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Y4 SA - oncology > Surgical oncology > Flashcards

Surgical oncology Flashcards

1
Q

When are incisional biopsies esp important?

A
  • for when the surgical site would make excision with margins difficult
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2
Q

When might excisional biopsy be indicated once a mass has been diagnosed as MCT?

A
  • if surgery site allows for wide margins
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3
Q

What are the Patnaik MCT grades?

A

Grade I = benign
Grade II = intermediate
Grade III = malignant

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4
Q

What are the Kiupel MCT grades?

A
  • low-grade
  • high-grade
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5
Q

How might lower-grade MCTs be managed?

A
  • excision and monitoring
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6
Q

How might higher-grade MCTs be managed?

A
  • may have spread to LN, liver, spleen, bone marrow -> need to be staged
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7
Q

What components of a MCT would mean it is classed as ‘low-grade’?

A
  • mitotic index of 0
  • well-differentiated cells
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8
Q

How might you stage an MCT once it is determined to be high-grade?

A
  • FNA/MRI LN
  • US ± FNA spleen
  • bone marrow aspirate
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9
Q

What options are there for non-resectable MCTs?

A
  • tyrosine kinase inhibitors
  • Mastinib
  • Tigilanol tillage
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10
Q

What is the blood supply of the spleen?

A
  • rich blood supply via single splenic artery and drains via splenic vein into hepatic portal system
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11
Q

What is the most common cause of splenic dz in cats?

A
  • splenic MCT (approx 1/2 MCTs in cats are splenic)
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12
Q

If splenic MCT has metastasised, is splenectomy worthwhile?

A
  • yes
  • good median survival time of 12-18m
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13
Q

When haemoabdomen is present with splenic mass, what does the likelihood of neoplastic disease increase by?

A
  • 50%
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14
Q

What are the 2 main splenectomy techniques?

A
  1. tie off all vessels in hilarity region
  2. tie off short gastric vessels within gastrosplenic ligament and splenic artery & vein
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15
Q

Which is the risk of tying off short gastric vessels for splenectomy?

A
  • risk of damaging surrounding tissues and blood supply
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16
Q

What are the surgical complications of splenectomy?

A
  • bleeding due to damaging major vessels
  • arrhythmia
  • depletion of clotting factors or thrombocytopenia resulting in coagulopathy
17
Q

What is the mets rate of haemangiosarcoma?

A
  • > 90% to lungs, liver, LN, brain, potentially skin
  • another common site is the right atrium
18
Q

What is the primary tx for haemangiosacroma?

A
  • surgery + thoroughly check abdo for mets
19
Q

What adjunctive therapy is usually indicated following surgical resection of haemangiosarcoma?

A
  • chemo
20
Q

What is the average survival time following splenectomy alone for tx of haemangiosarcoma?

A
  • 3 months
21
Q

What is the average survival time following splenectomy + chemotherapy for tx of haemangiosarcoma?

A
  • 6 months
  • pts often die of diffuse mets
22
Q

What is the chemo of choice as adjunct to splenectomy for haemangiosarcoma tx?

A
  • doxorubicin q3w
23
Q

Non-neoplastic causes of splenomegaly

A
  • nodular lymphoid hyperplasia
  • haematoma
  • abscess
  • granuloma
24
Q

What would you expect the PCV of a true haemoabdomen to be

A
  • similar to normal blood
25
Q

Would you expect a true haemoabdomen to clot when tapped? why?

A
  • no
  • blood loses fibrin when in contact with abdo space
26
Q

When performing a splenectomy due to neoplasia, what other organ is it vital to check for mets that would poorly impact prognosis if affected?

A
  • liver

Y4 SA - oncology (3 decks)

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