Skeletal System Flashcards

1
Q

What’s the most common primary bone tumour of the dog? What’s the %?

A

OSA, 85%

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2
Q

What’s the likelihood of OSA in small dogs (<15kg)? What’s the most common location?

A

5% of OSA can be found in small dogs, but 59% would be in the axial skeleton

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3
Q

Where is OSA most commonly found in the dog?

A

75% in the appendicular skeleton.
- thoracic limbs 2x as likely as pelvic limbs
- Proximal humerus & distal radius = 2 most common locations
- in the pelvic limbs, more even distributed with proximal femur slightly less common

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4
Q

What’s the distribution of OSA in the axial skeleton in the dog?

A
  • 27% mandible, 22% maxilla
  • 15% spine, 14% cranium
  • 10% ribs, 9% nasal/ paranasal, 6% pelvis
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5
Q

How often is multicentric OSA noted in the dog?

A

10%

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6
Q

Is OSA due to multiple micro-trauma of physeal region?

A

A cadaver study didn’t find a difference in incidence of microdamage in radius of small vs large breed dogs

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7
Q

What’s a common genetic mutation found in canine OSA?

A

loss of p53 function via missense mutation in exons 4-8 (found in 24-47% of spontaneous arising OSA samples)

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8
Q

What are two other suspected genetic factors in OSA in dogs?

A

pRB-E2F dysregulation and PTEN mutations

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9
Q

Which breed has shown strong inheritable factor for OSA?

A

Scottish deerhound

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10
Q

What are some pathways that have been implicated in canine OSA?

A
  • MET/HGF (esp. in Rotties)
  • IGF-1/IGF-1R; subsequent MAPK and Akt activation
  • possible HER2 overexpression
  • mTOR
  • Hedgehog & Notch
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11
Q

What’s the MST for amputation only for canine OSA?

A

19 weeks

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12
Q

What’s the MST for small dogs (<15kg) with appendicular OSA treated with amputation only vs amputation plus adjuvant chemotherapy?

A

Sx only MST = 257 days
Sx + Chemo MST = 415 days
BUT - they are not statistically different!

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13
Q

What’s the diagnostic yield of trephine and Jamshidi biopsy for canine OSA?

A

Trephine: 93.8% accuracy
Jamshidi: 91.9% for tumour detection (vs. other disorders) and 82.3% accuracy for specific tumour subtype

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14
Q

What’s the likelihood of pulmonary metastases on presentation for canine OSA?

A

<10%

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15
Q

What’s the best imaging modality to detect concurrent bone metastasis in canine OSA?

A

1 study compared scintigraphy, CT , and x-rays and found scintigraphy to be the best. BUT, the lesions were not confirmed histologically

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16
Q

What’s the surgical staging system for sarcoma in people?

A

Stage I: low grade (G1), no mets
Stage II: high grade (G2), no mets
Stage III: regional or distant mets, any grade
Substage A (T1): intracompartmental
substage B (T2): extracompartmental

most dogs with OSA = stage IIB

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17
Q

Which anatomical location for canine OSA carries poor DFI and ST?

A

proximal humerus

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18
Q

How does histological grade of canine OSA affect the prognosis?

A

the prognostic value = controversial

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19
Q

How does canine OSA of the head fare compared to other sites?

A
  • locally aggressive but maybe with a lower metastatic rate
  • one study found local recurrence rate of 51.3% with a metastatic rate of 38.5%
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20
Q

Which anatomical location has a better prognosis in the dog - maxillary or mandibular OSA?

A
  • Mandibular OSA: 1 year survival rate = 71%; still had a 58% metastatic rate and ST improved with adjuvant chemo
  • Maxillary OSA: MST = 5m
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21
Q

What’s the prognosis of canine rib OSA?

A
  • Chest wall excision alone - MST = 3m
    Sx + chemo MST = 8m
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22
Q

What’s the prognosis of scapular OSA in dogs?

A

guarded, with scapulectomy:
- DFI = 210 days
- MST = 246 days
Use of adjuvant chemo improves both DFI and ST

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23
Q

What’s the prognosis of canine OSA distal to the antebrachium or tarsocrural joints?

A

MST = 466 days
but still aggressive with high metastatic potential

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24
Q

What’s the prognosis of vertebral OSA in dogs?

