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SAM I > Oncology: General, Treatments, Head, GIT and Abdominal masses (E2) > Flashcards

Oncology: General, Treatments, Head, GIT and Abdominal masses (E2) Flashcards

1
Q

T/F: Oral tumors are more common in dogs than cats, and more common in males than females.

A

True

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2
Q

What are the “Big 3” DDx for oral tumors in dogs? What are the “Big 2” for cats?

A

Dogs: Melanoma, SCC, Fibrosarcoma (in order of most to least common)

Cats: SCC, Fibrosarcoma

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3
Q

What type of biopsy is indicated for a proliferative oral tumor? Non-proliferative oral tumor?

A

Proliferative - Incisional “shave” biopsy (under heavy sedation)

Non-proliferative- Incisional biopsy never through lip and NOT under sedation

DO NOT DO EXCISIONAL BIOPSY

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4
Q

What is the most important prognostic/staging indicator for oral tumors?

A

Size

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5
Q

What special stain can be used to differentiate a sarcoma from an amelanotic melanoma?

A

Melan A

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6
Q

Thorough staging is required for oral tumors, especially malignant melanoma. What needs to be done do stage these?

A

Abdominal US

Full body CT

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7
Q

A 1.5 year old golden retreiver presents with a very large benign loooking oral tumor. The biospy comes back as a fibroma. Thoughts?

A

Probably not a fibroma, but a fibrosarcoma

Aggressive surgery required

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8
Q

T/F: Oral fibrosarcomas and SCC have low metastatic rates but are locally invasive.

A

True

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9
Q

Why are significant bone resorption and hypercalcemia common PNS in cats with oral SCC?

A

Tumors tend to express PTH-rp

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10
Q

What is the predilication site for oral SCC in cats?

A

Sublingual

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11
Q

What is the feline counterpart for acanthomatous amelioblastomas? What is done to control these tumors?

A

Feline Inductive Odotogenic tumors

Aggressive local surgery

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12
Q

Why do more rostral oral tumors havea better prognosis?

A

Easier to excise

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13
Q

What is the benign slow growing oral tumor common in dofs that contains proliferative fibroblastic connective and odontogenic tisssue and how should you address it?

A

Peripheral odotogenic fibroma

Surgically excise mass, preferrably using cryo. Can wait and see if you have a confirmative biopsy.

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14
Q

What can be done to shrink oral melanomas?

A

Radiation therapy

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15
Q

What drug should be given to all cats with oral SCC?

A

Piroxicam (prolongs survival)

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16
Q

What parasite causes esophageal tumors and what kind of tumor forms?

A

Spirocerca lupi

Sarcomas

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17
Q

What is the most common esophageal tumor? Where do they tend to form in cats and which sex is prediposed?

What is the other most likely DDx?

A

SCC

Middle 1/3 of esophagus just caudal to thoracic inlet, females prediposed (cats)

DDx: Leiomyosarcoma

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18
Q

What is the gold standard for diagnosing esophageal tumors?

A

Biopsy via esophagoscopy

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19
Q

What breeds are prediposed to gastric tumors? Sex prediliction?

A

Belgian Shepherds

Chow chows

Males >> Females

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20
Q

What is the most common clinical sign with gastric tumors?

A

Anorexia

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21
Q

What are the “Big 2” Ddx for gastric tumors in dogs? What is the most common gastric tumor in cats?

A

Dogs: ACA (adenocarcinoma), Leiomyosarcoma

Cats: LSA

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22
Q

Where do gastric adenocarcinomas tend to form? What do they look like?

A

Pyloric antrum/lesser curvature

Often scirrhous (firm, white or serosal surface), Linitis plastica (leather bottle)

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23
Q

What is the staging test of choice for gastric tumors? What is the best tool for assessing resectability?

A

Ultrasound (US-guided FNA/cytology)

Endoscopy

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24
Q

Which gastric tumor has a better prognosis, ACA or leiomyosarcoma?

A

Leiomyosarcoma (MST 12-21 mo)

(ASA most dead within 6mo)

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25
Q

Species: Large intestinal tumrs are more common than small intestinal tumors in ____ while the opposite is true in ____.

A

Dogs

Cats

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26
Q

What are the “Big 3” DDx for intestinal tumors in dogs? Cats?

A

Dogs: LSA, ACA, Leiomyosarcoma

Cats: LSA, ACA, MCT

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27
Q

Unlike other tumors, WHO staging for intestinal tumors depends on what rather than tumor size?

A

Depth of invasion

28
Q

What are negative prognostic indicators for dogs with intestinal LSA? Cats?

A

Dogs: failure to achieve remission, diarrhea at initial presentation (MST 2 mo)

Cats: poor response to chemo (MST<3.5mo vs >11mo if do respond)

29
Q

What is a negative prognostic indicator for dogs with ACA?

A

Being female (MST males 27days, females 28 days)

30
Q

From what cells do gastrointestinal stromal tumors originate? What is their prediliction site?

A

Interstitial cells of Cajal

Cecum

31
Q

____ is a receptacle for metastasis and receives mets 2.5x more frequently than developing primary tumors in dogs. In cats primary tumors of this organ are more common than mets.

A

Liver

32
Q

What are the 4 general categories of primary liver tumors? What are these categories based on?

