Oral tumors Flashcards

Question

**Salivary gland tumors** Reported in young or older patients? Breed and sex in dogs? Cats? Type of cancer? Affect which salivary gland? Behaivour? Metastasis? Distant Mets? Clinical signs? Differentials?

Answer 1

Mainly reported in older patients (10-12), no sex or breed predilection in dogs; Siamese, male more common in cats Most are adenocarcinomas but wide variety (osteo, MCT, sebaceous ca, oncocytoma, malig. fibrous histiocytoma) Minor or major salivary gland origin 30% of 245 salivary tumors submitted were malignant Benign tumors are rare but mostly affect the mandibular gland (is this because this is more commonly palpated?) Locally invasive, metastatic to regional LNs (dog 17%, cat 39%), distant mets are rare and slow (8% dogs, 16% cats) Canine benign lipomatous infiltration can happen and is surgically curative Patients present with halitosis, dysphagia, exophthalmos, unilateral swelling of neck / base of ear/ lip, tongue Differentials include mucocele, abscess, infarct, sialadenitis, LSA, reactive lymphadeopathy

Answer 2

Aggressive surgical removal, but can be extensive; even so “extirpation of regional neck” à good outcome Main post-op impairment is inability to blink Post-op RT à good local control No reports of chemotherapy outcomes for this tumor type

Answer 3

Grade not prognostic, but stage prognostic Prognosis unkown, but presumably complete excision or partial + RT à good long term control; survival ~550d Poorer in cats than dogs; much poorer if metastatic - One report 6 dogs with mets à MST 74 days

Answer 4

Rare in dog and cat, and no known cause; Carcinomas affect older animals but no gender or breed predilection SCC, leiomyosarcoma, fibrosarcoma, osteosarcoma à Spirocerca lupi association in Africa, Israel, SE USA Benign tumors – leiomyoma, adenomatous polyp, plasmacytoma Paraoesophageal tumor invasion – heart base, thyroid, thymic Cat SCC have female predilection, locate middle 3rd of the esophagus Locally invasive, regional LN’s, direct extension, distant mets via bloodstream Signs include weight loss, dysphagia, regurgitation, aspiration pneumonia hypertrophic osteopathy, thoracic spondylitis, microcytic hypochromic anemia, neutrophilia with s. lupi

Answer 5

Rads show esophageal dilation, gas, or mass Positive contrast esophagogram, fluoro, esophagoscapy show dilation, stricture, or mass (frequently ulcerated) CT or MRI to localize Multiple biopsies because necrosis and inflammation common; low risk of perforation Leiomyomas are freely movable and submucosal – difficult to bx Surgical biopsy can be beneficial S. lupi ova can be detected in the feces

Answer 6

Difficult because generally advanced stage Surgery difficult except for low-grade leiomyosarcomas, benign tumors **If distal tumor,** gastric advancement thru diaphragm possible but high complication rate (reflux esophagitis) Chemotherapy rarely attempted RT of limited value d/t important surrounding tissues Palliation via e-tubes or g-tubes

Answer 7

Very poor except for leiomyoma, low-grade leiomyosarcoma, lymphoma

Answer 8

Almost all cancers of the pancreas are epithelial and most are adenocarcinoma of ductular or acinar origin Vast majority have already metastasized regionally or distantly at the time diagnosis Nodular hyperplasia and benign pseudocysts are also diagnosed Hx and Cx are vague and nonspecific and may be accompanied by pancreatitis Patients may present for symptoms of metastatic disease Paraneoplastic alopecia in cats Rarely associated with diabetes

Answer 9

Elevations of serum amylase and lipase are inconsistent Occasional (extreme cases) signs of pancreatic insufficiency In dog, masses are not palpable but there may be ascites; in cats, a palpable mass may be present Ultrasound to localize primary tumor and assess liver and spleen for mets A large \>2cm apparently single mass is suggestive of pancreatic cancer vs nodular hyperplasia in cats Most diagnoses are made by ExLap

Answer 10

Most tumors are locally extensive / invasive / metastatic Complete pancreatectomy or pancreoduodenectomy (Whipple’s procedure) has been described but mortality is high GI bypass can be palliative (for GI obstruction) Radiation and chemo are of limited value in humans and animals

Answer 11

More common than esophageal cancer but still rare (\<1% all cancer) Long-term use of nitrosamines in dogs may induce High incidence of gastric carcinoma in Belgian shepherd, Norwegian lundehunds, Dutch Tervueren shepheds Carcinomas: Male \> Female 2.5:1, middle age (8yr) Leiomyomas: very old (15 yrs) Lymphoma: male \>female Feline gastric cancer: chronic gastritis, Helicobacter, common descent are implicated Most common sign is progressive vomiting w/ blood or coffee grounds, for weeks to months

Answer 12

Adenocarcinoma 70-80%, presents as flat and nondistensible mass (linitis plastica = leather bottle) Others: Leiomyosarcoma, lymphoma, MCT, extramedullary plasmacytoma, fibrosarcoma, GIST (20% GIST in stomach) In humans and 50% of dogs, GIST expresses CD 117 (c-kit) 1/3 of GIST have met’d at the time of diagnosis 70-80% adenocarcinomas met to LN’s, then liver, lung, unusual (3) to testes Tumor antigen C2-O-sLE(x) is unregulated and may play a role in temastasis Benign tumors: leiomyoma, hypertrophy, hamartoma, adenoma Lymphoma is the most common gastric tumor in cat, most are FeLV-negative Feline adenocarcinomas are rare

Answer 13

leiomyoma/leiomyosarcoma (reversible)

Answer 14

Microcytic, hypochromic anemia

Answer 15

Adenocarcinoma @ lesser curvature and antrum Leiomyoma @ cardia, grow into lumen as a well-circumscribed mass

Answer 16

Surgery except for LSA

Answer 17

Wide surgical resection Bilroth I = gastroduodenostomy; Bilroth II = gastrojujenostomy

Answer 18

Leiomyomas are discrete masses in the cardia region that shell out – NOT premalignant

Answer 19

RT rarely utilized No effective chemotherapy for adenocarcinoma Lymphoma may be excised if localized but does not generally respond well to conventional therapy; exceptions being cats

Answer 20

Poor -- most \<6mo Perioperative mortality 24%, MST 33days; perioperative weight loss negative prognostic indicator 17 dogs with gastric ac, MST 2 months; rare cases… 3 yrs MST leiomyosarcoma if made it thru perioperative period = 1 yr Gastric extramedullary plasmyctyomas have excellent prognosis Gastric MCT usually metastatic at presentation; \<10% of patients survive 6mo

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Oral tumors Flashcards

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