A

MST = 4m with Sx + RT + chemo

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25
Q

What’s the prognosis of pelvic OSA in dogs?

A

With hemipelvectomy:
- local recurrence rate = 21%
- metastatic rate = 46%
- mean ST = 533 days

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26
Q

What’s the outcome of canine extraskeleetal OSA?

A

aggressive with high metastatic rate
- Sx only MST = 1m
- Sx + chemo MST = 5m

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27
Q

What’s the outcome of dogs with stage III OSA?

A
  • can be ok with appropriate treatment
  • Stage III on presentation MST = 76 days
  • bone mets: 132 days > lung mets (60 days) > lung + other soft tissue mets (19 days)
  • LN metastasis: 318 days
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28
Q

How do dogs with stage III OSA do with metastaectomy?

A

MST = 232 days vs 49 days (for those that did not have metastasectomy)

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29
Q

What are the theories behind how ALP influences prognosis in canine OSA?

A
  • ALP level is associated with disease burden (both the size of the primary tumour as well as macrometastasis)
  • ALP is a byproduct of osteoblastic properties of endothelin-1 signaling (pro-tumorigenic advantage)
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30
Q

What’s the cutoff value for bone ALP or total ALP for canine OSA?

A

Bone ALP @ 23 U/L
or total ALP @ 110 U/L

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31
Q

What’s the significance of ezrin in canine OSA?

A

Ezrin mediates early metastatic survival
- it’s a negative prognostic factor: DFI 116 days vs 188 days

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32
Q

What’s the significance of MET and RON in canine OSA?

A

MET and RON are tyrosine kinase receptors that are capable of forming heterodimers –> protumorigenic effects
- high RON expression = significant decrease ST compared to absent, low or intermediate expression
- MET was not found to be prognostic

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33
Q

What’s the role of survivin and its significance in canine OSA?

A

Survivin is an anti-apoptotic protein that participates in the processes of cell division as well as apoptosis inhibition
- survivin inhibits both caspase-dependent and -independent mediated apoptosis, and its expression can promote tumorigenesis
- survivin levels affects DFI: 331 days (low survivin) vs 173 days (high survivin)

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34
Q

What’s the significance of VEGF and COX-2 expression in canine OSA?

A
  • VEGF expression is associated with DFI, but not ST: 356 days vs 145 days
  • COX 2 expression is associated with MST: 86 days (high) vs 423 days (negative) vs 399 days (poor staining) vs 370 days (moderate)
  • COX-2 expression may play a role in tumour initiation and progression
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35
Q

What’s the role of heat shock protein and its significance in canine OSA?

A

HSP is involved in cellular responses to stress and aid in appropriate protein folding and protection cells after endoplasmic reticulum stressors –> avoids apoptosis
- HSP60 found to be associated with reduced DFI and STs

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36
Q

How does Treg influence OSA outcome in dogs?

A
  • Treg #’s on its own did not have differences in DFI or ST
  • but CD8:Treg ratio does:
    low CD8/Tregs = significantly shorter ST compared to high CD8/Tregs
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37
Q

What parameters on the CBC is prognostic for canine OSA?

A

Shorter DFI with:
- relative lymphocytosis (> 1000 cells/ uL) and
- relative monocytosis (>400 cells/ uL)
- due to presence of myeloid-derived suppressor cells?
- the monocytes also have down regulation of surface receptors (ex. CCR2, CXCR2 chemokines receptors) and other functional impairments

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38
Q

What’s the role of tumour-infiltrating macrophages in canine OSA?

A

Dogs with more than 4.7% surface area infiltrate with CD204+ macrophages experienced a significantly longer DFI.

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39
Q

What are some criteria for limb sparing surgery for canine OSA?

A
  • <50% involvement of the bone
  • no fracture
  • less than 360 degree soft tissue involvement
  • firm/definable soft tissue mass rather than edematous lesion
  • no mets
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40
Q

What’s the infection rate for limb sparing surgery for canine OSA?

A

40-50%

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41
Q

What’s the complication rate of endoprosthesis for canine OSA?

A
  • overall complication rate = 96%
  • 78% implant infection
  • 36% implant complication
  • 24% recurrence
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42
Q

What are the pros and cons of distraction osteogenesis for canine OSA?

