Oncology surgery (Yr4)

Question 1

what is the metric approach to surgical excision margins?

Answer 1

margin is measure by distance from primary tumour

Question 2

what is the barrier approach to surgical excision margins?

Answer 2

use of tumour resistant anatomic boundaries (such as fascia, periosteum, cartilage or air)

Question 3

which tissue do not act as a barrier in the barrier approach to surgical excision?

Answer 3

fat, subcutaneous tissue, muscle, parenchymal tissue

Question 4

what are the types of excision used for surgical margins?

Answer 4

intra-lesional
marginal (excision of macroscopic neoplastic tissue just outside the tumour pseudocapsule)
wide margin (all neoplastic tissue excised with a margin of microscopically normal tissue, the pseudocapsule isn’t entered)
radical (complete removal of tissue/organ compartment)

Question 5

what are the wide excision margins for benign masses?

Answer 5

1cm lateral and deep margins

Question 6

what are the wide excision margins for most carcinomas?

Answer 6

1cm lateral margins and one deep intact fascial plane

Question 7

what are the wide excision margins for low grade soft tissue sarcoma?

Answer 7

1cm lateral margin and one deep intact fascial place

Question 8

what are the wide excision margins for high grade soft tissue sarcomas?

Answer 8

2-3cm lateral margin and one deep intact fascial plane

Question 9

what are the wide excision margins for feline injection site sarcoma?

Answer 9

3-5cm lateral margin and 2 deep intact fascial planes

Question 10

what are the wide excision margins for grade 1-2 mast cell tumours?

Answer 10

1-2cm lateral margin and one deep intact fascial plane

Question 11

what are the wide excision margins for grade 3 mast cell tumours?

Answer 11

3cm lateral margin and one deep intact fascial plane

Question 12

what are the indications for marginal excision?

Answer 12

removal or lipoma
preservation of key anatomy
removal of malignant tumour as part of multimodal therapy

Question 13

what does complete surgical margins mean when assessed on histopathology?

Answer 13

no neoplastic cells with 3-5mm of tumour margin
margin contains normal tissue surrounding tumour pseudocapsule
(this is curative for benign tumours)

Question 14

what does complete but narrow surgical margins mean when assessed on histopathology?

Answer 14

neoplastic cells <3mm from surgical margin or margin doesn’t contains normal tissue beyond the tumour pseudocapsule

Question 15

what does incomplete surgical margins mean when assessed on histopathology?

Answer 15

tumour cells within the edges of the surgical margins in at least one tissue plane

Question 16

what is the procedure carried out if a neoplasm is removed with incomplete surgical margins?

Answer 16

monitor for recurrence
stage resection of surgical wound
wide excision (2-3cm and intact deep fascial plane) of surgical scar

Question 17

what suffix indicates a benign neoplasm of epithelial or glandular origin?

Answer 17

-oma
-adenoma

Question 18

what suffix indicates a benign neoplasm of mesenchymal origin?

Answer 18

-oma

Question 19

what suffix indicates a benign neoplasm of round cell origin?

Answer 19

-oma

Question 20

what suffix indicates a benign neoplasm of nervous tissue origin?

Answer 20

-oma

Question 21

what suffix indicates a malignant neoplasm of epithelial or glandular origin?

Answer 21

-carcinoma
-adenocarcinoma

Question 22

what suffix indicates a malignant neoplasm of mesenchymal origin?

Answer 22

-sarcoma

Question 23

what suffix indicates a malignant neoplasm of round cell origin?

Answer 23

-sarcoma

Question 24

what are the three factors of tumour staging?

Answer 24

tumour size/invasiveness
presence in local lymph nodes
metastasis to distant organs