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Small Animal Medicine > Oncology - Oral and Nasal > Flashcards

Oncology - Oral and Nasal Flashcards

1
Q

What is the most common oral tumor in the dog?

A

Melanoma

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2
Q

What oral tumors do dogs get?

A

Melanoma, SCC, fibrosarcoma, acanthomatous ameloblastoma

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3
Q

What nasal tumors do dogs get?

A

adenocarcinoma

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4
Q

What history is often associated with oral tumors in dogs?

A

Halitosis, blood in the water bowl, ptyalism, dysphagia, and hyporexia

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5
Q

When you are trying to diagnose canine oral tumors, what do you want to examine in the mouth?

A

Mandible, maxilla, palate, tongue, under the tongue, tonsils, and palpate under the mandible and between the rami

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6
Q

True or False: All oral tumors look the same.

A

False - they can be raised, pignmented, ulcerated, smooth, and friable

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7
Q

What is the first diagnostic test you want to do, aside from PE, when you have an oral neoplasia?

A

minimum database

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8
Q

You should aspirate one/both regional LN in patients with an oral mass.

A

both - even if they could look normal

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9
Q

True or False: FNA is better for diagnosing oral tumors.

A

False - biopsy is best

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10
Q

What imaging methods should you do if you are dealing with an oral tumor?

A

Chest x-rays to look for metastasis, +/- dental rads, and CT scan

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11
Q

Oral malignant melanomas are tumors of the _______.

A

melanocytes

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12
Q

Where are oral melanomas most commonly seen?

A

Gingiva, lips, tongue, and hard palate

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13
Q

True or False: Not all oral melanomas are pigmented

A

true - 1/3 of them are not

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14
Q

How do oral melanomas typically look in the mouth (not color)?

A

ulcerated and necrotic

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15
Q

What does the biological behavior of oral melanomas depend on?

A

size, site, and histologic parameters

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16
Q

Oral melanomas are ______ invasive with a high _______ potential.

A

Locally, metastatic

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17
Q

How can oral melanomas be treated?

A

Surgery, radiation, chemotherapy, COX 2 inhibition, and the melanoma vaccine

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18
Q

Does a patient have a better prognosis if it gets surgery alone or surgery with radiation therapy?

A

surgery with radiation therapy

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19
Q

Does the stage of oral melanoma affect the survival time?

A

Yes, the worse the stage, the shorter survival time

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20
Q

What are some negative prognostic factors for oral melanomas?

A

Incomplete surgical margins, locations, and surgery alone

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21
Q

Is radiation alone or radiation with surgery associated with a longer survival time in oral melanoma patients?

A

radiation with surgery

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22
Q

What is the only chemotherapy that oral melanoma is responsive to?

A

Carboplatin - still not very responsive

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23
Q

What drug can inhibit COX2 and aid in treatment of oral mealnoma?

A

Piroxicam

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24
Q

What stages of oral melanoma is the melanoma vaccination licensed for?

A

stage II/III with local control

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25
Q

True or False: The oral melanoma vaccination can be used to prevent oral melanoma.

A

False

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26
Q

What is the oral melanoma vaccination made out of?

A

Gene for human tyrosinase is inserted into a DNA plasmid

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27
Q

What does the oral melanoma vaccination do?

A

Stimulates the immune system to the presence of the tyrosinase and targets melanoma cells

28
Q

Large/small breeds more often get canine fibrosarcoma.

A

Large

29
Q

60-72% of fibrosarcomas have ____ involvement.

A

bone

30
Q

How are fibrosarcomas typically treated?

A

Surgical treatment and radiation treatment

31
Q

Which of the following have a longer survival time associated with fibrosarcomas?

a. surgery alone
b. radiation alone
c. surgery and radiation

A

c. surgery and radiation

32
Q

What are the prognostic factors for fibrosarcoma?

A

Size of the tumor, complete resection, smaller diameter, and rostral location

33
Q

Smaller/Larger fibrosarcomas are associated with a poorer prognosis.

A

larger

34
Q

In cases of oronasal fistulas as a result of fibrosarcoma therapy, what are treatment options?

A

Surgical flap or a temporary septal button

35
Q

Ideally, what is the recommended treatment for oronasal fistulas?