A

Pros:
- can weight bear in 48h after Sx
- no exercise restriction after the skin incision heals
- much less risk of infection compared to other limb spare techniques
Cons:
- extensive client involvement
- extended amount of time that the fixator remains in place

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43
Q

What are the pros and cons of ulna transposition for canine OSA?

A

Pros:
- no distant donor site morbidity
- the bone is autologous & vascularized –> improves healing and reduces risk of infection
Cons:
- poor biomechanical in post-op period –> ulna is much smaller than the radius
- permanent internal hardware

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44
Q

Describe intracorporeal and extracorporeal intrapoerative RT?

A

for intracorporeal:
- the bone if reflected out (after making one cut, and pivots from the joint that is still attached) for RT
for extracoproeal:
- 2 cuts are made in the bone and the diseased bone is removed completely for RT
IORT:
- 70Gy is given to the diseased bone
- complication rate = 69% within 5-9 months
- most common complication = fracture
- local recurrence and infection also possible

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45
Q

What’s the outcome of IORT with adjuvant chemo for canine appendicular sarcoma?

A
  • MST = 298 days (~10m)
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46
Q

What’s the outcome of SRT for canine OSA?

A

Single fraction SRS with adjuvant chemo:
- MST 9.8-12 months
- 63% developed pathologic fracture around 6m
- Acute skin toxicity = 58%
- Late skin toxicity = 16%

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47
Q

What can be an indicator of increased risk of fracture post SRT for canine OSA?

A
  • subchondral bone involvement
  • increasing CT grade (based on degree of lysis, length of identified full cortical lysis, subchondral bone lysis, and ratio of length of affected bone to normal bone.)
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48
Q

What’s the fracture rate of canine OSA treated with 10 Gy x 2 daily fractions?

A

35.7%

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49
Q

Describe isolation of limb circulation and perfusion for canine OSA?

A

Technique for local delivery of treatments that would be too toxic for systemic administration, and/or to improve tumour penetration

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50
Q

What’s the significance of tumour necrosis post treatment for canine OSA?

A

the more tumour necrosis induced by treatment, the better the outcome

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51
Q

Generally speaking, what’s the 1-year local recurrence-free rate and survival rate for dogs treated with limb sparing surgery?

A

76% recurrence-free at 1 year
60% alive at 1 year

52
Q

What’s are the general 3 major complications of limb sparing surgery?

A
  • infection
  • implant complications
  • local recurrence
53
Q

What’s the outcome of CFRT + chemotherapy for canine OSA?

A
  • median local disease control: 202 days (~7m)
  • MST = 209 days (~ 7m)
  • median time to metastasis = 314 days (~10.5m)
54
Q

What’s the general MST in dogs with OSA using adjuvant doxorubicin cisplatin concurrent chemo? Which had unacceptable toxicity?

A

MST 300 days; median DFI = 240 days
- concurrent doxorubicin @ 25mg/m2 and cisplatin at 60mg/m2 = unacceptable toxicity
- much better if doxorubicin in given 1 day later @ 12.5mg/m2
- or do alternating cisplatin/ doxorubicin q3w at MTD

55
Q

What’s the general outcome of adjuvant cisplatin for canine OSA?

A

MST = 262-325 days (~7-8m)

56
Q

What’s the outcome of carboplatin + gemcitabine concurrent combo for canine OSA?

A

median DFI = 203 days, MST = 279 days

57
Q

What’s the general outcome (DFI and MST) of single agent carboplatin post surgery for canine OSA?

A

DFI: 123; 137; 196; 256; 257 (~ 4-8.5m)
MST: 207; 230; 277; 307; 383 (~ 8-12m)

58
Q

In the one study comparing Carbo4, Carbo6, and Carbo/Dox for canine OSA, what’s the final conclusion?
Selmic et al 2014 (470 dogs!)

A
  • The overall median DFI = 291 days (~10m)
  • MST = 284 days (9.5m)
  • no significant difference in any of the protocols in the risk of met development or death
  • Carbo6 had the lowest AE
59
Q

What’s the outcome of single agent doxorubicin for canine OSA?

A
  • 2-3 doses pre-op and continued every 2 weeks for total of 5 doses post-op
  • 1 year survival rate = 50%, 2 year = 9.7%
60
Q

What’s the outcome of carbo/doxo concurrent chemo for canine OSA?

