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Surgical Oncology > Oral Tumours > Flashcards

Oral Tumours Flashcards

1
Q

How many cancers in dogs are oral?

A

6%

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2
Q

How many cancers in cats are oral?

A

3%

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3
Q

What are the most commonly encountered malignant tumours in dogs? (4)

A

malignant melanomas
squamous cell carcinomas
fibrosarcomas
osteosarcomas

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4
Q

In cats what are the most commonly encountered tumours? (2)

A

squamous cell carcinomas
fibrosarcomas

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5
Q

What clinical signs do Os usually report with oral tumours? (5)

A
  • difficulty or reluctance to eat
  • excessive drooling that may be blood tinged;
  • strong smell from the mouth;
  • lethargy;
  • weight loss.
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6
Q

What are the most likely cancers to have positive chest radiographs at the time of diagnosis? (2)

A

Melanoma and squamous cell carcinoma of the caudal oral and pharyngeal area.

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7
Q

How much bone mineral is lost when lysis can be observed?

A

40%

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8
Q

Regional lymph nodes (mandibular and retropharyngeal) should be carefully
for enlargement or asymmetry. They should always be aspirated. When is this especially important?

A

Melanoma
Caudally situated squamous cell carcinoma.

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9
Q

What is the most prevalent oral tumour in dogs?

A

Malignant melanoma

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10
Q

Metastasis of malignant melanomas regular occur at an early stage; to where? (2)

A

Lymph nodes
Lungs

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11
Q

Oral malignant melanomas are thought to metastasise in what percentage of cases?

A

50-80%

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11
Q

How many malignant melanomas are amelanotic?

A

One third

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12
Q

What is the predilection site for oral melanomas?

A

Buccal mucosa

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13
Q

What size oral melanoma + have not metastasised to LN have a better pronogisis?

A

<2cm (stage I)

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14
Q

What size oral melanoma has a worse prognosis? (+ nodal metastatsis)

A

> 4cm

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15
Q

What is the most common oral tumour in cats?

A

SCC

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16
Q

SCC in dogs:
A) Aggressive nature?
B) Metastasis

A

A) Local aggressive
B) Rarely met

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17
Q

In dogs, what surgical technique is often needed for SCC. Why?

A

Resected en-bloc with the tumour (maxillectomy, mandibulectomy
- Underlying bone is often invaded

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18
Q

What SCC has a more aggressive behaviour?

A

Tonsils

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18
Q

What is a high-low” FSA?

A

In dogs, there often is a discrepancy between the grade of the tumour, as estimated by histopathology, and its clinical behaviour (Ciekot et al., 1994). Such tumours are known as “histologically low-grade but biologically high grade”

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19
Q

Where do oral fibrosarcomas have propensity for?

A

Palate

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19
Q

Where do fibrosarcomas invade? (2)

A

Bone and soft tissue

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20
Q
A
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21
Q

What type of treatment do canine oral fibromas and FSA?

A

AGGRESSIVE

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22
Q

Signalment for oral osteosarcoma:
A) Size dogs?
B) Age?
C) Sex?

A

A) Mid-large breed
B) middle- old
C) Female

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23
Q

Which of the following statements is correct?
A) Squamous cell carcinomas are the most common oral tumour in dogs.

B) Malignant melanomas are the most common oral tumour in dogs.

C) Squamous cell carcinomas are the most common oral tumour in cats.

D) Malignant melanomas are the most common oral tumour in cats.

A

B) Malignant melanomas are the most common oral tumour in dogs.

C) Squamous cell carcinomas are the most common oral tumour in cat

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24
Q

What is the most common odontoggenic tumour?

A

Ameloblastoma

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25
Q

What is seen radiographically with an ameloblastoma?

A

Osteolysis around tooth roots with cystic changes

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26
Q

Where do ameloblastoma metastasise?

A

Rarely do

27
Q

Where does the acanthomatous ameloblastoma appear?

A

Gingiva and mucosa

28
Q

Does underlying bone get infiltrated with acanthomatous ameloblastoma?

A

In most cases

29
Q

What is the radiographic appearance of a acanthomatous ameloblastoma? (3)

A

infiltration, alveolar bone resorption, and tooth displacement.

30
Q

What resection is needed for acanthomatous ameloblastoma? Why?

A

Wide or radical
Local recurrence is common

31
Q

What were previously described fibromatous and ossifying epulides?

A

Peripheral Odontogenic Fibroma (POF)

32
Q

Peripheral Odontogenic Fibroma (POF):
A) Growth rate?
B) Benign va malignant?
C) recurrence if adequately excised?

A

A) Slow
B) Benign
C) does not

33
Q

What are Peripheral Odontogenic Fibroma (POF) characterised by?