A

Ideally place a button, give tumor time to regress further, and fix permanently with a flap

36
Q

Why should you use caution with fibrosarcomas?

A

They can be histologically low grade, but biologically high grade (very locally aggressive)

37
Q

What is a canine epulis?

A

Benign gingival proliferations arising from the periodontal ligament

38
Q

What do canine epulis appear similar to?

A

gingival hyperplasia

39
Q

True or False: Fibromatous, ossifying, and giant cell epulis have a bimodal peak in regards to age of onset (young and old)

A

False - It is acanthomatous that do that

Fibromatous, ossifying, and giant cell are unimodal

40
Q

Where are fibromatous, ossifying, and giant cell epulis typically located?

A

Maxillary and mandibular premolars

41
Q

What disease process are fibromatous, ossifying, and giant cell epulis associated with?

A

chronic gingivitis

42
Q

Where are acanthomatous epulis located?

A

mandibular canine

43
Q

What diagnostic test should you do in cases of acanthomatous ameloblastomas?

A

biopsy

44
Q

What do you need to make sure you include when doing surgical resection of acanthomatous ameloblastomas?

A

include the bony margins for better tumor control

45
Q

Can RT be used for acanthomatous ameloblastomas?

A

yes

46
Q

Canine nasal neoplasia is associated with acute/chronic nasal disease.

A

chronic

47
Q

Canine nasal neoplasia are typically ______ invasive.

A

locally - they can metastasize

48
Q

What type of tumors are nasal neoplasias?

A

Carcinomas (2/3), Sarcomas (1/3), and nasal polyps

49
Q

What clinical signs are associated with canine nasal neoplasia?

A

Intermittent and progressive unilateral epistaxis or mucopurulent discharge, neurologic signs possible, and may response initially to abx, steroids, and NSAIDs

50
Q

True or False: Dogs with epistaxis and concurrent clinical signs of systemic disease are likely to have a non-neoplastic disease

A

true

51
Q

What do you want to do on PE on patients with nasal neoplasia?

A

Palpate the head and nose, check airflow, check retropulsion, look for exophthalmos, ocular discharge, and fundic examination

52
Q

What differentials should there be along side with nasal neoplasia?

A

Fungal infections, coagulopathy, foreign body, and lymphocytic-plasmacytic rhinitis

53
Q

What should you do for staging of nasal neoplasia?

A

Minimum database, coagulation profile, blood pressure, LN FNA, chest rads, CT/rhinoscopy, biopsy, +/- ultrasound

54
Q

What should you always have set up when you are doing a CT/rhinoscopy for a nasal neoplasia?

A

radiation

55
Q

What are the considerations for nasal biopsies?

A

They need anesthesia (it is painful), measure, don’t go further than the medial canthus of the eye, be prepared for bleeding

56
Q

When treating nasal neoplasia, what is it important to keep in mind?

A

You need to control local disease and bone invasion is common

57
Q

True or False: Curative surgery is common for treatment of nasal neoplasia.

A

False

58
Q

What is the treatment of choice for canine nasal neoplasia?

A

Radiation - stereotactic

59
Q

Why is radiation such a good treatment for canine nasal neoplasia?

A

It treats the entire nasal cavity - including bone

60
Q

What normal tissue complications are associated with radiation therapy of nasal neoplasia?

A

Late - cataracts, brain necrosis, and osteonecrosis

We don’t see acute signs

61
Q

Is stereotactic radiation the only option for patients with nasal neoplasia?

A

No - you can do palliative radiation therapy to improve quality of life

62
Q

What imaging may be helpful with the use of palliative radiation therapy?

A

CT

63
Q

What is the preferred chemotherapy for canine nasal neoplasia?

A

Palladia

There is another protocol but it is less effective

64
Q

What are some palliative treatments for nasal neoplasia?

A

Carotid artery ligation, Yunnan Baiyao, and NSAIDs

65
Q

What are the negative prognostic indicators for canine nasal neoplasia?

A

Age >10 years, epistaxis, long duration of clinical signs, advanced local tumor stage (cribriform plate), metastatic disease, histologic subtype, and failure to achieve resolution of clinical signs

Small Animal Medicine (100 decks)

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