A

Carbo @ 175mg/m2 and doxo @ 15mg/m2 1 day later, every 3w x 4 treatments
- well tolerated
- median DFI = 195 days (6.5m)
- MST = 235 (~8m)
- so not better than single agents

61
Q

What’s the outcome of MTD carboplatin alternating with MTD doxorubicin for canine OSA?

A
  • generally well tolerated
  • median DFI = 202- 227 days (6.7m - 7.5m)
  • MST = 320 days (~ 8.6 -10.6m)
  • 18% grade III or IV hematological AE
  • 12% grade III or IV GI AE
62
Q

What’s the outcome with doxorubicin MTD followed by carboplatin MTD for canine OSA?

A

Similar to other combination protocols
- median DFI = 232 (~8m)
- MST = 247-317 (8-11m)

63
Q

In a head-to-head comparison of MTD carbo vs MTD carbo alternating with MTD doxo, what was the conclusion?

A
  • Carboplatin single agent DFI = 425 days (14m)
  • which is significantly longer than alternating with doxorubicin, DFI = 135 days (4.5m)
  • the MST = 479 days (16m) vs 287 days (9m) not statistically significant
64
Q

What’s the outcome of carboplatin MTD with cyclophosphamide metronomic dosing for canine OSA?

A
  • 1 study didn’t find a significant difference
  • another study found a different PFS (244 vs 480 days) and MST (458 vs 480 days), but 58% of the dogs developed SHC, and the difference was also not significant
65
Q

What’s the utility of immunotherapy for canine OSA?

A

stimulation of the innate immune system has beneficial outcome for canine OSA

66
Q

What’s the role of growth hormone and insulin-like growth factor in canine OSA?

A
  • aberrant GH and IGF-1 overexpression has been hypothesized as a tumorigenesis for canine OSA
  • but using a somatostatin + carbo did not improve DFI or MST compared to placebo + carbo post amputation
67
Q

What’s the role of metalloproteases in canine OSA?

A
  • MMP-2 and MMP-9 is associated with invasion and metastasis
  • inhibitors of MMP did not improved DFI or MST compared to placebo in a post-op setting
68
Q

What’s the outcome of using Palladia as maintenance after MTD carboplatin?

A

no difference in DFI or MST

69
Q

What’s the criteria of pulmonary metastasectomy for canine OSA?

A
  1. primary tumour in remission > 300 days
  2. limited to 1 to 2 nodules on CXR
  3. metastasis confined to the lungs (bone scan negative)
  4. long doubling time (> 30 days)
70
Q

What’s the outcome of pulmonary metastasectomy for canine OSA?

A

additional MST of 176 days! (~6m) for an overall MST of 487 days (16 months)

71
Q

What’s the effectiveness of toceranib for macroscopic pulmonary metastasis in dogs with OSA?

A
  • overall response rate = low –> 10-17.6% RR
  • median PFS: 36-57 days (~1-2m), MST 89-90 days (~3m)
72
Q

Which aerosolized drug delivery has shown some benefits for pulmonary mets for canine OSA?

A
  • Paclitaxel, 1 dog had CR for more than 325 days
  • Doxorubicin also showed PR, but lung toxicities noted on necropsy
  • no DLT hematologic or biochemical activities
  • Gemcitabine didn’t work (in theory would induced Fas receptor in tumour cells)
73
Q

What are some immunomodulating treatments tried for canine OSA with pulmonary metastasis?

A
  • nebulizing IL-2 or IV liposome DNA complexes coding IL-2
  • had 1 CR and 2 PR (IV liposome DNA_)
  • attenuated Salmonella typhimurium vaccine –> 1 PR for 68 days –> significantly longer time to met (308 vs 240 days [10 vs 8 m) and MST (621d vs 278d [20m vs 9m)
74
Q

What’s the response rate and duration of response (analgesia) for palliative RT for canine OSA?

A

RR = 74 - 93%
Duration of response = 53 - 130 days (2-4m)
- no limiting acute or late toxicity
- adding carboplatin may improve analgesic response and ST

75
Q

What’s the utility of 153Sm-EDTMP or 177LU-DETMP

A

Radioisotope tagged with a bisphosphonate for osteotropism.
- improved analgesia noted
- some also had improved c/s and reduced tumour size

76
Q

What’s the MOA of bisphosphonates?

