Perianal tumours and haemangiosarcoma

Question 1

What are the most common anal gland tumours

Answer 1

perianal sebaceous adenomas, perianal sebaceous adenocarcinomas, and apocrine gland adenocarcinomas of the anal sac

Question 2

Outline malignant perianal adenocarcinomas

Answer 2

Rarely have hypercalcaemia
Often spread first to regional nodes, then to distant sites; metastasis rate up to 50%, especially with multiple local recurrences.
treat with wide excision of primary tumor and lymphadenectomy if lymph nodes involved; postoperative radiotherapy for residual microscopic disease; radiation or chemotherapy if inoperable; castration of little benefit.

Question 3

Outline anal sac adenocarcinomas

Answer 3

25-50% have hypercalcaemia
Treat with wide excision of primary tumour and lymphadenectomy if lymph nodes involved; consider postoperative radiotherapy to primary site and to regional lymph nodes, as well as chemotherapy.

Question 4

Outline perianal adenomas

Answer 4

Nearly all in old intact male, rarely in speyed old females
Treat with castration/ can do conservative local removal
For diffuse or large benign lesions situated on or in the anal sphincter, castration followed by an observation period of several months to allow reduction in tumor volume may permit safer and easier mass removal.

Question 5

How can perianal adenocarcinomas appear differently to adenomas>

Answer 5

may look similar to adenomas but tends to grow more rapidly, be more firm, become ulcerated, adhere to underlying tissues, recur following conservative surgery, and generally be larger than its benign counterpart
Obstipation, dyschezia, or perianal pain/irritation can be seen with larger masses.16 Rarely, signs are related to obstruction of the pelvic canal by lymph node metastasis. Tumors can be multiple

Question 6

Where are the most common sites of metastasis of haemangiosarcomas

Answer 6

most frequent metastatic sites are the liver, omentum, mesentery, and lungs.
HSA is considered the most common metastatic tumor to the brain

Question 7

Compare HSA in dogs and cats

Answer 7

HSA in cats is considered to be a less aggressive disease. Cutaneous or subcutaneous HSA often behaves in a fashion similar to other soft tissue sarcomas, and local recurrence is the major concern. Reports do exist of more aggressive biologic behavior in a subset of cats with cutaneous HSA, however. Visceral HSAs have a higher metastatic rate, similar to that in dogs, and the common sites include the liver, omentum, diaphragm, pancreas, and lung

Question 8

What does staging a HSA involve?

Answer 8

staging for an HSA suspect typically includes hematology and serum biochemistry, coagulation testing, thoracoabdominal imaging, ±abdominocentesis, and/or echocardiography.

Question 9

What may you see on haematology with HSA?

Answer 9

presence of schistocytes (associated with microangiopathic hemolysis) and acanthocytes in the peripheral blood.* Anemia may be regenerative or nonregenerative, depending on duration. Blood typing and/or crossmatching may be indicated if surgery is planned in a severely anemic patient. In addition, a neutrophilic leukocytosis may be seen.61, 66 Thrombocytopenia is observed in 75% to 97% of cases, ranging from mild to severe

Question 10

What are the most common chemotherapy protocols for HSA?

Answer 10

Doxorubicin based

Question 11

What is the px for HSA?

Answer 11

Dog
MSTs for splenic HSA range from 19 to 86 days, and less than 10% survive to 12 months
If sx + chemo - then approx 140d

Cat
HSAs located in cutaneous and subcutaneous sites have recurrence rates of 60% to 80%
Visceral - poor like dogs