Oral Tumors/ Salivary Glands Flashcards
Riggs, JAVMA, 2018:
Dogs with oral SCC or fibrosarcoma
MST for SCC vs FSA?
Post-op radiotherapy improved the MST following incomplete excision of which tumor type?
Riggs, JAVMA, 2018:
MST: not reached for SCC, 557 days for FSA
Post-op radiotherapy improved the MST following incomplete excision of SCC but not FSA
MacLellan, JAVMA, 2018:
Partial maxillectomy in dogs
Most common intra-op complication?
What % of dogs received intra-op blood transfusions?
Most common complications within 48hrs post-op?
Most common complications between 2 days and 4 weeks after surgery?
MacLellan, JAVMA, 2018:
Surgical bleeding was the most common intra-op complication (53% of cases)
43% received intra-op blood transfusions
Most common complications within 48hrs post-op: Epistaxis (51%), excessive facial swelling (37%)
Most common complications between 2 days and 4 weeks after surgery: lip trauma (13%), oronasal fistula (11%), wound dehiscence (11%), infection (8%)
Grimes, JAVMA, 2019:
Oral malignant melanoma and SCC in dogs
Lymph node metastasis rate for malignant melanoma vs SCC?
What % of dogs had metastasis to both a medial retropharyngeal LN and a mandibular LN?
Of the dogs that underwent bilateral lymphadenectomy, what % had metastasis to LNs contralateral to the primary tumor?
Was distant metastasis more frequent with malignant melanoma or SCC?
Grimes, JAVMA, 2019:
Lymph node metastasis: 37% malignant melanoma vs 29% SCC
21% had metastasis to both a medial retropharyngeal and a mandibular LN
24% had metastasis to LNs contralateral to the primary tumor
Distant metastasis was more frequent with malignant melanoma than SCC
Riggs JAVMA 2018
Oral SCC or Fibrosarcoma
MST for all dogs was 2049 d, not reached for dogs with SCC and only 557 d for dogs w/ FSA
Tumor type significant predictor of survival time
Dogs w/ postop RT after incomplete excision of oral SCC had longer MST (2051 d) than dogs w/ no RT and incomplete excision (181 d)
Postop RT of dogs w/ incompletely excised FSAs did not offer protective value (299 d w/ RT, 694d w/o)
Cray JAVMA 2018
Acute Masticatory MM Compartmental syndrome
Dog w/ sudden onset of severe skeletal mm swelling, pain and dysfunction
Emergent fasciotomy of temporalis and masseter mm were performed
Plus medical management w/ corticosteroids and analgesics
Diffuse facial swelling resolved in 1 week
Serologic testing negative
Histo consistent w/ myositis
Grimes JAVMA 2019
Histo of lnn in dogs with OMM and SCC
Prevalence of lymph node metastasis did not differ significantly btw dogs w/ OMM 37% and dogs with OSCC 29%
Distant metastasis was ID in 41% of dogs with OMM and suspected in 1 dog with OSCC
MRLN was affected in 13/16 dogs w/ lymph node metastasis and 3 did not have concurrent metastasis to an MLN
Metastasis was ID in lnn contralateral to primary tumor in 4/17 dogs
Bilateral lymphadenectomy of MLN and MRLN is recommended for these dogs
Doyle VCOT 2019
Angiographic Study of Superior Labial Musculomucosal Flap
All angiograms demonstrated that superior and inferior labial a were located w/in musculomucosal layer of labia
At the junction of rostral and cd half of upper lip, extensive choke anastomoses joined the angiosome of the infra-orbital a.
The inferior labial a perfused the cd half of the lower labium and extensive choke anatomoses w/ middle and rostral mental a.
Superior labial flap survive to level of canine tooth
Inferior labial flap width would be narrower, but could be just as long as superior labial flap
Verganti JSAP 2017: Oncept Melanoma Vacc in UK
Sixty-nine dogs were included; 56 dogs, staged I to III, and with previous locoregional therapy, had a median survival time of 455 days.
No significant prognostic factors were identified for this population.
Of the 13 patients with macroscopic disease treated with vaccine alone or in combination therapy, eight showed clinical response. (palliative); 44.4% response rate
Three patients with stage IV oral malignant melanoma survived 171, 178 and 288 days from diagnosis.
Similar to U.S response
Tuohy Vet Surg 2019: Bilateral Cd Maxillectomy for tumors that cross palatal midline (Sarcoma and Osteochondrosarcoma)
Both tumors were resected with complete histologic margins.
The defects were closed with local buccal mucosal flaps, with or without a unilateral angularis oris flap.
Esophagostomy tubes were placed at time of surgery to bypass oral feeding.
Incisional dehiscence and subsequent oronasal fistula formation occurred as a postoperative complication in both dogs (3 and 10 days, respectively).
Both were successfully repaired with a combination of local buccal mucosal flaps and the angularis oris flap.
Both dogs had good functional outcome and quality of life after recovery from revision surgery.
Sharma
Juvenile dog Oral SCC
VetSurg 2021
MST not reached
Sarowitz
Curative intent sx for oral tumors in dogs
JSAP 2017
MST
~Melanoma 206d
~OSA 209d
Local reoccurrence
~FSA 54%
Distant metastasis
~Melanoma 30%
Complete surgical margins 85%
Riggs
Outcomes of oral tumors in dogs
JAVMA 2018
MST
~SCC not reached
~FSA 557d
SCC incomplete margins
~w/o radiation 181 d
~w/ radiation 2,051d
Radiation no effect on FSA MST
Grimes
Histopathology of retropharyngeal LN
JAVMA 2019
Distant metastasis
41% dogs with Oral Malignant Melanoma
MRLN was affected in 13 of 16
3 to the MRLN without concurrent metastasis to an MLN.
Contralateral LN to the primary tumor in 4 of 17 dogs
Carroll
Tumor size as a predictor of lymphatic invasion in oral melanomas in dogs
JAVMA 2020
< 6.5 mm r/o lymphatic invasion
> 24.5 mm rule in lymphatic invasion
Cinti
Ventral vs. Lateral Sialoadenectomy
VetSurg 2021
Recurrence
Lateral > Ventral
*prolonged surgery time risk factor
Wound related issues
Ventral > Lateral
71% affected are males