A
  • it preferentially deposit in area of active bone mineral remodeling
  • it’s taken up by osteoclasts –> inhibits post-translational prenylation of small GTP-binding proteins (Ras, Rho, and Rac) –> failure of normal intracellular signaling and extracellular interactions with the matrix –> apoptosis
77
Q

Which bisphosphonates have been used in canine OSA and what’s the benefit?

A
  • originally most studies were done with pamidronate
  • as single agent, helps with pain
  • 28% of dogs for > 4m
  • also effective when used with PRT
  • in PRT with doxorubicin, didn’t perceive additional analgesia, but helped with bone biologic effects within the bone tumour microenvironment
  • zoledronate also shown beneficial effect (100x more potent than pamidronate)
  • pain alleviation in 50% of dogs for >4m
78
Q

What’s the difference between parosteal and periosteal OSA in dogs?

A
  • they both arise from the periosteum of the bone, but parosteal is much less aggressive than periosteal
  • parosteal tend to be well circumscribed with minimal cortical involvement (grows outward, board pedicle) and histologically looks less aggressive than the typical intraosseous OSA
  • periosteal OSA is still just as aggressive as intraosseous OSA and often has cortical lysis with extension into the one and surrounding soft tissue
79
Q

What’s the 2nd most common primary bone tumour in the dogs?

A

chondrosarcoma (5-10% of all bone tumours)

80
Q

What’s the most common breed for chondrosaroma?

A

Golden Retrievers

81
Q

Where is chondrosarcoma most commonly found in the dogs?

A

nasal cavity

82
Q

What’s the biological behaviour of canine chondrosarcoma?

A
  • typically less aggressive/ metastatic than OSA, but a variant of de-differentiated chondrosarcoma has been reported
  • prognosis can depend on location and grade
83
Q

What’s the MST for nasal chondrosarcoma in dogs?

A

210-580 days (7-19m), treated with RT and/or Sx

84
Q

What’s the MST for rib chondrosarcoma in dogs?

A

> 1800 to > 3820 days (5-10y)

85
Q

What’s the MST for appendicular chondrosarcoma in dogs?

A

with surgery alone, MST = 979 days (2.6y)
- grade is an important prognostic factor for metastasis
- grade 1 = 0% @ 6y
- grade 2 = 31% @ 2.7y
- grade 3 = 50% @ 0.9 y

86
Q

How common is primary bone hemangiosarcoma and what’s the biological behaviour?

A
  • rare, <5% of all primary bone tumours
  • aggressive, metastasis within 6m
  • need thorough staging
  • predilection for distal tibia
  • MST = 299 days (10m) with amputation and chemotherapy
  • ddx: telangiectatic OSA
87
Q

How common is primary bone fibrosarcoma and what’s the biological behaviour?

A
  • rare, <5% of all bone tumours
  • ddx: fibroblastic OSA
  • can do well with amputation alone, but metastatic rate is still considerable
  • postulated to met to heart, pericardium, skin and bones rather than lungs
  • no good evidence of adjuvant chemo in preventing metastasis
88
Q

What is MLO?

A

MLO = multilobular osteochondrosacoma, aka. multilobular tumour of the bone
- predilection for the skull
- long term survival possible, esp with low grade and complete resection
- metastatic rate 56%, but median time to metastasis = 542 days (1.57)
- local recurrence rate = 47%, median DFI = 797 days (2y)
- MST = 800
- even with pulmonary metastasis, can still remain asymptomatic for lung disease for 1+ y

89
Q

What’s multiple cartilaginous exostosis (MCE)?

A

MCE = most commonly incidentally found in growing dogs
- typically palpable with no or minimal pain
- lesion from on bone that form from endochondral ossification
- lesion stops growing when animal reaches skeletal maturity (so benign neglect is ok if it’s not causing the patient any concerns)
- otherwise conservative surgery can remove the lesion
- malignant transformation later on as has reported
- genetic component – affected dogs should be neutered

90
Q

What’s the biological behaviour of bone cysts?

A
  • benign
  • typically found in young animal with mild to moderate lameness
  • may be due to trauma to the growth plate interfering with proper endothelial ossification
  • tx = curettage and packing with autogenous bone graft
91
Q

What’s the biological behaviour of aneurysmal bone cysts?

