tumor specific LC part 3 Flashcards
most common tumor of the nasal planum in cats
SCC
rare in dogs
cause of nasal planum scc
UV induced
may be malignant transformation from keratosis or carcinoma in situ
typically cats have white coat
breeds associated with scc
cats - white cats
dogs - goldens and labs 50-76% of cases
treatment of nasal planum scc
nasal planum resection
may need to remove incisive or maxillary bone sit sarcoma or mct
px is good but may recur or met
what is most important for recurrence of nasal plant tumors
complete resection
even with rt some dogs had recurrence within 9 weeks
nasal planecotmy in cats with scc recurrence, dfi, mst
less than 10% of cats had recurrence
DFI 426 - 594 d ~14-20 mo
mst 530 - 673 days ~18-22 mo
surgical curettage and diathermy has been used with rr of 6% for cosmesis
median time to recurrence in patients treated with primary RT or adjuvant RT
nasal squame????
2-3 months
orthovoltage rt in cats for scc pf
megvoltage rt in cats for scc pfi
protons rt in cats for scc
ortho - 1 year pf 60%
mega - pfi 361-916 d ~12-30 mo; mst 961(32 mo)
protons - mst 946d (11.5 mo) pf rate 64%
prognostic factors for cats with nasal planum scc treated with rt
ortho - stage and proliferative fraction
mega - larger size had 5.5 - 6 risk of dying
strontium penetration
depth of 3 mm
response in cats with nasal planum scc treated with strontium
cr - 88%
recurrence - 20%
new lesions in diff location - 33%
MPFI 1710 (~4.5 yr)
1 year df 89%
3 year df 82%
MST 3076 (8.5 yr)
intralesional chemo for feline nasal planum scc
carbo typically
cr 73%
local recurrence 30%
PFS 16 mth
electro chemo for feline nasal planum scc
CR 75%-86%
dfi 7-36 mths
cryosurgery for feline scc
must be smaller than 5 mm, superficial, non invasive
response rate 81%
local recurrence 17% - 73%
DFI 6mth - 26.7 mth
Photodynamic therapy
use of applied light after the administration of a photosensitizer.
The photosensitizer is activated by the light to form free radicals, which results in the induction of cell death. damages and restricts microvasculature inducing immune response
Due to the limited penetration of light into the tissue, the treatment depth is considered 5 mm or less
photodynamic therapy using 5-aminolevulinic acid (5-ALA) as a photosensitizer in cats with nasal planum scc
ORR 96% 49-85% CR
51% recurrence
rate of CR was dependent on stage
CR was noted in 100% of noninvasive tumors measuring <1.5 cm in diameter, 56% of invasive tumors measuring <1.5 cm in diam- eter, and 18% of invasive tumors measuring >1.5 cm in diameter
what is photodynamic therapy used for
nasal planum scc, K9 urinary tumros, equine sarcoids
what are the photosensitizers used in PDT
5-ALA and mTHPC
Nasal tumor SRT- what true
a. sarcomas do better than carcinomas
b. most common side effect oronasal fistula
c. IMRT leads to improved ST for stage I-VI Adams
a. all carcinoma vs all sarcoma - no difference in survival but grouping scc,carcin and undifferentiated carcinoma was worse
b. oronasal fistula can happen with srt - risk worse with surgery
c. stage 4 worse but overall mst improved compared to standard therapy 305 d vs
sinonasal tumor distribution
older >10 but report in dogs young as 9 mths
1% of tumors overall
medium to large breeds may be more affected
risk factors for sinonasal tumors
dolichocephalic breeds (long-nosed) or dogs living in urban envi- ronments, with resultant increased nasal filtering of pollutants, may be at higher risk for developing nasal cancer
tobacco smoke- conflicting reports
carcinomas make up what percent of sinonasal tumors
2/3 - adenocarcinoma, scc, undifferentiated carcinoma
sarcomas - fibrosarc, chondorsarc, osa, and undifferentiated make up most of the rest
rarely - mct, lsa, tvt
extremely rare - hsa, melanoma, neuroendocrine carcinoma, nerve sheath, neuroblastoma, histocytoma, MLO, rhabdo, leiomyo