A

The proliferation of fibrous tissue in which islands or strands of odontogenic epithelium are present.

34
Q

Odontoma:
A) Benign vs malignant?
B) Cells? (2)

A

A) Benign
B) Epithieal + Mesenchymal

35
Q

What is the radiographic appearance of an odontoma?

A

sharply defined mass of calcified material surrounded by a narrow radiolucent band or a variable number of tooth-like structures.

36
Q

Where is Feline Inductive Odontogenic Tumour most commonly occuring?

A

Rostral maxilla

37
Q

Does Feline Inductive Odontogenic Tumour metastasise?

A

No reports, but is locally invasive

38
Q

What material can be found histologically with Peripheral odontogenic fibromas? (4)

A

Bone
Osteoid
Dentinoid
Cementum

39
Q

What is the mainstay of treatment for most oral tumours?

A

Surgery

40
Q

What contributes to risk of wound dehiscence with oral surgery? (4)

A
  • Local conditions
  • Limited connective tissue
  • Movements
  • Bacteria burden
41
Q

What can be created to reduce oral tumour wound dehisence by increasing holding power of deeper tissue?

A

Bone tunnels

42
Q

Why is a partial maxillectomy or mandibulectomy often needed for oral tumours?

A

Most malignant tumours and ameloblastomas invade bone,

43
Q

What margins are required for excision of mandibular and maxillary malignant tumours:
A) Bone margins?
B) Soft tissue margins?

A

A) 2cm
B) 1cm

44
Q

Most common intra-op complications of mandibulectomy and maxillectomy?

A

Blood loss
Hypotension

45
Q

What contains the alveolar mandibular artery and vein?

A

Alveolar canal

46
Q

How to reduce significant haemorrhage in a maxillectomy?

A

Performing the bone sections in a logical order with cutting the bone that contains a large vessel last

47
Q

Post op mand/maxillectomy complications (6)

A

Incisional dehiscence
Epistaxis
Increased salivation
Ranula formation
Mandibular drift and malocclusion
Difficulty prehending food.

48
Q

Who is a feeding tube recommended for post mand/maxillectomy?

A

cat

49
Q

When is radiation therapy recommended? (3)

A
  • Curative intent for small SCCC
  • Localised tumour with incomplete margins
  • Downstage tumour prior to Sx
50
Q

What radiation therapy type is proposed for ameloblastoma?

A

Fractioned therapy

51
Q

Radiotherapy prior to Sx has best results in which tumour type?

A

SCC

52
Q

Why is systemic chemotherapy less important in oral tumours?

A

Death/PTS tends to be due to local dx not mets.

53
Q

What chemo protocol can be used for a malignant melanoma? (3)

A

Cisplatin
Carboplatin
Malphalan

54
Q

What are the response rate of malignant melanoma to chemo?

A

Less than 30%.

55
Q

Which anatomical location of oral tumours are associated with a better prognosis?

A

Rostral

56
Q

For an equivalent tumour type and grade, rostral tumours are associated with a better prognosis. why? (2)

A
  • diagnosed earlier
  • More amenable to complete excision
57
Q

Which anatomical location of SCC are more likely to metastasis?

A

Caudal

58
Q

Malignant Melanoma:
A) Mean survival, no Tx?
B) What tumour size has better prognosis?
C) With what have 6 to 19 months progression-free survival (PFS) times have been reported ?

A

A) 65 days
B) <2cm
C) Radiotherapy alone

59
Q

Squamous Cell Carcinoma:
A) Dog 1 year survival?
B) Cat 1 year survival?

A

A) 57-91%
B) <10%

60
Q

Is radiotherapy for Squamous Cell Carcinoma more sensitive in dogs or cats

A

dogs

61
Q

What is the mean survival time with just surgery for a fibrosarcoma?

A

9-12 mo

62
Q

Osterosarcoma:
A) 1 year survival rate after mandibulectomy
B) 1 year survival rate after maxillectomy?

A

A) 6-18mo
B) 4-10mo

63
Q

True or false:

The prognosis is better for malignant melanomas of less than 2 centimetres in diameter.

A

True

64
Q

True or false:
Dogs with squamous cell carcinomas are poorly responsive to radiation therapy.

A

False

65
Q

True or false:

Cats with squamous cell carcinomas are more sensitive to radiotherapy than dogs.

A

False

66
Q

True or false:

FSAs are widely regarded as poorly responsive to radiotherapy.

A

True

67
Q

True or false:
Osteosarcoma Local recurrence is a major concern after surgery.

A

True

68
Q

True or false:
The combination of surgery with radiotherapy or chemotherapy has been shown to significantly improve the outcome when oral osteosarcomas are incompletely excised.

A

False

Surgical Oncology (10 decks)

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