Oncology Exam 2 Flashcards
1
Q
Where is the 4th most common site of neoplasia in dogs and cats?
A
Oral tumors
2
Q
What is the common signalment seen for oral tumors?
A
Male, middle aged dogs
Boxers, GSD, goldens, cockers, mini poodles, GSP, Gordon Setter, Chow and Weimaraner
3
Q
What are the common presenting complaints for oral tumors?
A
Visible mass w/ oral bleeding, difficulty eating, halitosis
4
Q
What are the ddx for dog/cat oral tumors?
A
Dogs: Melanoma, SCC, Fibrosarcoma
Cats: SCC, Fibrosarcoma
5
Q
What is the preferred dx method for oral tumors?
A
Incisional biopsy
6
Q
If the oral tumor is proliferative-what is the preferred dx method?
A
Shave biopsy
7
Q
T/F: When obtaining a biopsy for oral tumors-it is okay to bx through the lip?
A
FALSE- never bx through the lip
8
Q
What imaging modality is preferred for oral tumor dx?
A
CT
9
Q
What is the classic pigment of malignant melanoma?
A
Black
10
Q
T/F: Malignant melanoma can be amelanotic.
A
TRUE
11
Q
What is the biggest point of sx failure for malignant melanoma patients?
A
systemic metastasis
12
Q
T/F: SCC in dogs is locally invasive with a low rate of metastasis
A
TRUE
13
Q
Where is the preference site for SCC in cats?
A
Sublingual site- you will notice the patient drooling, displaced tongue and very uncomfortable
14
Q
What is the common signalment for fibrosarcoma in dogs?
A
Large breeds(Goldens & Labs) and younger animals
15
Q
T/F: Fibrosarcomas are benign.
A
FALSE- these tumors present benign but are locally invasive
16
Q
What sites should be checked for mets with fibrosarcoma?
A
Lungs and LN
17
Q
What is the biggest point of sx failure in patients with fibrosarcoma?
A
recurrent dz after sx
18
Q
Where do odontogenic tumors arise from?
A
Peridontal ligament- similar appearance to gingival hyperplasia
19
Q
What are the three types of odontogenic tumors?
A
Acanthomatous ameloblastomas
Peripheral odontogenic fibroma
Feline inductive odontogenic tumor
20
Q
What are the common breeds over represented for acanthomatous ameloblastomas and in what location?
A
Shetland and OE sheepdogs
Rostral mandible
21
Q
T/F: Acanthomatous ameloblastomas are locally invasive with high risk of mets
A
FALSE- locally invasive with no mets
22
Q
What is a common benign odontogenic tumor in dogs?
A
Peripheral odontogenic fibroma
23
Q
T/F: Feline inductive odontogenic tumors are unique to young cats and are commonly located on the rostral maxilla
A
TRUE
24
Q
What is the gold standard tx for oral tumors?
A
Aggressive sx excision
25
Which oral cancer is an exception to tx with aggressive sx excision?
Peripheral odontogenic firbromas-cryotherapy works well
26
T/F: The more caudal the mass the easier it is meaning that it has a better prognosis?
FALSE
| Rostral mass --> easier to excise --> better prognosis
27
T/F: If a tumor crosses the midline of oral palate, poor prognosis
TRUE
28
Which oral tumors are responsive to RT?
SCC, melanoma, acanthomatous ameloblastoma, FSA
29
What are the four positive prognostic indicators for oral tumors?
Small tumors
Rostral location
Histologically resection
No evidence of preoperative mets
30
Which parasite can cause esophageal sarcomas?
Spirocerca lupi
31
What is the most common esophageal tumor?
SCC
32
Where is esophageal SCC in cats commonly located?
Middle 1/3 of esophagus caudal to thoracic inlet
33
What are the ddx of esophageal tumors?
Leiomyosarcoma, FSA, OSA
34
What are the two imaging modalities used for esophageal tumors?
Rads (dilation proximal to tumor) or positive contrast esophagram (stricture/mass effect)
35
What is the preferred tx for esophageal tumors?
Sx- best chance is low grade leiomyosarcomas
36
T/F: esophageal tumors have POOR prognosis
True
37
What can be used to treat secondary masses to S. lupi?
