Surgical Oncology

Question 1

In general, how large should your margins be?

Answer 1

3 cm & one deep fascial plane

Question 2

What is the difference between incisional & excisional biopsy?

Answer 2

incisional: removing a piece of the tumor
excisional: remove the entire tumor

Question 3

Two techniques for FNA?

Answer 3

fenestration (needle only)

aspiration (syringe)

Question 4

What can FNA be used to differentiate between?

Answer 4

Question 5

Cytology

Answer 5

round cell tumor

Question 6

Would you brings this dog to SX to remove the tumor?

Answer 6

Histiocyte tumor (will go away on its own, does not need sx)

Question 7

What are the tumor type on the cytology?

Answer 7

Left: sarcoma (mesenchymal tumor)

right upper: mast cell tumor

right bottom: carcinoma

Question 8

When should you biopsy?

Answer 8

Question 9

What are the three methods of biopsy?

Answer 9

punch

tru-cut

bone

Question 10

How does the punch biopsy work?

Answer 10

Question 11

How does the tru-cut biopsy?

Answer 11

Question 12

bone biopsy instruments?

What is an alternative method? What is the complication associated?

Answer 12

Question 13

When should you not biopsy?

Answer 13

diagnosis is certain

emergency (hemoabdomen/hemothorax) aka mass close to heart (hemagiosarcoma)

Maybe not biopsy if it will not change course of tx or risk is too high/complex location

Question 14

Where is the best location to collect a biopsy from a ST mass vs. a bone tumor?

Answer 14

ST mass: middle of mass may be necrotic, edges are better

bone tumor: periphery may be necrotic/reactive

(d/t difference in blood supply)

Question 15

What are the margins needed for a MCT & STS vs. injection site sarcome?

Answer 15

Question 16

What are the general principles of SX oncology?

Answer 16

• excise all biopsy & fistulous tracts
• early vascular ligation
• wide margins as indicated
• avoid the use of drains
• avoid rupture of the tumor
• gentle manipulation
• avoid contamination of healthy avoid areas
• avoid the use of grafts & flaps
• pre-tx w/ diphenhydramine (MCT)

Question 17

What are the survival times for SX as the sole tx?

Appendicular OSA

Splenic HSA

Oral melanomas

Oral SCC

AGASACA

Answer 17

Question 18

What are the consequences for doing a dirty resection where you do not get clean margins?

Answer 18

a significant increase in morbidity to the patient,

a significant increase in cost to the client

the potential to lose the ability to cure the patient.

Question 19

In general, where do carcinomas vs. sarcomas metastasize to?

Answer 19

carcinomas tend to metastasize to lymph nodes and sarcomas tend to metastasize to lungs

Question 20

Even w/ CT/MRI, what is a good initial screening test for metastasis?

Answer 20

3 view of thorax

Question 21

Anal sac adenocarcinoma often metastasizes to what? What test would be good if you are likely dealing with this tumor?

Answer 21

sublumbar l.n.

biopsy/FNA l.n.

Question 22

There are four doses of surgery that can be administered to a tumor:

Answer 22

Question 23

Where are the most aggressive tumor cells locations in a mass?

Answer 23

along periphery

move like muscle cells to lymph/blood vessels