met rate of nasal tumors
generally low but may be higher at death 40-50% - regional LN and lungs
less commonly bones, kidney, liver, skin, and Brain
mutations seen in sinonasal tumors
60% adenocarcinomas had mutated p53
COX-2 in epithelial tumors
50% EGFR in carcinomas
90% VEGR in carcinomas - tkis good tx
71% PDGFRα 40% PDGFRb - tkis good tx
average time to dx from start of cs in dogs with nasal tumors
2-3 mths
epistaxis, discharge, facial deformity, unwilling to open mouth, sneezing, dsypnea, starter, exophthalmos, ocular discharge
if caudal can cause neurologic sx -seizures, acute blindness, behavior change, paresis, circling, and obtundation
absence of this does not rule out cribriform plate involvement
differentials for nasal tumors non neoplastic
aspergillus fungal rhinitis
material rhinitis
idiopathic rhinitis
nasal parasite
bleeding disorders,
hypertension,
foreign body,
trauma,
developmental anomalies (e.g., cystic Rathke’s clefts
** if facial deformity almost always cancer
mri vs ct for nasal tumors
both good
mri cheaper
determining extent of tumor margins on MRI resulted in a higher tumor volume (18%) in 5/6 dogs and greater likelihood of detecting meningeal involvement. However, 5/6 dogs were classified as the same stage whether determined by CT or MRI
ct and mri findings suspicious for cancer
boney destruction
destruction of the sphenoid sinus
abnormal st in the retrobulbar space
nasopharyngeal invasion
hyperostosis of the lateral maxilla
a mass is not specific for neoplasia - inflammatory dz, polyps, fungal infections
PET CT markers for sinonasal tumors
18F-FDG as well as biomarkers of resistance to radiation, including 18F-FLT for proliferation and 61Cu-ATSM for hypoxia
PET/CT failed to reliably predict areas of residual tumor or recurrence that could be targeted with a boost dose of radiation to improve tumor control
Tumor volume measured by PET-CT and radiation-induced changes in tumor proliferation as shown by FLT uptake may be predictive of tumor behavior and clinical outcome
Adams staging for sinonasal tumors
and survival differences
stage 1 - mst 23.4 mth
stage 4 - mst 6.7 mths
met rate in sinonasal tumors
10-24% to local LN - mostly carcinomas
2-10% pulmonary mets
mst sinonasal tumors no treatment
95 days
epistaxis worse mst 88 vs 224 days
negative prognostic factors for sinonasal tumors
epistaxis, age >10, duration of signs, advanced stage, mets, histo carcinoma, scc, undifferentiated worse, expression of survivin, failure to relieve cs
prognostic factors in the treatment of canine sinonasal tumors remains controversial
treatment with rt on m-f schedule > mwf
extension past the cribriform did not change outcome but cribriform involvement did
mst of surgery sinonasal tumors
boney invasion occurs early and curative surgery is likely impossible
mst after sx 3-6 mths (similar to no tx)
mst of definitive fractionated rt for sinonasal tumors
8 - 20 mths
dose 42 - 54 gy in 10 - 18 fx
toxicity of fractionated rt to sinonasal tumors
acute - oral mucositis, keratoconjunctivitis and blepharitis, rhinitis, desquamation
late cataracts, kcs, atrophy of the cornea, uveitis, retinal hemorrhage/degeneration, brain necrosis, optic nerve degeneration, seizures, osteonecrosis, skin fibrosis
what is the life limiting problem for nasal tumors
locally aggressive - invade and recur
definitive rt following by sx of residual disease
mst 47 mth vs 19 mth for rt alone
another study with different protocol showed MST of 457
increased incidence of late effects, including rhinitis (bacterial and fungal), osteomyelitis, and fistula formation, but MST was the longest
gemcitabine as a radiosensitizer for sinonasal carcinoma
Gemcitabine was given intravenously at a dosage of 50 mg/m2 twice weekly before daily RT
