Oral Tumors (some OMM)

Question 1

What % of oral melanomas are amelanotic?

Answer 1

38%

Question 2

What antiboides hawve been found to have 100% specificity and 94% sensitivity for dx’ing melanoma?

Answer 2

PNL2, Melan A, TRP-1 and TRP-2

Question 3

What is the metastatic rate for dogs with OMM?

Answer 3

Stage dependent, can be as high as 80%

Question 4

What are the five histologic subtypes of SCC in dogs?

Answer 4

conventional, papillary, basaloid, adenosquamous and spindle cell

Question 5

What is the common case presentation for oral papillary SCC in dogs?

Answer 5

Young dogs (usually <9mo) in the rostral oral cavity

Question 6

What location of oral SCC has a higher rate of metastasis vs. lower?

Answer 6

Higher: tongue and tonsil Lower: rostral oral cavity

Question 7

What has been shown to increase the risk of oral SCC in cats?

Answer 7

flea collars and high intake of either canned food or canned tuna, household tobacco smoke

Question 8

Mutations in what gene are significantly increased in SCC lesions in cats with smoke exposure compared to those w/o smoke exposure

Answer 8

p53

Question 9

Increased tumor expression of ____ in cats with oral SCC may play a role in bone resorption and tumor invasion

Answer 9

parathyroid hormone-related protein (PTH-rp)

Question 10

What is the rate of metastasis for cats with oral SCC?

Answer 10

31% mandibular LN, 10% lungs

Question 11

Where do hi-low fibrosarcs usually occur in dogs?

Answer 11

hard palate and maxillary arcade b/w canine and carnassial teeth

Question 12

What are peripheral odontogenic fibromas?

Answer 12

benign gingival proliferations arising from the periodontal ligament (previous name = epulides)

Question 13

Where are peripheral odontogenic fibromas more likely to occur in the mouth?

Answer 13

Maxilla rostral to the 3rd premolars

Question 14

Where is the most common location for acanthomatous ameloblastoma?

Answer 14

Rostral mandibule (51%)

Question 15

What was the diagnostic accuracy of FNA and impression smear cytology for cats and dogs with oral tumors?

Answer 15

FNA: dogs 98%, cats 96% impression: dogs 92%, cats 96%

Question 16

Bone lysis is not evident on radiographs until ____% of the cortex is destroyed

Answer 16

40% or more

Question 17

How did CT vs. radiographs compare for diagnosing invasion into surrounding structures for maxillary masses in dogs?

Answer 17

CT showed >90% of dogs had invasion vs. only 30% on radiographs

Question 18

What was the relationship of normal and enlarged LN and presence of metastasis in dogs with OMM?

Answer 18

40% of dogs with normal sized LN had mets 49% of dogs with enlarged LNs did not have mets

Question 19

For cats and dogs with oral tumors with LN metastasis, what was the rate of the mandibular LN being affected?

Answer 19

55% - need to look at other nodes, too!

Question 20

What is the one type of oral tumor that does not often invade the underlying bone?

Answer 20

peripheral odontogenic fibromas

Question 21

How do cats tolerate mandibulectomy?

Answer 21

Not well - usually need to have reconstruction (compared to dogs which reconstruction is not recommended due to high rate of complications)

Question 22

What are the most common complications from maxillectomy?

Answer 22

Blood loss and hypotension

Question 23

What % of cats will never eat voluntarily after mandibulectomy?

Answer 23

12%

Question 24

What is the overall rate of mets to the lungs for OMM

Answer 24

14-67%

Question 25

What is the overall rate of mets to the lungs for OMM

Answer 25

14-67%

Question 26

What are known prognostic variables for dogs with OMM treated with surgery +/- other therapies

Answer 26

Tumor size, age, clinical stage, ability of 1st sx to achieve local control, degree of differentiation, MI, nuclear atypia score, pigment quant, COX-2 expression, PDGFR expression, Ki67 expression, c-kit expression

Question 27

What is the overall rate of response of OMM to RT? What percent are CR?

Answer 27

81-100%, up to 70% CR

Question 28

what is the overall ST for dogs with OMM treated with RT?

Answer 28

192-401d

Question 29

MST for OMM T1 vs. T2 vs. T3

Answer 29

T1 19mo T2 or T3 \<7mo

Question 30

MST for dogs treated with hypofractionated RT based on stage?

Answer 30

Stage I = 758d II = 278d III = 163d IV 80d

Question 31

Result of phase I OMM vx trial? (Responses?, MST?)

