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Small Animal Medicine > Oncology - STS, HS, Mammary > Flashcards

Oncology - STS, HS, Mammary Flashcards

1
Q

What are soft tissue sarcomas?

A

Mesenchymal tumors/spindle cell tumors - it is an umbrella term

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2
Q

What tumors are soft tissue sarcomas?

A

Fibrosarcoma, peripheral nerve sheath tumor, myxosarcoma, liposarcoma, rhabdomyosarcoma, synovial cell sarcoma, and lymphangiosarcomas

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3
Q

Soft tissue sarcomas are typically solitary/in multiples.

A

solitary

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4
Q

What age of dogs and cats typically get soft tissue sarcomas?

A

older dogs and cats

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5
Q

Where else, aside from the skin, can soft tissue sarcomas be seen?

A

GI tract, liver, and bladder possible

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6
Q

What is the behavior of STS?

A

slow growing/insidious onset

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7
Q

STS are __________.

a. not encapsulated
b. pseudoencapsulated
c. encapsulated

A

b. pseudoencapsulated

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8
Q

What grade of STS are more likely to recur and metastasize?

A

Grade III

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9
Q

What size STS generally have a poor response to chemo and/or radiation?

A

Bulky tumors - >5cm

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10
Q

Is an FNA or a biopsy preferred for STS diagnosis?

A

biopsy

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11
Q

What type of biopsy is preferred for STS diagnosis?

A

incisional - can be misleading

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12
Q

How do you need to position your biopsy for STS?

A

Position so that the biopsy tract is removed with surgery

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13
Q

What is staging for STS based on?

A

Minimum database, FNA local lymph node, 3 view chest rads and CT scan for surgical planning

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14
Q

What makes STS tumors especially difficult to excise?

A

They have spindles that can spread out from the tumor

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15
Q

What is grading of STS based on?

A

differentiation, mitosis, and necrosis

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16
Q

What treatment can be done for STS?

A

Wide surgery, +/- radiation therapy, +/- chemotherapy

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17
Q

What margins do you want for STS?

A

3cm lateral and 1 fascial plane

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18
Q

What may make it difficult to get complete excision for STS?

A

Less likely if >5 cm
Deep location
Invasive

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19
Q

Can STS recur after surgery?

A

Yes, the potential for recurrence is greater with a greater grade

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20
Q

If you chose not to do wide therapy for STS, what are the other options?

A

Amputation/hemipelvectomy or marginal excision with radiation therapy

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21
Q

When you take a STS out, what do you want to do before placing it into formalin?

A

pin it out and ink to help prevent shrinkage in formalin

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22
Q

What type of radiation do you want to use with STS if you got marginal excision?

A

Definitive radiation

Stereotactic doesn’t seem to work as well

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23
Q

What side effects are associated with definitive radiation for STS?

A

Acute skin effects and a long term potential for secondary tumors

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24
Q

What is the chemotherapy agent of choice for STS? When is it indicated?

A

Doxorubicin

Indicated for grade III STS

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25
Q

What is the average time to metastatic disease development from STS diagnosis?

A

1 year

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26
Q

What are the negative prognostic factors for recurrence of STS?

A

Large tumor size, incomplete excision, and high grade

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27
Q

What are the negative prognostic factors for metastatic disease of STS?

A

Grade, necrosis, mitotic index, and local regrowth

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28
Q

What is the MST for dogs with a grade I STS?

A

48 months

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29
Q

What is the MST for dogs with a grade II STS?

A

17 months

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30
Q

What is the MST for dogs with a grade III STS?

A

7.8 months

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31
Q

Can STS be cured?

A

Yes, with proper planning some can be cured

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32
Q

What type of neoplasia is a cutaneous histiocytoma?

A

A benign skin tumor that is a solitary lesion with rapid growth, but has spontaneous regression in 1-2 months

33
Q

Where can histiocytic sarcomas (HS) be located?

A

They can be localized anywhere in the body or can be disseminated

34
Q

What is the origin of hemophagocytic HS?

A

macrophage origin

35
Q

What do hemophagocytic HS do?

A

Eat the RBCs

36
Q

How are HS diagnosed?

A

Cytology or biopsy

Definitive diagnosis can be difficult

37
Q

What may be needed for a definitive diagnosis for HS?

A

ICC/IHC

CD18 stain

38
Q

What is needed for staging of HS?

A

minimum database, chest rads, abdominal ultrasound

39
Q

How is the disseminated form for HS treated?

A

It is rapidly fatal and difficult to treat

40
Q

How is localized HS treated?

A

Surgery if you can. radiation therapy, and chemotherapy

41
Q

What is the treatment of choice for HS?

A

CCNU/lomustine

42
Q

What are the most common tumors of intact female dogs?