A
  • a proposed mechanism is trauma or benign bone tumour causing vascular disruption –> rapidly enlarging lesion with anomalous blood flow –> damages bone mesenchyme –> will eventually be stabilized and the reactive bone becomes more consolidated and matures
  • tx = en bloc resection and reconstruction or curettage and packing with autogenous bone graft
92
Q

Which IHC can be used to differentiate histiocytic sarcoma vs synovial cell sarcoma vs myxosarcoma?

A
  • Histiocytic sarcoma: vimentin (+), cytokeratin (-), CD18 (+)
  • Synovial cell sarcoma: vimentin (+), cytokeratin (+), CD 18 (-)
  • Myxosarcoma: vimentin (+), cytokeratin (-), HSP (+), variable CD 18
93
Q

What’s the MST of periarticular histiocytic sarcoma in dogs?

A

Adjuvant CCNU post amputation greatly improves ST:
568 days vs 161 days (1.5y vs 5m)

94
Q

What’s the MST of periarticular synovial cell sarcoma in dogs?

A

With amputation alone MST = 455-967 days (1.2 - 2.6y)
- depends on grade
- grade I = 365-1460 days (1-4y)
- grade II = 156 -1095 days (5m - 3y)
- grade III = 183 days (~6m)

95
Q

What’s the MST of periarticular myxosarcoma in dogs?

A
  • tx = amputation or local resection (synovectomy)
  • prolonged ST still possible with incomplete excision (>2y)
96
Q

What’s the most common primary bone tumour in the cat?

A

OSA, accounts for 70-80% of all bone tumorus
- but bone tumours in general is rare in cats

97
Q

What’s the biological behaviour of OSA in cats?

A
  • more common in appendicular vs axial skeleton (one study reported 2:1, but some 1:1)
  • predilection of pelvic limbs (distal femur and proximal tibia)
  • if in axial skeleton, skull (esp oral cavity) and pelvis = most common
  • locally aggressive but metastatic rate is low (5-10%)
  • rare to see metastasis on presentation
98
Q

What’s the biologic behabviour of osteochondroma in cats?

A
  • can continue to develop after skeletal maturity (unlike the dog) in sites not associated with endochondral ossification (ex. skull)
  • also has the potential for malignant transformation
99
Q

What’s the biological behaviour of MCE in cats?

A
  • unlike the dogs, MCE in cats can develop after skeletal maturity
  • may have a viral origin
  • seldom affect long bones, rarely symmetric
100
Q

What are some molecular differences between feline and canine OSA?

A
  • MMP-2 and MMP-9 have greater expression in canine vs feline OSA
  • KIT IHC positive in 79% of canine OSA but none in feline OSA
  • cats more commonly express phosphorylated form of ezrin, dogs more commonly express in a membranous location (more biologically active)
101
Q

What’s the most common site of MCE in cats?

A
  • scapula, vertebrae, and mandible
  • rapidly progressing, conspicuous, hard swelling
  • pain, loss of function
102
Q

What’s the outcome of feline appendicular OSA?

A
  • MST = 22-44m with amputation alone
  • 1- and 2-y survival rate = 66% and 55%
  • adjuvant chemo is not recommended
  • complete surgical excision is prognostic for DFI, PFS, and ST
  • Young age negatively impacted local tumour progression
103
Q

What’s the outcome of feline axial OSA?

A

MST = 6.7m, worse than extraskeletal OSA
- mostly a reflection of inability to obtain complete margin rather than a more aggressive biological behaviour

104
Q

What’s the prognosis of MCE in cats?

A

guarded
- recurrence or new lesion development = common
- no effective treatment protocol

105
Q

What’s the significance of grade or histological subtypes of OSA in cats?

A
  • grade is prognostic
  • subtype is not
106
Q

What are the top 3 bone tumours in the cat?

A

bone tumours are rare in cats
1. OSA
2. fibrosarcoma
3. chondrosarcoma
4. hemangiosarcoma
Tx = aggressive resection, met rate is likely low, but mets also reported with CSA and HSA

107
Q

What’s the likelihood of cutaneous/ SQ metastasis for canine OSA?

A
  • in this cohort, 19/20 with cutaneous/ SQ mets were found incidentally
  • there were also 17/20 lung mets and 1/20 bone mets
  • median time to cutaneous mets = 160 days
  • ST after cutaneous mets = 54 days –> Sx + chemo = 94 days vs no tx = 11 days
108
Q

How can IHC differentiate between hemangiosarcoma and telangiectatic OSA?

