available?
“Systemic staging is critical for proper decision making in animals with skeletal neoplasia. Thoracic radiography or CT is indicated. Pulmonary nodules must be 6 to 8 mm in diameter to be detected by radiography; CT is more sensitive in the detection of pulmonary disease ”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
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397
Canine appendicular OSA - is regional LN sampling considered part of standard clinical staging?
“Spread to regional lymph nodes is rare, and fine-needle aspiration is not indicated unless an enlarged lymph node is recognized clinically.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
398
List 6 differential diagnosis for suspected primary bone cancer like OSA
bacterial osteomyelitis
fungal osteomyelitis
metastatic bone tumor (e.g., prostatic carcinoma)
direct extension of soft tissue tumors (e.g., nail bed carcinomas)
hypertrophic pulmonary osteopathy
bone infarcts
hypervitaminosis A
periosteal response to trauma
aneurysmal bone cysts
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
399
What condition is radiographically indistinguishable from OSA? What diagnostic should be performed before considering amputation?
“Perform fine-needle aspiration or another biopsy technique before amputating a leg because fungal and neoplastic lesions can be radiographically indistinguishable.”
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
400
List 5 important principles pertaining to bone biopsies
• Obtain samples from the radiographic center of tumors
• Obtain multiple samples
• Take radiographs after biopsy to confirm biopsy site.
• Using Jamshidi needles may reduce the risk of pathologic fracture.
• Have pathologists with expertise in evaluating bone biopsies perform histology.
Excerpt From
Small Animal Surgery E-Book
Theresa Welch Fossum DVM, MS, PhD, Dipl ACVS
https://books.apple.com/us/book/small-animal-surgery-e-book/id1367916984
This material may be protected by copyright.
401
Eyelid tumors in dogs - usually malignant or benign? List 4 of the most common eyelid tumors in dogs, overall percentage of malignancies and most common types.
“Roberts et al (1986) reported that 88% of eyelid neoplasms in dogs were sebaceous tarsal gland adenomas, benign melanomas or papillomas, and that malignant tumours (melanoma, adenocarcinoma, basal cell carcinoma, mast cell tumour, squamous cell carcinoma, haemangiosarcoma and myoblastoma) comprised only 8.2%. Other malignant eyelid tumours in dogs include lymphoma (LSA) and fibrosarcoma (FSA).”
Excerpt From
Small Animal Oncology E-Book
Susan M. North BSc(Hons), PhD, DVM, DipACVIM(Med Onc), DipECVIM-CA(Int Med and Med Onc), MRCVS & Tania Ann Banks BVsc, FACVSc(Small Animal Surgery), MRCVS
https://books.apple.com/us/book/small-animal-oncology-e-book/id582697699
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402
Adrenal tumors in cats - most common clinical presentation and tumor types; prognosis (MST) with surgery is operable
Clinical signs typically derive from hyperaldosteronism, leading to severe hypokalemia and hypernatremia. Most common clinical signs include weakness, cervical ventroflexion, dysphagia, hyphema, retinal hemorrhages and blindness (due to hypertension caused by hypernatremia)
Most commonly adenomas or carcinomas
MST w/surgery for adenoma: 45 months
MST w/surgery for carcinoma: 7 months
403
Name five common BENIGN lip neoplasms of dogs
• benign ceruminous gland adenoma
• basal cell tumor
• hemangioma
• histiocytoma
• cornifying epithelioma.
404
Name four common MALIGNANT lip neoplasms of dogs
• melanoma
• quamous cell carcinoma
• mast cell tumor
• various types of sarcomas.
405
Explain the most common mechanism by which tumors, particularly lymphomas and carcinomas cause paraneoplastic hypercalcemia
PTHrP is a fetal form of PTH which, under natural conditions, only exists in the fetus or in a pregnant female. Tumors such as lymphoma and carcinoma‘s are able to produce PTHrP, which has similar effects to parathormone. These include increasing intestinal calcium absorption, suppressing calciuresis and stimulating osteoclastic activity to raise ionized calcium levels in the blood.
406
How does multiple myeloma cause hypercalcemia?
Through direct osteoclastic activity on multiple bones (not PTHrP related as in the case of lymphomas and carcinoma).
407
OncoK9 MCED test overall sensitivity, sensitivity for three most common cancers (types), overall specificity and false positive rate.
Overall sensitivity: 54.7%
Sensitivity for the three most common malignant cancers ( lymphoma, hemangiosarcoma and osteosarcoma): 85.4%
Overall specificity: 98%
False positives: 1.5%
408
Two dog breeds particularly predisposed to mammary gland cancer
American Cocker Spaniel
English Springer Spaniel
409
Three breeds with a relatively low incidence of mammary cancer
Pug
West Highland White Terrier
Shetland Sheepdog
410
Which tumor, primary or metastatic, is most likely to cause hypercalcemia?