A

mammary tumors

43
Q

What percentage of canine mammary tumors are considered malignant? How many of them metastasize?

A

50% are malignant - 50% of those metastasize

44
Q

What are the 3 major factors important in development of canine mammary tumors?

A

Age, hormonal exposure, and breed

45
Q

What age is malignant canine mammary tumors associated with?

A

middle-older age

46
Q

During what time in life is obesity especially an issue for canine mammary tumors?

A

9-12 months of life because adipose tissue produces estrogens and is inflammatory

47
Q

What is field carcinogenesis?

A

when the entire mammary chain is exposed to estrogen

48
Q

What mammary glands most commonly develop tumors first?

A

the caudal two glands

49
Q

What is needed for diagnosis of canine mammary tumors?

A

Minimum database, FNA, chest x-rays, FNA to rule out other tumor types, and biopsy

50
Q

What are the most common mammary tumors that we find?

A

carcinomas - malignant epithelial tumors

51
Q

What are the types of malignant epithelial tumors that can be a canine mammary tumor?

A

In order from least to most aggressive - carcinoma in situ, complex carcinoma, simple tubulopapillary carcinoma, simple solid carcinoma, and simple anaplastic carcinoma

52
Q

What is grading for canine mammary tumors based on?

A

tubule formation, nuclear pleomorphism, and mitotic index

53
Q

What are some prognostic factors for canine mammary tumors?

A

Tumor size, differentiation, histologic classification, detection off lymphatic vessel invasion (BAD), and regional LN metastasis and distant metastasis

54
Q

What are the treatment options for canine mammary tumors?

A

surgery, radiation therapy, and chemotherapy

55
Q

What are the types of surgery that can be done for canine mammary tumors?

A

Simple lumpectomy, mastectomy, regional mastectomy, chain mastectomy, and bilateral mastectomies

56
Q

What surgery should you start with first in dogs with canine mammary tumors?

A

conservative surgery

57
Q

What surgery is recommended for dogs with one mammary tumor?

A

Surgery to completely remove the tumor

58
Q

What surgery is recommended for dogs with multiple mammary tumors?

A

regional mastectomy or unilateral chain mastectomy

59
Q

What surgery is recommended for intact dogs with multiple tumors?

A

unilateral or bilateral mastectomies

60
Q

An OHE is recommended for intact females with mammary tumors. When should it be done?

A

It should be done before removal of the mammary glands

61
Q

Why are inflammatory canine carcinomas in the mammary glands so bad?

A

They are highly metastatic and have local coagulopathies

62
Q

When should radiation therapy be considered for canine mammary tumors?

A

if there are incompletely removed tumors

63
Q

When is chemotherapy indicated for canine mammary tumors?

A

If the tumor is >3cm, if it has metastasized, or if it is inflammatory or an osteosarcoma

64
Q

What chemotherapy agent is recommended for canine mammary tumors?

A

Doxorubicin or carboplatin

65
Q

What is the prognosis for canine mammary tumors?

A

Overall great, but a worse prognosis is associated with high grade, inflammatory, or OSA

66
Q

What are the three risk factors for feline mammary tumors?

A

Age, hormonal exposure, and breed

67
Q

___% of cats have more than one mammary tumor.

A

60%

68
Q

What age is associated with diagnosing mammary tumors in cats?

A

older cats

69
Q

What is the malignancy percentage and metastasis percentage for feline mammary tumors?

A

85-95% are malignant and 90% are metastatic

70
Q

What is needed for staging of feline mammary tumors?

A

minimum database, chest rads, AUS, and FNA of LN

71
Q

What benign tumors can be feline mammary tumors?

A

Very rare - adenomas, ductal adenoma, and fibroadenoma

72
Q

What malignant tumors can be feline mammary tumors?

A

simple carcinoma or other types of carcinoma

73
Q

What are the prognostic factors for feline mammary tumors?

A

Grade, lymphovascular invasion, positive LN, +/- Siamese, size

74
Q

What treatment can be done for feline mammary tumors?

A

surgery, radiation, and chemotherapy

75
Q

What is the recommended surgical approach for feline mammary tumors?

A

Chain mastectomy - we need to be aggressive because they are aggressive

76
Q

IF you do radiation therapy for feline mammary tumors, what type do you do?

A

palliative

77
Q

What chemotherapy options are there for feline mammary tumors?

A

Doxorubicin, mitoxantrone, or carboplatin

78
Q

When is chemotherapy indicated for feline mammary tumors?

A

High grade and vascular invasion, >3cm, or if there is LN involvement

79
Q

Overall, what is the most common type of mammary tumor in dogs and cats?

A

carcinoma

Small Animal Medicine (100 decks)

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