A

HSA: ALP (-), factor VIII (+)
Telangiectatic OSA: ALP (+), factor VIII (-)

109
Q

What’s the prognostic implication of different subtypes of canine OSA?

A

fibroblastic = 546 days (18m)
- osteoblastic = 257 days (8.5m)
- chondroblastic = 170 days (5.6m)

110
Q

What’s the outcome of SRT (9Gy x 3) for canine OSA?

A
  • fracture rate = 41%
  • max. lameness improvement median 3 weeks post
  • median time to first event = 143 days
  • MST = 233 days (with chemo)
111
Q

What’s the “optimal” time to initiate chemotherapy post OSA amputation in dogs?

A

within 5 days
Median OST = 445 days vs 239 days (14m vs 8m)
- didn’t seen increased in incidence of grade III or IV AE

112
Q

What’s the rationale behind high dose losartan and toceranib for canine stage III OSA and what’s the response outcome?

A
  • inhibition of the CCL2-CCR2 axis reduced monocyte migration
  • ORR = 25% of the dogs
  • SD more than 8 weeks in another 25%
113
Q

What’s the reported outcome of OSA dogs receiving amputation, carboplatin chemotherapy (4–6 doses), and EGFR vaccine?

A

1y survival rate = 65%

114
Q

What’s the outcome of cranimaxillofacial OSA in dogs treated with SBRT?

A
  • median time to first event (TFE) of 171 days,
  • MST of 232 days. (~8m)
  • Cause of death was local progression for 22/35 (63%) patients, metastasis for 9/35 (26%) patients and unknown for four
  • administration of chemotherapy along with five fractions of SBRT was associated with increased survival time
115
Q

What’s the pre- and post- treatment (SBRT + chemo) PET-CT difference for canine OSA?

A
  • significant reduction in avidity
  • metabolic tumor volume and total lesion glycolysis both showed a significant reduction of -99.8%.
  • post-tx PET SUV max was predictive of metastasis
116
Q

What’s the significance of circulating tumour cells in canine OSA?

A

12/15 dogs had a pre-metastatic CTC spike, and these patients had a median survival time of 301 days, significantly shorter than the 626 days for those without a spike.

117
Q

What’s the fracture rate and most common site of fracture for canine OSA treated with 12Gy x 3 daily fractions?

A

50/127 ~ 40%
- most common site = distal tibia

118
Q

How common is a secondary cancer found on necropsy for canine OSA treated with standardized therapy?

A

12% (HSA was the most common 2nd tumour)
- most common met = lungs, followed by bone, kidney, liver and heart

119
Q

What was the outcome of 18F-FDG for staging for canine OSA?

A

Of the 71 dogs assessed,
- 23.9% were identified with a high suspicion or confirmation of a metastatic neoplasm,
- 16.3% had comorbid malignant neoplasms
- 8/71 (11.3%) having both metastatic and comorbid lesions.

120
Q

What’s the outcome of autologous cancer cell vaccination, adoptive T-cell transfer, and interleukin-2 administration for canine OSA?

A
  • DFI = 231 days
    MST = 415 days (13m)
121
Q

What’s the outcome of dogs with OSA undergoing a secondary amputation?

A

Dogs originally had limb-spare surgery that required an implant to reconstruct the osseous defect.
- 31/192 had a secondary amputation (14%)
- median disease specific survival = 604 days (20m)
- lived for a median of 205 days (7m) after secondary amputation

122
Q

What’s the outcome of canine MLO treated with 10Gy x 3 SRT?

A
  • median PFI = 223 days (~7m)
  • MST = 329 days (~11m)
123
Q

What’s the difference in outcome between SRT vs palliative RT with adjuvant chemo for canine OSA?

A

SRT MST = 350d (~1y)
PRT MST = 147d (5m)

124
Q

What’s the metastatic rate of feline appendicular or scapular OSA?

A
  • 46.3%; 41.9% developed metastasis after amputation
  • median time to metastasis = 235 days (~8m)
  • MST = 527 days (1.4y)
  • Humerus location was significantly associated with a higher rate of distant metastasis.
125
Q

What’s the outcome of amputation followed by single SQ carboplatin for canine OSA?

A

MST = 196 days (6.5m)
median met free interval = 197 days
3/45 (7%) hospitalized for GI AE