Squamous cell carcinoma
411
What are the three most common tumors associated with hypercalcemia in dogs?
Lymphosarcoma
AGASACA
Multiple Myeloma
412
What are the most common causes of hypercalcemia in cats?
Idiopathic
Lymphosarcoma
Squamous cell carcinoma
413
Common site for SCC in cats
Mouth
Ears
414
You have a hypocalcemic patient with PTH levels in the upper end of the normal range. Would you say that this is compatible with hyperthyroidism? Why?
Absolutely yes. PTH levels should go down with an increase in calcium serum levels
415
Prognosis for surgical versus medical management of insulinoma
416
None of the above
• Short term pronosis for surgery is good - 1 to 2 years survival; 6months with medica managent
• Elevated liver enzymes is common, liely due to chronic hypogycemia. No prognostic value
• Mestasis are seldom seen during U/S; most commonly observed intra-op. Even is not observed, they are always present
• Insulinomas metastasize to regional LN’s and liver, Not lungs.
417
What is the most likely diagnosis?
MAMMARY DISORDERS, NON-NEOPLASTIC Gross appearance of fibroepithelial hyperplasia in a young cat.
418
List 6 of the main types of mammary tumors observed in dogs
• carcinoma in situ
• simple carcinoma (tubular/tubulopapillary, solid, cribriform, and anaplastic)
• complex carcinoma
• inflammatory carcinoma (uncommon)
• carcinosarcoma (rare)
• sarcomas (fibrosarcoma, osteosarcoma, other; uncommon)
419
What is the reported risk difference concerning the development of mammary neoplasia between dogs spayed after 2 years Vs. Before 6 months of age?
• Females spayed after 2 years of age have a sevenfold greater risk of mammary neoplasia than those spayed before age 6 months.
420
Do pregnancy or lactation offer bitches any degree of protection against mammary neoplasia as it does for women?
○ Unlike in people, pregnancy does not afford a protective effect against the development of mammary tumors in dogs. Lactation and pseudocyesis also do not seem to have an influence.
421
You excised a simple mammary carcinoma from a bitch 4 weeks ago. She presented today for a firm, erythematous and painful mammary mass near the previous surgery site. What is your main clinical suspicion? What is this patient’s prognosis now?
• Secondary inflammatory carcinoma may develop after (mean, 48 days) surgical removal of a mammary tumor; secondary inflammatory carcinoma typically behaves as aggressively as primary inflammatory carcinoma.
422
What are the three categories of the clinical staging used for canine mammary tumors? Describe how each category is graded?
• Clinical staging
○ Tumor: T1 < 3 cm; T2 3-5 cm; T3 > 5 cm
○ Regional lymph node: N0, no metastasis; N1, metastasis detected
○ Distant metastasis: M0, no metastasis; M1, metastasis detected
423
Discuss the histological staging and grading of mammary carcinomas.
• Histologic staging
○ 0: carcinoma in situ
○ 1: stromal invasion
○ 2: vascular/lymphatic invasion; lymph node metastasis
○ 3: distant metastases
• Histologic grading of carcinomas is based on tubule formation, nuclear pleomorphism, and mitotic index and offers prognostic significance. Low-, intermediate-, and high-grade tumors correspond to well, moderately, and poorly differentiated tumors.
424
In the mammary inflammatory carcinoma a different histological subtype from that of simple carcinomas?
○ Inflammatory carcinoma is not a specific histologic subtype but an aggressive, high-grade carcinoma with invasion of the dermis and dermal lymphatics. The inflammatory cell infiltrate is moderate in most cases and consists of lymphocytes, plasma cells, and macrophages.
425
What is the expected pattern of metastasis of mammary carcinomas?
• Tumors metastasize most commonly to the regional lymph nodes and lungs, although liver and bone metastases are frequently described.
426
What is the basis for the use of NSAIDs as part of mammary tumor growth control?
• Cyclooxygenase 2 (COX2) is overexpressed in most mammary carcinomas. Prostaglandin E2 (PGE2), the product of COX2, may promote tumor development and angiogenesis/metastasis. COX-2 inhibitors may play a role in tumor control.
427
What is the minimal database recommended for a canine with mammary masses? Include physical exam (TNM) and staging diagnostics.
• Physical exam
○ Measure primary tumor (T).
○ Describe possible signs of invasiveness (ulceration, fixation).