Droamectin
38
What are the breeds predisposed to gastric tumors?
Belgian shepherds & chows
Beagles=benign
MALES
39
What bacteria may play a role in development of chronic gastritis?
Helicobacter infection
40
What is the most common presenting complaint of patients with gastric tumors?
Anorexia
41
What are the ddx for dogs vs. cats with gastric tumors?
Dogs (BIG 2): Adenocarcinoma, Leiomyosarcoma
| Cats (BIG 1): Lymphoma
42
What is the anatomical preference for gastric tumors?
Pyloric antrum/lesser curvature
| HIGH MET RATES
43
What does gastric adenocarcinoma commonly look like?
Scirrhous (firm/white on serosal surface)
44
What are some dx tests that can be ran for patients suspected to have gastric adenocarcinoma?
Postive contrast gastrogram
Abdominal US
US guided FNA cytology
Endoscopy (preferred technique)
45
What is the predilection site for gastric ACA vs. leiomyomas?
ACA: pylorus
Leiomyomas: cardia
46
What is the recommended tx for gastric tumors?
Sx excision
| Partial gastrectomy or gastroduodenostomy
47
What is the prognosis for gastric ACA?
poor prognosis- most dead within 6 mo. due to recurrence of dz
48
What factors does gastric tumor prognosis depend on?
Sx excision
Tumor type/grade
Presence of metastatic lesions
49
Which intestinal tumors are more common in dogs?
LI tumors > SI tumors
50
Which intestinal tumors are more common in cats?
SI tumors > LI tumors
51
Why is endoscopy not performed for intestinal tumors?
Scope will NOT allow access to jejunum and proximal ileum
52
What is the preferred dx modality used for intestinal tumors?
US guided FNA/cytology
53
What are the ddx for dogs vs. cat intestinal tumors?
Dogs: LSA, ACA, Leiomyosarcoma
Cats: LSA, ACA, MCT
54
What is the tx for intestinal tumors?
Exploratory laparotomy w/ sx excision via intestinal resection & anastamosis
55
What are the margins used for intestinal tumors?
4-8 cm (WIDE)
56
What is the MST for K9 intestinal LSA?
77 days
57
What are negative prognostic indicators for k9 intestinal LSA?
Failed to achieve remission or patients that had D+ at initial presentation
58
What are the negative prognostic factors for cats with intestinal ACA?
Histologic subtype and metastasis
- Undifferentiated ACA- 4m vs. Tubular ACA-11 m
- mets have worse prognosis
- lack of omental spread has better prognosis
59
Where do gastrointestinal stromal tumors arise from?
Originate from interstitial cells of Cajal- Pacemaker cells of GI tract
60
What is the predilection site for gastrointestinal stromal tumors?
Cecum
61
What are the ddx for chest wall tumors?
OSA and CSA
62
What is the test used to stage chest wall tumors?
Open wedge biopsy
63
What is the tx for chest wall tumors?
En bloc excision w/ chest wall reconstruction (max excision=6)
64
T/F: Adjunctive chemotherapy is recommended in dogs w/ rib OSA?
TRUE
65
What should always be placed prior to complete chest wall reconstruction?
Thoracostomy tube
66
Why is it important that we differentiate between OSA and CSA?
CSA has a MUCH longer MST compared to OSA
67
What are the predisposed breeds to lung tumors?
Boxer, doberman, irish setter, bernese MD, australian shepherd
68
What is a unique CS to cats with lung tumors?
LAMENESS
| Lung digit syndrome- lung tumor mets to toes (weight bearing digits & 3rd phalanx)
69
What are the ddx for lung tumors in cats and dogs?
CARCINOMAS
Dogs: Carcinoma and histiocytic sarcoma
Cats: Bronchial ACA
70
Which lung lobes are more commonly affected in dogs?
Caudal lobes
71
What are the three radiographic presentations of lung tumors in cats?
Mixed bronchoalveolar pattern
III- defined alveolar mass
Pulmonary mass w/ cavitation
72
What are the positive prognostic indicators of lung tumors in dogs?