A

Hepatocellular

Bile duct

Neuroendocrine (carcinoid)

Mesenchymal

Based on cell of origin

33
Q

What do you call a primary hepatobiliary tumor that is large, solitary and confined to a single liver tobe? What tumor type is most commonly of this morphology?

A

Massive

Hepatocellular

34
Q

What is the morphologic descriptor for hepatocellular masses that are multifocal and involve all liver lobes? What tumor type is most commonly of this morphology?

A

Diffuse

Neuroendocrine

35
Q

What staging modality is recommended for staging an assessing resectability for large or infiltrative hepatobiliary tumors?

A

CT

36
Q

What is the most common liver tumor in dogs? Cats?

A

Dogs: HCC

Cats: Hepatocellular adenoma

37
Q

What dictates the treatability of hepatocellular tumors?

A

Morphologic subtype

38
Q

In division of the liver are complications of tumor removal most severe and why?

A

Right division

Vena cava runs through liver here

39
Q

T/F: MST for dogs who have had surgery to remove a liver mass is significantly higher than for patients who did not undergo surgery.

A

True (>1460 days vs 270 days)

40
Q

How much of the total mass of the liver can you remove and how long does it take for it to regain its original size?

A

75%

6 weeks

41
Q

What tumor is common in cats and account for >50% of all feline hepatobiliary tumors?

A

Hepatobiliary cystadenoma

42
Q

What is a risk factor for bile duct carcinomas in dogs and cats?

A

Trematode infestation

43
Q

What is carcinomatosis and in what species does it occur?

A

Diffuse intraperitoneal mets from bile duct carcinomas

Cats

44
Q

T/F: Chemotherapy and RT are not effective for bile duct carcinomas.

A

True

45
Q

How are neuroendocrine tumors differentiated from carcinomas? Does this tumor occur in younger or older animals? Is it common?

A

Silver stains

Younger

No, rare

46
Q

What is the non-invasive interventional radiologic technique used to isolate affected liver lobes microvascularly (i.e. stop blood supply)?

A

Chemoembolization

47
Q

Why does chemotherapy not work well for liver tumors? How do you bypass the issues that make chemo ineffective?

A

Rapid development of drug resistance

Bypass by using chemoembolization

48
Q

Why does radiation therapy not work well for liver tumors?

A

Liver cannot tolerate the high levels of radiation (>30 Gy) required to achieve remissions

49
Q

Where is the preferential site of metastasis for renal tumors?

A

Lungs

50
Q

What are the 4 general categories of primary renal tumors?

A

Renal tubular carcinomas

Transitional cell carcinomas

Nephrobastic tumors

Non-epithelial tumors (Sarcomas and LSA)

51
Q

What PSA occurs in GSD with renal cystadenocarcinoma?

A

Nodular dermatofibrosis

Females get uterine leiomyomas

52
Q

What is the gold standard for assessing and staging renal tumors?

A

Abdominal ultrasound + US guided FNA/cytology

53
Q

Why do we tend to shy away from using excretory urography for renal tumors?

A

Contrast agents are nephrotoxic and could compromise the healthy kidney

54
Q

Why would you want to use CT to work-up/stage a renal tumor?

A

To ensure the caudal vena cava is not being infltrated

55
Q

What is the most common renal tumor in dogs? Is it usually uni- or bilateral? What is the most common PNS associated with this tumor?

A

Renal cell carcinoma

Unilateral

Polycythemia

56
Q

Aside from the autosomal dominant cystadenocarcinomas that GSD get, what congenital tumor also affects young dogs? What is this tumor called in humans?

A

Nephroblastomas

Humans: Wilms’ tumor

57
Q

What is the most common renal tumor in cats? Why is staging very important? Is it usually uni- or bilateral?

A

Lymphoma

Staging important because LSA is often multicentric

ALWAYS consider disease bilateral

58
Q

How is renal lymphoma treated in cats

A

Multi-agent chemotherapy

(NEVER SURGERY)

59
Q

What is the treatment for renal carcinoma in dogs?

A

Surgery (resistant to chemo, hormonal therapy and RT)

60
Q

What symptoms accopany functional adrenocortical tumors originating in the zona glomerulosa?

A

Cushinoid symptoms

61
Q

Where do pheochromocytomas originate? What do they produce?

A

Medulla of adrenal gland

Epi, norepi, dopamine

62
Q

If a dog is asymptomatic and has an adrenal mass that is ____cm it is probably benign. Serial US should be done every ________ to monitor the mass and track its growth.

A

<2cm

3 months

63
Q

What tests can you use to confirm functionality of an adrenocortical ACA or adenoma?

A

ACTH stim

U:C ratio

64
Q

What test can you perform to confirm that an adrenocortical tumor is adrenal dependent?

A

Endogenous ACTH

65
Q

What test can you use to diagnose a pheochromocytoma?

A

Metanephrine/Normetaneohrine to Creatinine ratio (urine test)

66
Q

If you suspect that a tumor is a pheochromocytoma, what should you pre-treat the animal with before surgery? Why?

A

Phenoxybenzamine (q2-3 weeks)

To minimize the potential for surges in blood pressure during surgery

67
Q

T/F: The prognosis is the same regardness of whether an adrenal tumor is an ACA or an adenoma.

A

True

SAM I (2 decks)

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