○ Evaluation of regional lymph nodes (N): palpation and cytologic study
• CBC, serum biochemistry profile, urinalysis
• Thoracic radiographs (three views)
• Abdominal ultrasound in case of suspected metastasis to abdominal organs or lymph nodes
• Coagulation profile in cases of suspected inflammatory carcinoma (risk of DIC)
428
What clinical syndrome is frequently associated with canine mammary inflammatory carcinomas? What percentage of cases are reportedly affected??
• Up to 21% of dogs with inflammatory carcinoma may have concurrent disseminated intravascular coagulation (DIC), and appropriate testing should be assessed accordingly
429
In there a prognostic value in performing unilateral radical chain mastectomy for the removal of canine mammary carcinomas?
• Unilateral radical chain mastectomy decreases the chances of tumor development in the remaining mammary tissue. In one study, 58% of dogs that underwent a regional mastectomy for a solitary mammary tumor developed a new tumor in the ipsilateral mammary chain after the first surgery.
Ref. Stratmann N, et al. Mammary tumor recurrence in bitches after regional mastectomy. Vet Surg. 2008;37:82–86.
430
When should inguinal or axillary LN’s be excised as part of mastectomy?
• Remove inguinal lymph nodes with caudal gland tumors; excise axillary nodes only if metastasis is suspected; always submit all excised tissue for histologic assessment.
431
Should estrogen therapy be considered as part of the adjuvant protocol for mammary tumors? Why?
• Anti-estrogen therapy (tamoxifen): NOT RECOMMENDED. Most anaplastic mammary tumors lack estrogen receptors, and anti-estrogen therapy may not be beneficial for most cases in which systemic therapy is indicated. Estrogen-like side effects, including vulvar swelling, vaginal discharge, stump pyometra, signs of estrus, and urinary tract infection may occur.
432
Prognosis for dogs with malignant mammary gland tumors is extremely variable and ranges from a cure with surgery (especially low-grade malignancy) to rapid recurrence and metastasis within the first year after surgical excision. Prognostic factors include (three main categories)
○ Tumor size: tumors < 3 cm have a better prognosis than tumors > 3 cm.
○ Tumor histologic characteristics
▪ Epithelial tumors (adenocarcinomas, cystadenocarcinomas, carcinomas) may have a better prognosis than sarcomas and carcinosarcomas. Median survival times are 6.5 months (solid carcinoma), 12 months (invasive tumor), 29 months (noninvasive tumor), 10 months (sarcoma), and 18 months (carcinosarcoma).
▪ Inflammatory carcinomas have a grave prognosis.
▪ Anaplastic and high-grade, invasive tumors with stromal or lymphatic or vascular infiltration carry a worse prognosis than well-differentiated, low-grade or noninvasive lesions.
○ Clinical stage: a worse prognosis is associated with
▪ Large tumors (stages II-V)
▪ Lymph node involvement (stages IV-V)
▪ Distant metastasis (stage V)
433
Does concurrent OVH or OV at the time of mastectomy affect the prognosis for mammary gland neoplasia in dogs?
• The benefit of OHE at the time of mammary tumor surgery remains controversial, but a subset of dogs with differentiated estrogen receptor–positive tumors may benefit from concurrent OHE.
434
List three other round cell tumor which must be considered as differential for TVT
mast cell tumor, histiocytoma, and lymphoma
435
You are presented with a stray female dog with a red, irregularly-shaped vaginal vestibular mass. You suspect TVT. What point-of-care diagnostic can you use to confirm your diagnosis? What findings do you expect to observe? What confirmatory testing can you also consider?
Cytologic exam of impression smears stained with Wright's or new methylene blue reveal homogeneous sheets of round to oval cells with prominent nucleoli and a small amount of cytoplasm with multiple mitotic figures.
Definitive diagnosis is made by polymerase chain reaction assay or histologic classification of a biopsy specimen (after formalin fixation and staining with hematoxylin and eosin) and by immunochemistry testing to determine degree of malignancy.
436
Discuss the available treatment modalities for TVT and their efficacy.
• Surgical excision: physically removes the mass and induces an immune response. Effective for small masses; excision of large tumors (>2 cm in diameter) is often followed by tumor regrowth.
• Intratumoral injection (1-4 treatments) with vincristine 0.5-0.7 mg/m2 and interleukin-2 (IL-2) 2 × 106 units has impressive therapeutic effects. However, IL-2 alone did not cause tumor regression in all cases.
• Chemotherapy with vincristine 0.7 mg/m2 IV (highly corrosive if extravascular [pp. 152 and 609] for precautions) once weekly for 6 weeks until complete tumor regression is the treatment of choice for metastatic or multifocal TVT.
• Orthovoltage radiotherapy is effective (100% cure with a single radiation dose of 10 Gy); it requires an appropriate facility.