< 5 cm, peripheral, absence of CS, lack of mets and lack of vascular/lymphatic invasion
73
What is the most important prognostic indicator in cats with lung tumors?
Histologic grade
Poor differentiation: 2.5 m
Well differentiation: 23 m
74
T/F: Presence of pleural effusion is a negative prognostic factor in cats with lung tumors?
TRUE
75
What is caval syndrome?
Cranial mediastinal tumor invasion into the cranial vena cava
Edema builds up in head, neck & forelimbs due to impairment of venous return to R atrium
76
What are the ddx for cranial mediastinal tumors?
LSA (most common) or thymoma
77
What is found on a cytology of cranial mediastinal tumors?
Large # of small mature lymphocytes and intermittent mast cells
78
What is the gold standard tx for thymoma?
Surgical tx- exploratory thoracotomy or median sternotomy
79
What is the MST in dogs and cats w/ thymoma?
Dogs: 790 days
Cats: 1,825
80
What is the most common primary bone tumor in dogs/cats?
OSA
81
What is the typical signalment for K9 OSA patients?
Large-giant breed, male
| Rotties, great dane, irish wolfhound, greyhound
82
T/F: The chances of developing OSA in a k9 patient are doubled when gonadectomized
TRUE
83
What are the ddx of K9 appendicular cancer?
OSA and CSA
| Infectious-Coccidioides immitis "Valley Fever"
84
What is the main difference in a patient with a fungal infection vs. tumor?
Fungal infection patients are systemically ill
85
T/F: Hind limbs are more commonly infected compared to forelimbs
FALSE- forelimbs 2X more affected than pelvic limbs
86
What are the common anatomical sites OSA is found?
Distal radius and proximal humerus
| Away from elbow, towards the knee
87
What are some rad appearances of a patient with OSA?
Cortical lysis-Hallmark sign
Lack of distinct border between normal & abnormal
Periosteal proliferation w/ extension into soft tissue
DOES NOT CROSS JOINTS
88
What are two different dx procedures that can be performed for OSA?
FNA/Cytology
| Bone bx
89
What is the instrument used for bone bx?
Jam Shedi
90
What is the gold standard for local management of primary bone tumors?
Limb amputation
91
What are the techniques used for thoracic and pelvic limb local control?
Thoracic: forequarter technique
Pelvic: coxofemoral disarticulation technique
92
What should be performed if there is a proximal femoral OSA lesion present?
Aggressive sx- en bloc acetabulectomy or subtotal hemipelvectomy
93
What are indications for limb salvage sx?
Severe osteoarthritis, neurologic dz, morbid obesity
94
What are the three chemo drugs used for OSA?
Cisplatin, Carboplatin, doxorubicin
95
What do bisphosphonates do in OSA patients?
Inhibit osteoclastic bone resoprtion
| Zoledronate and pamidronate
96
What is the MST for a patient with OSA who underwent palliative tx?
analgesia:1-3 months
RT: 4-10 months
97
What is the MST for a patient with OSA who underwent sx tx?
MST: 4-6 mo.
98
What is the MST for a patient with OSA who underwent sx tx w/ chemo?
8-12 mo.
99
What is the predilection site for feline OSA?
Diaphysis- more commonly affecting pelvic limbs
| Distal femur, proximal tibia and proximal humerus
100
T/F: Feline OSA is less aggressive than K9 OSA with a slower growth rate and less chance of mets
TRUE
101
What is the MST of feline OSA patients?
24-49 mo.
102
What is the most common cutaneous tumor in dogs?
MCT
103
What is the common signalment for MCT patients?
Dogs:8-9 yrs. old; brachy breeds (boxer, bull terrier, boston terrier, bulldog)
Cats: 8-9 yrs., SIAMESE
104
T/F: Boxers and brachycephalic dogs are predisposed for MCT but have a low grade and less aggressive form
TRUE
105
What can MCT commonly be mistaken for?
Lipomas
106
What is the name for the erythema and swelling of the skin of a MCT patient?
Darier's sign
107
What can you use to premedicate a patient with a MCT before sx?
H1 Antagonist- prevent platelet degranulation, anaphylaxis and hypotension
108
T/F: MCT will metastasize to the lungs
FALSE
109
Which type of MCT found in cats can spontaneously regress over 4-24 mo. and is found in young Siamese cats?
