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Year 4 Small Animal Studies > Oncology: Sarcomas > Flashcards

Oncology: Sarcomas Flashcards

1
Q

What is a sarcoma?

A

A malignant cancer that arises from transformed cells of mesenchymal origin

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2
Q

What are the names for sarcomcas of following tissues?
1. Bone
2. Connective tissue
3. Blood vessels
4. Muscle
5. Fat
6. Cartilage

A
  1. Osteosarcoma
  2. fibrosarcoma
  3. Haemangiosarcoma
  4. Rhabdomyosarcoma
  5. Liposarcoma
  6. Chondrosarcoma
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3
Q

What is the general behaviour of sarcomas?

A
  • Locally invasive
  • High metastasis- oestoesarcoma, haemangiosarcoma, histiocytic sarcoma
  • Low risk- fibrosarcoma, chondrosarcoma, histocytic around joint, feline injection site

fibrosarcomas, soft tissue and peripheral nerve sheath- grade affects metastatic potential

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4
Q

What is the difference between grade and stage?

A

Stage- how far has it got (LNs)- disease burden
Grade- histological features- likely behaviour

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5
Q

How are primary sarcomas assessed?

A
  • FNA- no grade
  • Tru-cut biopsy
  • Biopsy and histology- larger samples
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6
Q
  1. Generally what is the metastatic potential of lymph nodes?
  2. How do mosy sarcomas metastasise?
  3. What is their prediliction site for metastasis?
A
  1. Most have low metastatic potential
  2. Haematogenous route
  3. Lung
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7
Q

What are ideal surgical margins?

A

3cm lateral and 1 fascial plane beyone extent of tumour- includes FNA tract and biopsy scar

Not always possible

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8
Q

How are margins assessed?

A
  • Cardinal- 3 sections
  • Bread loafing- sliced bread
  • Shaved margins- states of USA

Margins assessed histologically by pathologist- complete/incomplete/narrow

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9
Q

What classifies as narrow margins?

A

Less than 3mm of tissue edge

recurrence depends on tumour type and grade

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10
Q

What are the treatment options for microscopic residual disease (narrow/incomplete margins)

A
  • Further wide surgical excision- treat scar as tumour
  • Adjuvant radiation therapy
  • Metronomic chemo
    cyclophosphamide with pioxicam
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11
Q

What is the prognosis of resectable sarcomas?

A

Without metastatic disease- >4y

Prognostic factors
* Tumour grade and mitotic rate
* Tumour size
* Tumour location
* Achieveing local control

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12
Q

How can non-resectable tumours be treated?

A
  • Referal surgery
  • Primary radiation therapy- less effective than surgery
  • Anti-metastatic treatment- not known
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13
Q
  1. What is FISS?
  2. How does it appear histologically?
A
  1. Feline injeciton site sarcoma
  2. Malignant fibroblasts, inflammation, macrophages
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14
Q

What is the 3,2,1 rule of FISS?

How can definite diagnosis be achieved?

A
  • Any mass present for 3 months or longer
  • Any mass greater than 2cm diameter
  • Any mass that continues in size 1 month after injection

FNA may not be diagnostic- inflammator component
Incisional biopsy

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15
Q

How are FISS diagnosed and staged?

A
  • Advanced imaging
  • Local staging- size, margins highly invasive
  • Distand staging- variably metastatic
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16
Q

What are the margins for FISS surgery?

A

3-5+ cm marhins and 2 fascial planes deep- can involve removal of spinous process or vertebrae

Still good chance of reccurence

17
Q

What adjuvant treatments can be used for FISS?

A
  • For non-resectable- pre-op radiation/chemo
  • Incomplete resections- adjuvant radiation therapy
  • Doxorubicin based chemo
18
Q

What are the recommendations for prevention of FISS?

A
  • Injections to be given in sites amenable to wide surgical excision
  • Reduce inflammatory reactions at injection sites- avoiding irritating substances where possible
  • Don’t over vaccinate
19
Q

What are the clinical signs of oesteosarcoma?

A

Pain and lameness
* Sudden or progressive
* Localised

Swelling

20
Q

How is osteosarcoma diagnosed?

A

Radiographic changes
* Bone lysis
* Soft tissue swelling
* New bone
* Periosteal elevation
* Long zone transition

Cytology/histo to confirm

21
Q

What are the differentials for bone tumours?

A
  • Chondrosarcoma
  • Histiocytic sarcoma
  • Fibrosarcoma
  • Haemangiosarcoma
  • Benign tumours/cysts
22
Q

How are oesteosarcomas treated?

A

Amputation
* Most dogs tolerate amputation well
* Pain free around 1 week after
* Complete adaption take 1 months

23
Q

How can pain of oesteosarcoma be treated?

A
  • Amputation
  • Analgesics- layered, multimodal
  • Slow bone distruction- bisphosphonates
  • Reduce sensation- radiation therapy
  • Bone stabilisation
24
Q

What is the protocol for gross metastasis of oesteosarcomas?

A
  • Carboplatin or anthracyclines
  • Toceranib may be helpful in presence of gross metastasis
25
Q

What are the osteosarcoma prognostic factors?

A

Location
* Appendicular- humerus worst
* Axial- skull has low metastatic rate

Presence of metastatic disease
Total alkaline phosphatase

26
Q

What is a haemangiosarcoma?

A

Tumour of blood vessel walls

Most commonly spleen, liver, muscle and then skin

27
Q

What are the clinical signs of haemangiosarcoma and how is it diagnosed?

A

CS
* Shock, collapse, haemoabdomen, pericardial effusion
* Anaemia, schistocytosis
* Low platlet cound
* DIC

Diagnosis- histology

28
Q

What are poor prognostic factors of haemangiosarcoma?

A
  • Tumour rupture and bleed
  • Invasive tumours in other sites
29
Q

How are primary haemangiosarcomas treated?

A

Surgery
* Splenectomy
* Staging before splenectomy

Survival depends on stage

30
Q

What is the MST for haemangiosarcoma with metastasis?

How can it be treated?

A

MST 4-6 weeks

Systemic chemo with anthracycline
Metronomic chemo possibly

31
Q

What is a histiocytic sarcoma?

A
  • Highly metastatic sarcoma
  • Originates from histiocytes- antigen presenting cells
  • Can affect: lung, spleen, liver, bone, brain, joint
32
Q

What is the best therapy for good outcome of histiocytic sarcoma?

A
  • Surgery
  • radiation
  • Lomustine/anthracycline chemo

Year 4 Small Animal Studies (97 decks)

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