437
Vincristine is the recommended chemotherapy agent for the treatment of TVT. What major precaution must be observed when administering this drug?
Extravasation injuries associated with perivascular injection of vincristine can range from irritation to necrosis and tissue sloughing.
438
What is the overall prognosis for TVT?
Despite the location or pattern of metastasis, the prognosis for TVT is excellent with recommended therapy.
439
Subungual SCC - rough incidence and breed/size/coat predisposition
• Subungual SCC: seen in large breeds (75% of cases) and in breeds with a black coat (66% of cases), such as in the black Labrador retriever and black poodle
440
Typical clinical findings for subungual SCC in dogs
• Subungual SCC
○ Single, swollen, painful toe with paronychia and associated erosive/ulcerative dermatitis and often loss of the claw
○ Multiple digits can be affected over time in black Labradors, black standard poodles, giant schnauzers, and rottweilers.
441
What are the four most common disorders associated with Mast Cell Tumors in dogs?
Caused by mast cell degranulation:
• Gastrointestinal ulceration
• Pruritus
• Hypotension
• Delayed wound healing
442
You are presented with this 5 yo Staffordshire Terrier. The mass has been present for 3 months, and the dog has also had recurring vomiting episodes. What is your primary differential diagnosis?
MAST CELL TUMORS, DOG Interdigital mast cell tumor in a dog. Note the ulceration, superficial infection, and displacement of the digits associated with this tumor.
443
What is the “Darier’s sign” as it pertains to tumors? What tumor is it most commonly associated with?
Darier sign refers to the urtication and erythematous halo that are produced in response to the rubbing or scratching of the tumor. It is most commonly observed with aggressive types of Mast Cell Tumors.
444
Cutaneous Mast Cell Tumors
• List three factors which may influence the likelihood of metastasis
• Accounting for the variations in metastatic rates introduced by these factors, what is the reported overall metastatic rate of cutaneous MCT’s in dogs? (Range)
• The likelihood of MCT metastasis depends on tumor grade, mitotic index, location, and other factors, and it varies from 10%-50%. In dogs, MCTs most commonly metastasize to regional lymph nodes, followed by spleen, liver, mesenteric lymph nodes, other cutaneous sites, and bone marrow.
445
List two know factors, besides breed, which may predispose dogs to Mast Cell Tumors. Include the influence of a specific gene mutation on the biological behavior and tendency to recurrence/metastasis.
• Chronic dermatitis or mutations in a proto-oncogene (KIT) may predispose dogs to mast cell neoplasia. KIT encodes the tyrosine kinase receptor KIT, which promotes mast cell growth and differentiation. Mutations in KIT (≈20%-30% of canine MCTs) allow abnormal continuous activation of the receptor and predispose dogs to aggressive MCTs that are more likely to recur and metastasize. Inhibition of receptor tyrosine kinases through targeted therapies (see Treatment below) has a role in the treatment of advanced local or metastatic MCTs.
446
The characteristic intracytoplasmatic metachromatic granules of MCT’s may not be observed if using Diff-Quick stain. What does this finding suggest and what stain can be used to improve the visibility of these granules?
• Less differentiated MCT’s tend to have granules less visible using Diff-Quick
• The use of Wright stain improves granule visibility (used by most commercial labs)
447
What CBC abnormalities may you expect in a case of MCT?
○ CBC abnormalities associated with MCTs can include eosinophilia, basophilia, and regenerative or nonregenerative anemia.
448
What 4 diagnostics should always be performed prior to considering surgical excision of cutaneous or subcutaneous Mast Cell Tumors?
• Before surgical excision, a CBC, serum chemistry panel, urinalysis, and regional lymph node aspiration (if accessible; regardless of size of the lymph node) should be obtained.
449
Concerning Mast Cell Tumors
• Is the presence of Mast Cells in a lymph node ever considered normal?
• Normal lymph nodes may contain scattered mast cells; increased numbers or clusters of mast cells in a lymph node draining an MCT suggest metastasis.
450
List three findings which may prompt you to recommend a complete staging prior to surgical removal of a Mast Cell Tumor
• Lymph node metastasis
• Darier’s sign (peritumoral edema, or bruising)
• Recurrent tumors
• Tumor location. Tumors located on the prepuce, scrotum, muzzle, digit, pinna or ear canal, or oral mucosa (locations potentially associated with a higher rate of metastasis).
451
Is the evaluation of a buffy coat smear considered a useful diagnostic tool? Why?
• The buffy coat smear to evaluate circulating mast cells has a high rate of false-positive results for dogs and is not recommended.
