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

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

True

How well did you know this?

Not at all

Perfectly

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

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

Cats: SCC, Fibrosarcoma

How well did you know this?

Not at all

Perfectly

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

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

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

DO NOT DO EXCISIONAL BIOPSY

How well did you know this?

Not at all

Perfectly

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

Size

How well did you know this?

Not at all

Perfectly

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

Melan A

How well did you know this?

Not at all

Perfectly

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

Abdominal US

Full body CT

How well did you know this?

Not at all

Perfectly

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

Probably not a fibroma, but a fibrosarcoma

Aggressive surgery required

How well did you know this?

Not at all

Perfectly

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

True

How well did you know this?

Not at all

Perfectly

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

Tumors tend to express PTH-rp

How well did you know this?

Not at all

Perfectly

What is the predilication site for oral SCC in cats?

Sublingual

How well did you know this?

Not at all

Perfectly

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

Feline Inductive Odotogenic tumors

Aggressive local surgery

How well did you know this?

Not at all

Perfectly

Why do more rostral oral tumors havea better prognosis?

Easier to excise

How well did you know this?

Not at all

Perfectly

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?

Peripheral odotogenic fibroma

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

How well did you know this?

Not at all

Perfectly

What can be done to shrink oral melanomas?

Radiation therapy

How well did you know this?

Not at all

Perfectly

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

Piroxicam (prolongs survival)

How well did you know this?

Not at all

Perfectly

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

Spirocerca lupi

Sarcomas

How well did you know this?

Not at all

Perfectly

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?

SCC

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

DDx: Leiomyosarcoma

How well did you know this?

Not at all

Perfectly

What is the gold standard for diagnosing esophageal tumors?

Biopsy via esophagoscopy

How well did you know this?

Not at all

Perfectly

What breeds are prediposed to gastric tumors? Sex prediliction?

Belgian Shepherds

Chow chows

Males >> Females

How well did you know this?

Not at all

Perfectly

What is the most common clinical sign with gastric tumors?

Anorexia

How well did you know this?

Not at all

Perfectly

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

Dogs: ACA (adenocarcinoma), Leiomyosarcoma

Cats: LSA

How well did you know this?

Not at all

Perfectly

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

Pyloric antrum/lesser curvature

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

How well did you know this?

Not at all

Perfectly

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

Ultrasound (US-guided FNA/cytology)

Endoscopy

How well did you know this?

Not at all

Perfectly

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

Leiomyosarcoma (MST 12-21 mo)

(ASA most dead within 6mo)

How well did you know this?

Not at all

Perfectly

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

Dogs Cats

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

_Dogs:_ LSA, ACA, Leiomyosarcoma _Cats:_ LSA, ACA, MCT

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

Depth of invasion

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

_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)

What is a negative prognostic indicator for dogs with ACA?

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

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

Interstitial cells of Cajal Cecum

\_\_\_\_ 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.

Liver

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

Hepatocellular Bile duct Neuroendocrine (carcinoid) Mesenchymal Based on cell of origin

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?

Massive Hepatocellular

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?

Diffuse Neuroendocrine

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

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

_Dogs_: HCC _Cats:_ Hepatocellular adenoma

What dictates the treatability of hepatocellular tumors?

Morphologic subtype

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

Right division Vena cava runs through liver here

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.

True (\>1460 days vs 270 days)

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?

75% 6 weeks

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

Hepatobiliary cystadenoma

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

Trematode infestation

What is carcinomatosis and in what species does it occur?

Diffuse intraperitoneal mets from bile duct carcinomas Cats

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

True

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

Silver stains Younger No, rare

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

Chemoembolization

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

Rapid development of drug resistance Bypass by using chemoembolization

Why does radiation therapy not work well for liver tumors?

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

Where is the preferential site of metastasis for renal tumors?

Lungs

What are the 4 general categories of primary renal tumors?

Renal tubular carcinomas Transitional cell carcinomas Nephrobastic tumors Non-epithelial tumors (Sarcomas and LSA)

What PSA occurs in GSD with renal cystadenocarcinoma?

Nodular dermatofibrosis Females get uterine leiomyomas

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

Abdominal ultrasound + US guided FNA/cytology

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

Contrast agents are nephrotoxic and could compromise the healthy kidney

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

To ensure the caudal vena cava is not being infltrated

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?

Renal cell carcinoma Unilateral Polycythemia

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

Nephroblastomas Humans: Wilms' tumor

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

Lymphoma Staging important because LSA is often multicentric ALWAYS consider disease bilateral

How is renal lymphoma treated in cats

Multi-agent chemotherapy | (NEVER SURGERY)

What is the treatment for renal carcinoma in dogs?

Surgery (resistant to chemo, hormonal therapy and RT)

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

Cushinoid symptoms

Where do pheochromocytomas originate? What do they produce?

Medulla of adrenal gland Epi, norepi, dopamine

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.

\<2cm 3 months

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

ACTH stim U:C ratio

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

Endogenous ACTH

What test can you use to diagnose a pheochromocytoma?

Metanephrine/Normetaneohrine to Creatinine ratio (urine test)

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

Phenoxybenzamine (q2-3 weeks) To minimize the potential for surges in blood pressure during surgery

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

True