significant hematologic toxicity (neutropenia) and local acute tissue com- plications
not a good option for tx
low-dose cisplatin (7.5 mg/m2 given intravenously every other day) administered in conjunction with definitive RT
well tolerated and did not appear to cause an increase in acute or late radiation effects
efficacy is unknown
Use of firocoxib, a COX-2 inhibitor, was evalu- ated in combination with RT
under powered
Quality of life was improved
no difference in outcomes
srt for nasal tumors
total 24 - 36 gy given over 1-3 tx
improved cs
mst 8.5- 19.5 mth - based on total dose
tumor stage was not prognostic in any of these SRT studies
severe late complications can include
oronasal fistula formation, seizures, ocular changes, skin necrosis, and osteonecrosis
reported in 3% to 40% of dogs
palliative rt outcome nasla tumors
improved cs in 66-100% of dogs with limited se
mst 146 - 512 days ~5-17mo
prognostic factors for nasal tumors treated with palliative rt
Tumor stage (stage 1) and duration of clinical signs (>90 days) have been correlated with longer survival in cases receiving this type of radiation
can dogs with nasal tumor get rt again
yes
small study dogs received 50 gy at first then 36gy after about 500 days , 2nd psi 282 d
mst after two rt protocols 927 days - 31 mth
second study reports a MST of 453 days 15mth in 37 dogs that were reirradiated after a coarsely fractionated radiation protocol
acute se limited
all had late SE and late se did lead to euth in some - sudden blindness
chemo alone for nasal tumors
cisplatin RR 27% - mst 5 mths
carbo/doxo/prioxicam RR 75%- mst 8 mths (if tcc worse 5 mth, if scc or undiff carc 2 month, if sarcoma better 15 mth)
palladia RR 71% - st 8 mths
can get TCC IN NASAL CAVITY!!!!
electrochemo for nasal tumors
RR 90%
MST 16.9
RT + adjunctive Palladia
RR
ST
RR - 80% vs RT alone (69%), toceranib alone (22%)
ST between groups not stat sig
10 mth palladia alone, 20 months palladia and rt, 12 mths rt alone
When all treatments fail to control epistaxis in nasal tumors
unilateral or bilat- eral carotid artery ligation can palliate symptoms in dogs for up to 3 months or longer without damage to the brain
mst nasal sarcoma treated with fractionated rt
MST was 444 days (15 months)
palliative 305 days - 10 mth
definitive MST 523 days - 17mth
prognosis of sinonasal osteosarcoma treated with RT is not clear
nasla lymphoma with rt +/- chemo
MST was 375 days for intermediate/large cell and 823 days 27 mths for the small cell group
no difference in MST for dogs treated with RT and chemotherapy versus chemotherapy alone
90% of dogs treated with RT improved clinically
Angiofibroma in nasal cavity
histologically benign but locally aggressive vascular nasopharyngeal tumor character- ized by a proliferation of irregular appearing blood vessels that are surrounded by a connective tissue stroma
no mets
Surgery tx
Where is SCC mostly located on the dog & cat?
Dog-nailbed; Cat-nasal planum, eyelids, pinnea
Which is more aggressive dog or cat nasal planum SCC?
Dog
What is the survival time with stage4 sinonasal tumors?
Cribiform lysis; 6.7months vs. 23.4 months
What is the survival time with epistaxis?
88 days (3 mo) vs. 224days (8 mo)
On MRI is turbinate lysis is diagnostic for neoplasia also is MRI better than CT?
no but cribriform lysis on mri was always neoplastic
MRI is no better than CT unless brain extension
Is sx helpful with sinonasal disease
No survival with sx+RT not better then MeV RT alone; RT then sx MST 47 months but high late effects
What is the survival with any RT protocol alone for sinonasal tumors?
8-19.7 months; IMRT spares eyes best with best control
What is the tx and survival for feline nasal adenoCA?
12months 1yr survival 44% with RT
What are risk factors for developing lung cancer?