452
List the 7 diagnostics to be included in the complete staging of a case of suspected aggressive or metastatic Mast Cell Tumor.
• CBC
• Biochemistry
• UA
• LN aspirate (cytology)
• Incisional biopsy
• Abdominal Ultrasound
• Bone Marrow aspirate (cytology)
453
Discuss the importance, interpretation, and estimated MST of Mast Cell Tumors based on Mitotic Index
• Mitotic index (MI) is an important, independent predictor of prognosis. The MI (numbers of mitotic figures per 10 high-power fields) correlates with grade and prognosis. Dogs having cutaneous MCTs with an MI ≤ 5 had a median survival time of 70 months, compared with 5 months for an MI > 5. • Mitotic index (MI) is an important, independent predictor of prognosis. The MI (numbers of mitotic figures per 10 high-power fields) correlates with grade and prognosis. Dogs having cutaneous MCTs with an MI ≤ 5 had a median survival time of 70 months, compared with 5 months for an MI > 5.
454
What are the two classification schemes for MCT’s? What two cellular features does the most current scheme evaluate?
• Patnaik grading system: grade I = well-differentiated tumors, grade II = intermediately differentiated tumors, grade III = poorly differentiated tumors.
• Kiupel grading system: This system evaluates cellular criteria such as mitotic figures and nuclear characteristics, assigning grades “high” or “Low”. Dogs with high-grade tumors have a higher metastatic rate and shorter survival time than dogs with low-grade tumors.
455
What type of MCT’s are more likely to be associated with non-visible cytoplasmic granules? What can be done to further evaluate these tumor’s biologic behavior?
• Mast cell granules may not be present or visible in highly anaplastic MCTs; CD117 (KIT) immunohistochemistry or toluidine blue staining can be used to confirm a diagnosis of MCT.
456
List one available targeted receptor therapy for non-resectable or recurrent MCT’s
• Targeted therapies work by inhibiting cellular receptors. A receptor tyrosine kinase inhibitor (RTKI) currently in common use for MCT in dogs is toceranib phosphate (Palladia) for recurrent or metastatic grade II and III MCT. This drug has been used in combination with other therapies in many dogs with MCTs, and consultation with an oncologist is warranted for specific current treatment recommendations. This drug should be dispensed only by veterinarians familiar with its indications and side effects. Ongoing patient monitoring and veterinary follow-up for response to therapy and monitoring for adverse effects is warranted.
457
Are MCT’s responsive to radiation therapy? Are are some possible indications?
• MCTs are responsive to RT.
○ Treating MCT in a microscopic disease setting (i.e., postsurgical resection) yields better results than when treatment is performed with macroscopic (measurable) disease.
○ Potential indications for RT for MCTs include incompletely excised, low-grade MCTs where wider surgical excision is not possible; as an adjunct to surgery and chemotherapy in dogs with high-grade MCT; and to attempt cytoreduction of nonresectable MCTs.
458
What drugs are indicated prior to the surgical excision of MCT’s?
○ Preoperative H1 histamine blockers (such as diphenhydramine): begin therapy a few days before and premedicate immediately before surgery (and ongoing for nonresectable or metastatic disease)
○ Preoperative corticosteroids to attempt to shrink the tumor (measure and record at baseline first), making complete surgical resection more viable: prednisone 0.25-0.5 mg/kg PO q 24h × 5-7 days preoperatively, especially if MCT is difficult to access surgically
○ Proton pump inhibitors (omeprazole 0.5-1 mg/kg PO q 24h) and/or H2 histamine blockers are indicated for dogs with measureable MCT (preoperatively or in cases of nonresectable disease) to attempt to prevent or treat histamine-associated gastric ulceration.
459
Concerning Mast Cell Tumors - when is chemotherapy indicated (criteria) and what chemotherapy drug are considered effective?
• The goal of chemotherapy is to delay or prevent metastasis and possibly local recurrence or attempt to cytoreduce or slow progression of nonresectable tumors or metastatic lesions. Potential indications for chemotherapy in dogs with MCT include
○ Dogs with high-grade MCT or tumors with MI > 5
○ Dogs with metastasis at diagnosis or with recurrent tumors
○ Dogs with tumors in locations associated with aggressive behavior (see above)
○ Before attempting surgical excision of large, fixed tumors or tumors with peritumoral edema or bruising
○ Chemotherapy drugs considered to be effective in the treatment of MCT include CCNU (lomustine), prednisone, vinblastine, vinorelbine, chlorambucil, cyclophosphamide, hydroxyurea, and others. Special handling requirements and potentially severe or life-threatening adverse patient effects exist with these chemotherapeutic drugs. These concerns and rapid evolution of protocols warrant consultation with/referral to an oncologist.
