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Small Animal Medicine > Oncology - Osteosarcoma and Hemangiosarcoma > Flashcards

Oncology - Osteosarcoma and Hemangiosarcoma Flashcards

1
Q

What is an osteosarcoma?

A

It is a malignant mesenchymal tumor of primitive bone that produces an extracellular osteoid matrix

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2
Q

True or False: Osteosarcoma is the most common skeletal malignancy in dogs.

A

True

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3
Q

What type of age distribution does osteosarcoma have?

A

Bimodal - young dogs, and old dogs

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4
Q

What breeds more commonly get osteosarcomas?

A

Large/Giant Breed dogs

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5
Q

What legs usually get osteosarcomas more commonly?

A

Front legs

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6
Q

Where do osteosarcomas more commonly happen?

A

at the metaphysis

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7
Q

What are the developmental factors that can lead to osteosarcoma?

A

Large, fast growing dogs

Dogs who get ionizing radiation

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8
Q

How are osteosarcomas diagnosed?

A

Radiographs primarily

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9
Q

Is cytology or a biopsy necessary for osteosarcoma diagnosis?

A

It has decent accuracy of determining malignancy and an average accuracy of determining tumor type Can fracture

Long story short - not entirely necessary

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10
Q

Is a definitive diagnosis of osteosarcoma needed before treatment?

A

no - any other lesion that could be caused there may be treated similarly
If you are doing radiation - no

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11
Q

What should be done for staging?

A

3 view chest rads
LN aspirate
Bone scan is not helpful

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12
Q

What percentage of cases have micrometestatic disease at diagnosis of osteosarcoma?

A

90%

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13
Q

What is osteosarcoma grading based on?

A

Amount of pleomorphism, tumor cell appearance, MI, and necrosis

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14
Q

What grade of osteosarcoma has the highest risk of death

A

Grade III

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15
Q

What are subclassifications of osteosarcoma based on?

A

the type and amount of matrix, may impact survival

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16
Q

What is a stage I OSA?

A

Low grade, no metastasis

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17
Q

What is a stage II OSA?

A

high grade, no metastasis

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18
Q

What is a stage III OSA?

A

Low or high grade, mets

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19
Q

What is a stage A OSA?

A

Intracompartamental

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20
Q

What is a stage B OSA?

A

Extracompartamental

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21
Q

What stage and grade are most dogs that we diagnose with OSA?

A

Stage IIB

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22
Q

What are the treatment options for OSA?

A

Surgery, radiation, chemotherapy, and pain control

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23
Q

What is the recommended surgery for OSA?

A

Amputation - this does nothing for the metastasis

Limb spare

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24
Q

What is limb spare?

A

You take the tumor out and replace it with something - can only do for distal radial osteosarcoma

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25
Q

What radiation therapy options are there for osteosarcoma?

A

Palliative and stereotactic

26
Q

What is something important to keep in mind about stereotactic therapy and OSA?

A

The leg will fracture within a year

27
Q

What is the chemotherapy of choice for OSA?

A

Carboplatin (less side effects) or doxorubicin

28
Q

What can be done to remove pulmonary metastatic disease associated with OSA?

A

pulmonary metastasectomy

29
Q

What criteria are there for pulmonary metastasectomy?

A

Stable primary disease for 300 days
3 lesions or less
Radiographic doubling time for >40 days
No other evidence of disease

30
Q

What pain control can be given to manage OSA?

A

NSAIDs, Opioids, Gabapentin, and bisphosphonates

31
Q

What do bisphosphonates do?

A

Prevent oseoclastic activity - bone break down

32
Q

What is a risk with pain management of OSA?

A

When they are feeling better they may end up fracturing their bone

33
Q

What is the median survival time for OSA with one of the treatments if done alone?

A

5 months

34
Q

What is the median survival time for OSA when multiple treatments are done together?

A

9-12 months

35
Q

True or False: Pathologic fracture in a patient with OSA does not impact prognosis.

A

True

36
Q

What are negative prognostic factors for OSA?

A

Large tumor, humeral location, high tumor grade, high MI, stage III, elevated ALP, monocytosis, and lymphocytosis

37
Q

True or False: Osteosarcoma is not painful and aggressive.

A

It is very painful and aggressive

38
Q

If you see anisocytosis, polychromasia, or acanthocytes, what should you be worried about?

A

Something is going on in the spleen

39
Q

What differentials should you consider with hemangiosarcoma (HSA)?

A

Hematoma, hemangioma, sarcomas, other tumors, and extramedullary hematopoiesis

40
Q

What is a HSA?

A

Aggressive vascular endothelial cell tumor

41
Q

What percentage of splenic neoplasias are hemangiosarcomas?

A

50%

42
Q

What is the typical signalment for HSA?

A

middle aged to older

Breeds - GSH, goldens, labs, large breed dogs, lightly pigmented breeds

43
Q

What can cause cutaneous HSA?

A

UV light or radiation therapy

44
Q

What can cause visceral HSA?

A

Ionizing radiation pre or postnatally or genetic predisposition

45
Q

Where are the primary sites of HSA in dogs?

A

Spleen, right auricular, skin, subcutis, and muscle, liver, and kidney

46
Q

What percentage of HSAs present with overt metastasis at presentation?

A

80%

47
Q

True or False: HSA are the number one neoplasia that goes to the brain.

A

True

48
Q

What clinical signs are associated with HSA?

A

Weakness and collapse, signs associated with hypovolemia, abdominal distension, weight loss, signs of right hearted failure, seizures, and lameness

49
Q

What will you see on CBC/Chem/UA in patients with HSA?

A

Regenerative anemia, neutrophilic leukocytosis, thrombocytopenia, schistocytes, acanthocytes, and hypoglycemia

50
Q

What will you see on coagulation profile in patients with HSA?

A

Elevations in PT/PTT - 50% will have coagulation abnormalities meeting the criteria for DIC

51
Q

What other diagnostics and staging tests should be done for HSA?

A

Three-view thoracic rads. abdominal ultrasound, ECG, EKG

52
Q

What will you see on an EKG in patients with HSA?

A

VPCs and ventricular tachycardia

53
Q

What is the gross pathology of HSA?

A 
Solitary or multifocal, disseminated
pale grey to dark red/purple
Soft, gelatinous, blood filled, necrotic
nonencapsulated
friable
54
Q

What is staging for HSA based on?

A

Primary tumor, regional lymph nodes, distant metastasis

55
Q

What is the only chemotherapy agent effective in hemangiosarcomas?

A

Doxorubicin

56
Q

What is the survival time for chemotherapy in patients with HSA?

A

6 months

57
Q

What does I’m Yunity do?

A

It contains polysaccharides that are immunomodulatory, inhibit tumor cell growth, and free radical scavenger

58
Q

What does Yunnan Baiyao do?

A

It stops bleeding and can be helpful in HSA cases

59
Q

What is the most effective treatment for HSA?

A

splenectomy with doxorubicin

60
Q

True or False: All splenic masses are malignant.

A

False - but 2/3 are

Small Animal Medicine (100 decks)

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