Histiocytic MCT
110
What are the two grading systems used for MCT?
Patnick 3-tier system (grades I, II, III)
| Kiupel 2-tier system (low vs. high grade)
111
What stain is used for the cytologic grading of MCT?
May-Grunwald-Giemsa stain
112
What chemotherapy agents are used for MCT?
Pred/Vinblastine
113
What locations of MCT typically do worse?
Subungual, oral or other mm's
Preputial & Scrotal
Visceral or BM
114
What is the most common hematopoietic tumor?
Lymphoma
115
What is the most common anatomical classification of lymphoma?
Multicentric
116
Which is the less aggressive form- lymphoblastic or lymphocytic?
Lymphocytic- slow growth with a low met rate
117
Which form is better to have- B cell or T cell lymphoma?
B-cell
| B-cell is always better, T-Cell is terrible
118
What is the most common form of lymphoma in cats?
Alimentary/gastrointestinal form
119
What is the difference of substage a vs. substage b multicentric nodal lymphoma?
Substage a: clinically healthy
| Substage b: lethargy, weakness and other CS
120
What are the sites used for bone marrow aspirate in dogs and cats?
Dogs: greater tubercle of humerus and iliac crest
Cats: femoral intertrochanteric fossa
121
T/F: Clinical pathologists can dx lymphoma in dogs with FNA?
TRUE
122
What treatment method for K9 lymphoma has the highest success rate?
Multi-agent chemotherapy
| CHOP- cyclophosphamide, hydroxydaunorubicin, oncovin, prednisolone
123
What tx method for feline lymphoma has the highest success rate?
Multi-agent chemotherapy
| COP- cyclophosphamide, oncovin, prednisolone
124
If relapse of lymphoma occurs over 2 months post chemo what should you do?
re-induction of previous chemo drug
125
If relapse of lymphoma occurs less than 2 months post chemo what should you do?
Rescue chemotherapy
126
What is defined as immature lymphoblastic neoplasia of the bone marrow?
Acute lymphoblastic leukemia
127
What is defined as a proliferation of phenotypical mature lymphocytes in bone marrow?
Chronic lymphocytic leukemia
128
What proteins are associated with multiple myeloma?
Bence jones proteins
129
what is the most common bladder tumor?
TCC
130
What is the most common non-neoplastic ddx for bladder tumors?
Polypoid cystitis
131
What are some possible Etx of bladder tumors?
Topical insecticide & herbicide exposure
Environmental pollution
Obesity
132
Which breed is predisposed to TCC?
Scottish terriers
133
What can be don to reduce the risk of TCC in dogs?
Feeding vegetables (carrots) at least 3x a week
134
T/F: Fipronil products have no correlation to TCC in dogs?
TRUE
135
What anatomical site is K9 TCC most commonly found?
Trigone of bladder
136
What specific type of urine collection should be used in a TCC patient
Traumatic catheterization
137
What are the three dx modalities used for TCC and what is the most preferred method?
Cystosonography- most preferred
Cystoscopy w/ bx
CADET BRAF Mutation Detection Assay
138
What is "field effect" in terms of TCC?
Entire bladder lining is thought to undergo malignant change in response to carcinogens in urine
139
What are the tx methods for TCC?
```
Partial cystectomy w. localized bladder neoplasia
Laser ablation
Cystostomy tube/transurethral stenting
NSAIDs
Chemotherapy- Mitoxantrone w/ piroxicam
```
140
What is the common signalment for K9 mammary tumors?
Females, 7-13 yrs. old
Pointers, Irish Setter, Brittany Spaniel, English Springer Spaniel, Lab, G pyrenees, Samoyed, Airedale Terrier, Mini/Toy Poodle, Dachshund & Keeshond
141
What is the common signalment for feline mammary tumors?
3rd most common tumor
| Siamese, 10-12 yrs.
142
What is inflammatory carcinoma?