460
What is the most significant prognostic indicator for MCT’s? What is the prognosis for low-grade, completely excised cutaneous MCT? Include percentage risk of recurrence and metastasis
• The most significant prognostic indicator for MCT is tumor grade. For dogs with completely excised, low-grade MCTs, the prognosis is excellent: only ≈5% of these tumors recur locally or metastasize.
461
What is the therapy of choice for an incompletely-excised low grade MCT if surgical revision is not possible?
• For dogs with incompletely excised, low-grade MCTs where additional surgery (scar revision) is not possible, RT is the treatment of choice, with 80%-90% of dogs free of tumor 2-5 years after treatment. If RT is not an option, careful monitoring with routine exams is warranted. Benefit of treating dogs with incompletely excised, low-grade MCTs with corticosteroids, chemotherapy, or targeted therapies in an attempt to prevent recurrence remains unproved.
462
What is the estimated biological behavior of MCT’s located in mucous membranes as compared to haired skin?
• Tumors located on mucous membranes may have a worse prognosis compared with MCTs of haired skin.
463
What percentage of dogs who develop one MCT will develop others in their lifetime?
• Importantly, 10%-40% of affected dogs (especially pugs and boxers) develop additional cutaneous MCTs in their lifetime. Owners should be advised that any new skin mass should be addressed right away.
464
What is the effect of SSI on the MST of osteosarcoma cases treated with limb-sparing curative-intent treatment? What is the proposed explanation for this effect? Is this also observed with non-limb sparing curative intent treatment?
Multiple independent studies have identified a significant increase in MST associated with the diagnosis of SSI after limb-sparing surgery.17,20,21 Although the mechanism by which SSI prolongs MST has yet to be fully elucidated, systemic activation of the innate immune system and associated antitumor activity has been proposed.22,23 Fluoroquinolone antibiotic therapy used in the treatment of SSI may also play a role in prolonging survival.24,25
Hans, EC, Pinard, C, van Nimwegen, SA, et al. Effect of surgical site infection on survival after limb amputation in the curative-intent treatment of canine appendicular osteosarcoma: a Veterinary Society of Surgical Oncology retrospective study. Veterinary Surgery. 2018; 47: E88– E96. https://doi.org/10.1111/vsu
465
What are the three forms of appendicular OSA? What form is most commonly diagnosed in dogs, and what are it's clinical (radiographic) features?
The three basic types of OSA are endosteal, periosteal, and parosteal.1,
However, periosteal and parosteal OSA are very rare compared with endosteal OSA.1 The radiographic appearance of endosteal OSA can range from lytic to blastic and is usually a mixture of both patterns.1,4,5
Ref:
Canine Appendicular Osteosarcoma: Diagnosis and Palliative Treatment*
Julius M. Liptak, BVSc, MVetClinStud, FACVSc†
William S. Dernell, DVM, MS, DACVS
Nicole Ehrhart, DVM, MS, DACVS
Stephen J. Withrow, DVM, DACVS, DACVIM (Oncology) Colorado State University
466
What percentage of MCT's are likely to be metastatic at the time of diagnosis?
The majority of these tumours will remain localised, while 5% will infiltrate internal organs, distant lymph nodes (LNs), and the bone marrow.
1. Fejös C, Troedson K, Ignatenko N, Zablotski Y, Hirschberger J. Extensive staging has no prognostic value in dogs with low-risk mast cell tumours. Veterinary and Comparative Oncology. 2022;20(1):265-275. doi:10.1111/vco.12773
467
What is the reported MST for high grade MST with distant metastasis?
The MST of the dogs with DM was 84 days, which corresponds to the findings of earlier reports with survival times ranging between 34 and 119 days.25
1. Fejös C, Troedson K, Ignatenko N, Zablotski Y, Hirschberger J. Extensive staging has no prognostic value in dogs with low-risk mast cell tumours. Veterinary and Comparative Oncology. 2022;20(1):265-275. doi:10.1111/vco.12773
468
What is the importance of tumor size on the prognosis of canine MCT's?
Tumour size >3 cm does seem to play a significant role in stage IV disease. It is a variable, which has been associated with worse outcomes in several reports.1
1. Fejös C, Troedson K, Ignatenko N, Zablotski Y, Hirschberger J. Extensive staging has no prognostic value in dogs with low-risk mast cell tumours. Veterinary and Comparative Oncology. 2022;20(1):265-275. doi:10.1111/vco.12773
469
According to Bush et al VetSurg 2023, what is the most common salivary gland neoplasia in dogs, and which gland is most often affected? What other tumors were reported?
What is the primary site for metastasis, which should be checked in every case?