Answer 31

Dog with lung mets at CR n=2 stage IV lived \>400d n=2 stage II or III lived 500d w/o evidence of melanoma at necropsy \*\*MST sig improved when primary site + LN treated with sx or RT\*\*

Question 32

One study of the OMM vx showed that dogs under what wight did better

Answer 32

20kg

Question 33

What locations may be associated with longer STs for OMM

Answer 33

Lip (MST 580d) Tongue (MST 551)

Question 34

What is prognosis for dogs with well-differentiated OMM treated with surgery alone?

Answer 34

only 5% died of OMM, MST 34mo

Question 35

Rate of metastasis for dogs with oral SCC?

Answer 35

Regional LN 10%, lungs 3-36%

Question 36

What areas of the mouth are associated with a more aggressive behavior and higher rate of mets for canine oral SCC

Answer 36

tonsils and base of tongue - rate of mets 73%

Question 37

What is the rate of local recurrence from oral SCC for dogs treated with mandibulectomy and what is the MST?

Answer 37

0-10%; MST 19-43mo

Question 38

What is the rate of local recurrence from oral SCC for dogs treated with maxillectomy and what is the MST?

Answer 38

14-29%; MST 10-39mo

Question 39

What are prognostic factors for dogs with OSCC?

Answer 39

Presence of tumor-associated inflammation and risk score of 2 or ≥ 3 (combination of tumor-assoc inflammation, lymphatic or vascular invasion and peripheral nerve invasion)

Question 40

What molecular marker has been shown prognostic in dogs with surgically resected mandibular or maxillary OSCC?

Answer 40

proliferating cell nuclear antigen expression (PCNA) \>65% MST 155d ≤65% MAR not reached

Question 41

What is the MST for dogs with OSSC treated with RT alone vs. surgery + RT

Answer 41

RT alone 15-16mo RT + surgery: 34mo

Question 42

What was the response rate to piroxicam alone for dogs with OSCC?

Answer 42

17% - 1 CR and 2 PR

Question 43

What was the CR rate for dogs with T3 oral SCC treated with carbo + piroxicam

Answer 43

57% - sustained in all dogs at median follow-up time of 534d

Question 44

Rate of metastasis for OMM vs. OSCC (Grimes JAVMA 2019)

Answer 44

OMM 37% to LN, OSCC 29% to LN Lungs: OMM 41% (most after surgery), 1 dog suspected with OSCC (4.7%)

Question 45

Rate of medial retropharyngeal LN metastasis in dogs with OMM or OSCC?(Grimes JAVMA 2019)

Answer 45

13/16 dogs that had MLN and MRLN removed (81%), 3 of which had MRLN affected w/o MLN

Question 46

Rate of contralateral LN mets in dogs with OMM or OSCC (Grimes JAVMA 2019)

Answer 46

4/17 dogs that underwent ipsilateral and bilateral lymphadenectomy

Question 47

**What are the types of feline epulides and what is their rate of occurrence? (Bruijn Vet Path 2007)**

Answer 47

**Fibromatous - 57.7%** **Ossifying - 5.8%** **acanthomatous - 7.7%** **giant cell - 28.8%**

Question 48

**Which form of feline epulides has a more aggressive behavior? (Bruijn Vet Path 2007)**

Answer 48

**Giant cell - rapid growth, ulceration, rapid recurrence after surgery**

Question 49

**In addition to other markers, what mm specific marker should rhabdomyosarcomas be positive for?**

Answer 49

**desmin**

Question 50

**Of 8 cats treated with a radical mandibulectomy for oral neoplasia (most commonly scc) what was the rate of local recurrence and MST? Also, how many voluntarily ate after? (Boston vet surg 2019)**

Answer 50

**3 had local recurrence** **MST 712d** **6/8 ate on own**

Question 51

**What was the most common intraoperative complications of partial maxillectomies for oral tumors in dogs? (MacLellan JAVMA 2018)**

Answer 51

**excessive bleeding (53.4%0 - 42.7% needed transfusion intraoperatively**

Question 52

**What was the rate of local recurrence and metastasis for dogs with oral FSA treated with surgery +/- RT? (Frazier VCO 2011)**

Answer 52

**24% local recurrence (historic higher at 32-57%)** **24% mets**

Question 53

**What was the mPFI and MST for dogs with oral FSA treated with surgery +/- RT? (Frazier VCO 2011)**

Answer 53

**mPFI \>653d (21.8mo)** **MST 743d (24.8mo)**

Question 54

What was associated with OSCC vs. CAA and correlated with a more aggressive local behavior? (Peralta J Comp Path 2019)

Answer 54

Ki67 labeling index - higher in OSCC

Question 55

Sanger sequencing showed that CAA had a 94% rate of _____ mutations which have also been found in humans with AA (Peralta VCO 2019)

Answer 55

HRAS (somatic HRAS, p.Q61R)