Sarcoma And Tumors Of Abdominal Cavity Flashcards
What are soft tissue sarcomas?
Locally invasive with low to moderate risk of mets
Most are solitary
Many variants: fibrous, adipose, skeletal muscle, vascular/lymphatic, peripheral nerve, synovial, smooth muscle
What are the important common features of STS?
Pseudo-encapsulated soft to firm masses with poorly defined margins (infiltrative)
Local recurrence after conservative excision is common
Hematogenous route of mets
Regional LN met uncommon (except synovial cell)
Grade is predictive of local recurrence
Bulky tumors do not respond to chemo or RT
What workup/staging do you do for soft tissue sarcomas?
FNA—> rule out lipoma/seroma/inflammation/abscess
Sarcoma —> is it important to know grade for therapy?
Incisional biopsy (tru-cut vs wedge —> not usually punch since they are often hypodermal)
Thoracic radiographs for pulmonary mets
Regional imaging - abdominal us for presurgical staging is generally not indicated for most STS
What are negative prognostic indicators for soft tissue sarcomas?
Large tumor size
Incomplete surgery margins
High histologic tumor grade = higher met rate and more locally invasive
What is the recurrence rate of soft tissue sarcoma that is not completely resected?
28%
— recurrent STS are more difficult to control than the primary tumors
What is a feline injection site sarcoma ??
Sarcoma are histologically and biologically more aggressive
What causes an injection site sarcoma?
Aluminum adjuvant in vaccine was contributing to massive inflammatory rxn —> leads to uncontrolled fibroblast and myofibroblast proliferation and eventual tumor formation
For feline injection site sarcomas, what is the time between vaccination to tumor development
Anywhere from 4 weeks to 10 yrs
Workup for Feline ISS?
Cytology —> give Dx of sarcoma
Can to incisional biopsy to confirm type of sarcoma
DO NOT do excisional biopsy
What is the treatment for Feline ISS?
Surgical excision with 5cm radial margins and 2 muscle planes deep
- including body wall, soft tissue, or bone
What is the recurrence rate of feline ISS?
14%
T/F: liver tumors in dogs and cats are most commonly metastatic because the liver is a receptacle for blood supply form GI tract, spleen, and pancrease
False
Dogs — met tumors 2.5x more common than primary tumors
Cats — primary tumors more common
Liver tumors are more commonly (malignant/benign) in dogs and are vice versa in cats
Malignant
What are the 4 classifications of liver tumors?
Hepatocellular
Bile duct
Neuroendocrine
Mesenchymal
- prognosis of any tumor determined greatly by histology of the tumor
Primary hepatobiliary tumors can have what morphological?
Massive - large, solitary mass on a single liver lobe
Nodular - multifocal varying sizes, on one or several lobes
Diffuse - multifocal to coalescing nodules involving ALL liver lobes or diffused effacement of parenchyma
Most hepatocellular tumors have what morphology?
Massive
Common signalment of hepatobiliary tumors?
Disease of older animals
HCC and sarcomas occur slightly more frequently in male dog with slight female predisposition in bile duct tumors
Common presenting complaint its hepatobiliary tumors?
Most are asymptomatic - most found while chasing
Clinical signs are variable/ non-specific = anorexia, wt loss, PU/PD, ascities
- icterus seen with biliary or diffuse neuroendocrine tumors
- seizure rare but can be caused by paraneopalsic hypoglycemia
What is the most common primary liver tumor in dogs?
Hepatocellular carcinoma
What is the most common primary liver tumor in cats
Hepatocellular adenoma
How much liver can you surgically remove?
Liver is capable of removing form 65-75% loss of total mass = remaining volume can hypertrophy to original size within 6 week
What is the mechanism of liver regeneration ?
Quiescent hepatocytes “primed” or simulated to grow
Continued growth mediated by growth factors (hepatocyte GF and TGFa)
What is the complication rate to surgical excision of liver tumors>?
29% complication rate with 5% operative mortality
T/F: local recurrence often develops in liver tumors if there are incomplete margins
False
Local recurrence did not occur inn tumors even with incomplete margins
What are the two types of bile duct neoplasias?
Bile duct adenoma —> biliary or hepatobiliary cystadenoma
Bile duct carcinoma
What is the most common liver tumor of cats repressing more than 50% of all feline hepatobiliary tumors
Hepatobiliary cystadenoma
The most common malignant hepatobiliary tumor in a cat is ______________ and in a dog is __________
Bile duct carcinoma; hepatocellular carcinoma
T/F: there have been long-term survival times reported in cats with hepatobiliary cystadenoma when treated with benign neglect
True
- remote possibility of malignant transformation should be discussed with owners
T/F: hepatobiliary cystadenomas are most commonly incidental findings
True
What is a risk factor for bile duct carcinoma in cats and dogs?
Trematode infestation
Are bile duct carcinomas usually non- aggressive or aggressive?
Aggressive
Cats = carcinomatosis (diffuse intraperitoneal mets)
T/F: chemotherapy and RT are good treatment options for bile duct carcinomas
False
-not effective
Surgical resection warranted, but survival times are poor