Most important negative prognostic indicator and how often it was diagnosed at time of presentation
Most common perioperative complication
What was the reported MST with surgical treatment? How does it compare to previous reports?
Overall recurrence rate
• squamous cell carcinoma affecting the mandibular/sublingual (54%), parotid (38%) and zygomatic glands (6.9%).
• other reported, tumors include fibrosarcoma, lipoma, extra-skeletal osteosarcoma, mast cell tumor, and lymphoma
• Metastasis to mandibular, medial retropharyngeal and superficial cervical LN
• lymph node metastasis negative prognostic factor (28%)
• Most common complication was facial nerve paresis or paralysis, but only with parotid sialoadenectomy. Also seromas.
• MST with surgery 1800 days. Previous reported MST 550 days
• Recurrence observed in 42% of patients, often requiring revision surgery. Overall DFI 191 days.
Bush, KM, Grimes, JA, Linden, DS, et al. Outcomes and clinical features associated with surgically excised canine salivary gland carcinoma: A multi-institutional, retrospective, Veterinary Society of Surgical Oncology study. Veterinary Surgery. 2023; 1- 9. doi:10.1111/vsu.13928
470
According to Bush et al VetSurg 2023, can thyroid carcinoma be diagnosed based on cytology? What percentage of patients were diagnosed with a neoplastic process based on cytology alone?
No
Only 57% of dogs were diagnosed with a neoplastic process based on cytology

Bush, KM, Grimes, JA, Linden, DS, et al. Outcomes and clinical features associated with surgically excised canine salivary gland carcinoma: A multi-institutional, retrospective, Veterinary Society of Surgical Oncology study. Veterinary Surgery. 2023; 1- 9. doi:10.1111/vsu.13928
471
According to Bush et al Vet Surg 2023, who reported on the outcome of patients surgically treated for salivary gland neoplasia, did the use of adjuvant therapy affect the overall survival in the study population?
Adjuvant therapy was not shown to impact survival
Bush, KM, Grimes, JA, Linden, DS, et al. Outcomes and clinical features associated with surgically excised canine salivary gland carcinoma: A multi-institutional, retrospective, Veterinary Society of Surgical Oncology study. Veterinary Surgery. 2023; 1- 9. doi:10.1111/vsu.13928
472
According to Bush et al.,Vet Surg 01/2023:
1)What is the most common malignancy affecting the dog's salivary gland? List two other tumors
2) What is the overall median survival time (MST) and Disease-free Interval (DFI)?
3) What percentage of cases had regional LN metastasis at the time of surgery?
4) What was the rate of local recurrence?
1) Adenocarcinoma; fibrosarcoma, extraskelletal osteosarcoma, MCT.
2) Overall MST: 1800 days; DFI: 300 days (rounded figures)
3) Regional metastasis at the time of surgery: 30%
4) Rate of local recurrence: 40%
473
According to Bush et al.,Vet Surg 01/2023:
What were the two most common postoperative complications associated with the surgical treatment of salivary gland neoplasia? What gland was this complication observed with?
Seroma and facial nerve injury; Parotid salivary gland
474
According to Bush et al.,Vet Surg 01/2023:
1) What was the most important negative prognostic indicator for patients diagnosed with salivary gland neoplasia? What what the rate of this factor?
Regional LN metastasis (30%)
475
According to Bush et al.,Vet Surg 01/2023:
What was the reported sensitivity of FNA for the diagnosis of salivary gland neoplasia?
57% (poor)
476
According to Bush et al.,Vet Surg 01/2023:
1) Most common gland (s) affected by salivary adenocarcinoma?
Mandibular and monostomatic sublingual
477
According to Villedieu et al. JAVMA 01/2021:
* What was the rate of metastasis for grades I and II STS? How about for grade III?
* What was the conclusion regarding the yield of thoracic imaging before surgery?
* Metastatic rate for grades I and II: 6%
* Metastatic rate for grade III: 38%
* Results indicated that pulmonary staging was a low-yield diagnostic procedure for dogs with grade 1 or 2 cutaneous or subcutaneous STSs, especially when tumors had been present for ≤ 3 months.
1. Villedieu EJ, Petite AF, Godolphin JD, Bacon NJ. Prevalence of pulmonary nodules suggestive of metastasis at presentation in dogs with cutaneous or subcutaneous soft tissue sarcoma. Journal of the American Veterinary Medical Association. 2021;258(2):179-185. doi:10.2460/javma.258.2.179
478
What is this?
Nodular sebaceous hyperplasia
479
What is this?
Cutaneous papilloma
480
What is this?
Oral papilloma
481
What is this?
Interdigital cyst
482
What is this?