Unique and aggressive variant of mammary gland tumors
CS: pain, anorexia, wt. loss, generalized weakness, PU/PD
Diffuse swelling and poor demarcation between normal/abnormal tissue
POOR sx candidates- POOR prognosis
143
T/F: The risk of developing mammary gland tumors in cats is 7x higher when intact
TRUE
| OHE before 6 mo. has a 91% reduction rate
144
How can you reduce the risk of mammary tumors in dogs?
OHE before first estrus cycle
145
T/F: FNA and cytology has high potential for false negatives with mammary gland tumors
TRUE
146
What are the margins for a simple lumpectomy vs. a mastectomy?
Simple lumpectomy: <0.5 cm, moveable and B9
| Mastectomy: >1 cm, fixed or moveable
147
What are the MST for the following tumor sizes in cats:
<2 cm
2-3 cm
>3 cm
<2 cm: 3 yr
2-3 cm: 2 yr
> 3cm: 6 m
SIZE MATTERS
148
What are the prognosis for the following tumor sizes in dogs:
< 3cm
> 5 cm
< 3 cm: better prognosis
> 5 cm: worse prognosis
SIZE DOESN'T MATTER- LN involvement=BAD
149
What is the second most common K9 repro tumor?
Vaginal tumor- majority are B9 and smooth muscle origin
150
What is the most common malignant vaginal tumor?
Leiomyosarcoma
151
What are the presenting complaints of a patient with vaginal tumor?
Visible protruding mass (most common)
| Vaginal discharge, hematuria, dysuria, tenesmus & excessive licking of vulva
152
What is needed to make a definitive dx of a vaginal tumor?
histopathology
153
What is the treatment for B9 vs. malignant vaginal tumor?
B9: conservative sx resection w/ exploratory laparotomy for OHE
Malignant: complete vulvovaginectomy & perineal urethrostomy
154
What is the most common tumor of male genitalia?
Testicular tumors
155
What are the predisposed breeds for testicular tumors?
Boxer, GSD, Weimaraner, Afghan, Collie, SHeltie & Maltese
156
What are the three ddx for testicular tumors?
Interstitial cell tumor (interstitial cells of leydig)
Seminoma (germinal epithelium of seminiferous tubules)
Sertoli cell tumor (sustentacular cells of seminiferous tubules)
157
What is the common signalment for soft tissue sarcomas?
Middle-aged to older patients
| Large breed dogs
158
What variant of soft tissue sarcomas tends to develop in younger dogs?
Rhabdomyosarcoma
159
What are the common features of a soft tissue sarcoma?
Pseudo-encapsulated soft to firm masses w/ poor margins
Local recurrence is common
Hematogenous route of mets
160
What kind of bx is performed for soft tissue sarcomas?
True cut/wedge (not punch since hypodermal)
161
What are negative prognostic factors for soft tissue sarcomas?
Large tumor size
Incomplete margins
High histologic tumor grade
162
What vaccines were associated with feline injection site sarcomas?
Killed RV and FeLV vaccines
163
What is the suspected problem that could've led to the feline injection site sarcomas?
Suspected aluminum adjuvant in vaccine contributing to massive inflammatory rxn leads to uncontrolled fibroblast & myofibroblast proliferation and eventual tumor formation
164
T/F: You can perform and excisional bx for feline injection site sarcomas
FALSE- incisional bx should be performed
165
What is the margin recommendation for feline injection site sarcomas?
sx excision w/ 5 cm radial margins & 2 muscle planes deep
Recurrence rate- 14%
166
T/F: Primary tumors of the liver are more common than metastasized tumors in dogs
FALSE- true for cats
167
What are the 4 categories of primary tumors?
Hepatocellular
Bile duct
Neuroendocrine
Mesenchymal
168
What morphological primary hepatobiliary tumor is most frequently seen?
Massive- large solitary masses confined to a single liver lobe
169
What is the most common primary liver tumor in dogs?
HCC
170
Which liver lobe accounts for 75% of hepatocellular tumors?
L sided lobe
171
What is the malignant and B9 bile duct neoplasia in dogs?
B9: bile duct adenoma
Malignant: bile duct carcinoma
172
Which bile duct neoplasia represents more than 50% of all feline hepatobiliary tumors?
Bile duct adenoma
173
Trematode infestation is a risk factor for what neoplasia in dogs and cats?
Bile duct carcinoma
