Transitional Cell Carcinoma & Mammary Tumors Flashcards
What is the most common urinary bladder cancer? Where does it arise from? What dogs are over-represented?
TCC —> transitional epithelium (urothelium) of the renal pelvis, ureters, bladder, urethra, and prostatic urethra
older (~10 y/o) Scottish Terriers and WHWTs
What is metastasis of TCC like?
frequent, but generally slow —> commonly goes to sublumbar LNs, lung, and bones
What is the typical presentation of TCC?
mimics UTI - hematuria, dysuria, pollakiuria, stranguria
- often improves with empiric antibiotics due to secondary infections
What is seen on abdominal ultrasounds in cases of TCC?
multifocal mass in bladder, most commonly at the trigone (between ureteral openings and internal urethral sphincter)
- U/S usually performed due to persistent urinary signs
What urine test is available for TCC diagnosis? What happens if it comes back negative in cases highly suggestive of TCC?
CADET test for BRAF mutation not seen in other cancers or normal transitional cells (highly sensitive, will be positive is only few TCC cells are present)
lab will run a BRAF-PLUS to detect DNA copy number variants
Why is TCC not commonly directly aspirated? What are some options to run cytology/histopath?
concern for tumor seeding
- traumatic catheterization/suction biopsy
- cystoscopic biopsy
- surgical biopsy
- urine cytology
How does bloodwork in cases of TCC typically look? What method for collecting urine for UA is recommended? What is commonly seen on radiographs?
typically WNL
free catch —> want to avoid tumor seeding
uncommon to see pulmonary metastasis until very late in the course of disease
When is surgery for TCC contraindicated? When is it possible?
if located in the trigone
if apical —> impact on survival time is debatable, may make no clinical difference since tumors in this region are not obstructive, but may resolve hematuria
What NSAIDs are recommended in cases of TCC? What 2 effects do they have?
Piroxicam, Meloxicam, Deramaxx
- decreases peritumoral inflammation to improve urinary signs
- antitumor effects - anti-angiogenic, not cytotoxic
What 3 chemotherapies are used for TCC? Is much of a benefit commonly seen?
- Vinblastine
- Mitoxantrone
- Carboplatin
typically does not reduce tumor size (debatable if beneficial in dogs)
What surgical procedure may give temporary relief for TCC? What risk is seen?
stenting - small flexible tube is placed in the urethra or ureters if the TCC is causing an obstruction (tumor will eventually obscure the stent)
urinary incontinence
When is radiation therapy recommended for TCC?
sterotactic for prostatic TCC
How does prognosis differ in cases of TCC based on location?
- TRIGONE = piroxicam along = 6 months; piroxicam + chemo = 9-10 months
- APICAL = 1-2 years post-surgery, can do well without
- STENT ONLY = 80 days
How does feline TCC compare to canine TCC?
- uncommon
- same testing, treatment, and prognosis recommended
What affects the incidence of mammary tumors in dogs? At what ages is this commonly seen?
OHE timing
- prior to first estrus = 0.05%
- after first estrus = 8%
- after second estrus = 26%
10-11 y/o females (rare in males)
What is inflammatory mammary carcinoma? What is it commonly mistaken with?
presence of mammary tumor with painful, diffusely swollen mammary tissues, ulceration, oozing, and lymphedema, commonly extending onto limbs and trunk
mastitis (ill-defined)