Interdigital cyst
483
What is this?
SCC in situ (Bowen’s disease)
484
What is this?
Fibrovascular papillomas
485
What is this?
Fibrovascular papilloma
486
What is this?
Millia (millium cysts)
487
What is this?
Feline Epitheliotropic Lymphoma
488
What is this?
Canine epitheliotropic lymphoma
489
What is this?
Feline MCT
490
What is this?
Canine MCT (looks like pyotraumatic dermatitis)
491
According to Michizuke et al. 2016 and Smiech et al. 2019, list five breeds with an INCREASED prevalence of MCT diagnosis. 
Boxer
Golden retriever
Weimaraner
Labrador retriever
Staffordshire bull terrier
492
According to Michizuke et al. 2016 and Smiech et al. 2019, list five breeds with a DECREASED prevalence of MCT diagnosis.
Jack Russell terrier
Border collie
Cocker spaniel
West highland white terrier,
Yorkshire terrier
German shepherd
493
According to Michizuke et al. 2016 and Smiech et al. 2019, what breed had a particularly low risk of MCT?
Pug
494
What are the two most common myeloproliferative neoplastic disorders that caused generalized splenomegaly?
Lymphosarcoma and mastocytosis
495
What are the current thoughts regarding fibrohistiocytic nodules in the dog spleen?
Fibrohistiocytic nodules are distinct from nodular hyperplasia. They represent a complex group of diseases, including stromal, sarcoma, histiocytic, sarcoma, lymphoid, nodular, hyperplasia, and others.
496
Hemangiomas, hematoma’s, and him, and just sarcoma’s cannot be differentiated based on gross appearance. At a basic level, what is the main histologic difference between these conditions? 
Hematomas contain well differentiated endothelial cells with well formed vascular spaces. Hemangiosarcomas have endothelial cells and vascular spaces haphazardly arranged.
497
Define hemartoma
A rare, benign proliferation of mature cells and tissues, normally present within an organ, but without the normal architecture of the surrounding tissue.
498
Splenic neoplasia can be divided into hemic and non-hemic sources. Define and give examples of each.
Hemic neoplasms: lymphoid, mast, cells, histiocytic, plasma cells, myeloproliferative
Non-hemic: sarcomas, such as image of sarcoma, and benign tumors of connective tissue
499
What percentage of dogs with splenic hemangiosarcoma also have tumors in the right atrium? 
Dogs presenting with splenic Hemangiosarcomas have concurrent right atrial mass 8.7% of cases.
Dogs presenting with a right atrial hemangiosarcoma have splenic Hemangiosarcomas in 29% of cases 

500
What is the prognosis for gastric lymphoma in dogs versus cats ?
Dogs > poor > 17 days
Cats > poor for high-grade but good for small-cell + chemo (700 days)
501
Most common gastric tumor in dogs, signalment, clinical forms
Adenocarcinoma
8-10 years
Exposed breeds: Belgian Shepherd, rough coated collie, Staffordshire terrier
Males proposed
Pyloric antrum or lesser curvature
Metastasis in 80-90% to regional lymph nodes, lungs, and testicles
Diffuse, ulcerative, or isolated/polypoid mass
502
Name five types of round cell tumors
Lymphoma
Mast cell tumor
Transmissible venereal tumor
Melanoma
Plasmacytoma
503
Chondrosarcoma – biological behavior, metastasis at the time of diagnosis, most commonly affected bones, prognosis
Second, most common bone, tumor in dogs, aggressive
28% metastasis at the time of diagnosis
Tibia, followed by femur and humerus
MST dependent on histologic grade. Grade I: 3+ years; Grade II: 2+ years; Grade III < 1 year
504
what is the reported rate of metastasis for hepatocellular carcinoma versus cholangiocellular carcinoma?
where are these tumors most commonly observed?
Hepatocellular carcinoma: 4.8%
Cholangiocellular carcinoma: 86%
Both most commonly observed in the left lateral liver lobe
505
You are presented with a 4month old dog diagnosed with an aggressive tumor affecting the muscles of the thigh. What is the most likely differential diagnosis?
Rhabdomyosarcoma
506
You are presented with a patient with hypoglycemia, which also has a large subcutaneous mass. What is the most likely diagnosis?
Leiomyoma or leiomyosarcoma may lead to hypoglycemia (paraneoplastic syndrome)
507
What is the rough metastatic rate for grades one, two and three STS?
Grade 1: 10%
Grade 2: 30%
Grade 3: 50%
508
What gene mutation is associated with poor prognosis for soft tissue sarcoma?
P53
509
What gene mutation is associated with poor prognosis for soft tissue sarcoma?
P53