Smoking, plutonium and other RT, anthracosis
What is the etiology and survival with feline multiple digit masses?
Usually met from SCC in lung; amp digits MST 67days
What are prognostic factors for lung cancer?
Size, stage, grade, mets, effusion, signs, disease post-op
Cat-only grade
What is the survival lung tumor with ln mets?
60-126 days (2-4 mo)
12-15 months if neg
What is the survival with stage for lung cancer?
T1 26months, T2 7months, T3 3months
What is the survival by grade of lung tumors?
Low grade 16 months, high grade 6 months
What is the MST for SCC lung cancer?
8 mth
What is the survival if surgery could not remove the entire lung tumor?
28 days vs. 330 if surgery complete
What is prognostic in cats with lung tumors and what is the survival?
Grade, low grade 25 months vs. high grade 2.5months
What are the criteria to perform a metestectomy?
Disease control >300 days; Less than 3 lesions on CXR, Long doubling time >40 days, no other mets
What causes ovine pulmonary adenocarcinoma?
Virus JSRV, originate in alveolar type2 & clara cells
What is the most common site for chondrosarcoma in the dog?
Nasal cavity-MST 210-580days (~7- 19 mo) various tx
Cat has incidental 3 cm primary pulmonary mass what to tell owner
px good despite histopath
frontal sinus carcinoma met rate
12%
frontal sinus tx with pallida and piroxicam
- subjective regression in skull deformity in 80%
MST 184 d ~6 mo
Use of a cyclical hypofractionated radiotherapy regime (‘QUAD shot’) for the treatment of feline sinonasal carcinomas
4Gy x 4 delivered within 48 hours
OST 460d, 15mth 1 yr 80%, 2 yr 0%, 4 euthanized d/t tumor related causes
No AE
CB in 6/7 cats
Diagnosis of feline mesenchymal nasal hamartoma by squash preparation cytology
pretence of osteoblast like and osteoclast like cells on cyto associated with mesenchymal nasal hamartoma on histo
primary pulmonary adenocarcinoma after surgical resection in small-breed dogs
PFI
MST
MPFI 754 d (25 mo)
MST 716 d (23 mo)
prognostic factors for primary pulmonary adenocarcinoma after surgical resection in small-breed dogs
Tumor size was associated with progression free interval in all cases
> 7 cm was negatively associated with OST
> 5 <7 cm and margins where associated with PFI on multivariate
UNIVARIATE ; clinical signs, lymph node metastasis, margin, and histologic grade were associated with PFI, and age, clinical signs, margin, and lymph node metastasis were associated with OST
primary lung tumors in dogs and cats and environmental radon activity
Primary pulmonary neoplasia (PPN) rate is higher in dogs and cats residing in counties with a high radon exposure risk (Environmental Protection Agency [EPA]zone 1) compared to zones 2 (moderate radon exposure risk) and 3 (low radon expo-sure risk).
histopathologic types of primary pulmonary neoplasia and outcomes MST
Pulmonary carcinoma most common 87.1% then sarcoma 7.6%
5.9% of sarcoma classified as HS with sig worse MST of 300 vs 399d for carcinoma
Dogs with neuroendocrine tumors (1.5%) best MST of 498d
No difference for carcinoma based on stage or adjuvant chemotherapy
modified human lung cancer stage classification in dogs with surgically excised primary pulmonary carcinomas
MST for stages
prognostic factors
incomplete excision (241d - 8 mth vs 758d 25mth)
LN mets (95 3mth vs 731d 24mth)
grade (I = 41 1.5 mth, 2 = 268 9mth, 3 = 731d- 24mth)
T stage (T1= NR, T2 = 731d 24mth, T3=522d 17mth, T4=158d 5mth)
chemo did not change outcome
Tolerability and outcome of palliative treatment for metastatic pulmonary carcinoma in cats
chemo, steroids, NSAIDs, or no tx
MST 64 days
Presence of respiratory signs decreased survival
Treatment tolerated, response not really evaluated (table shows mostly SD in cats with recheck cxr or PD; no PR/CR)
Bronchial Stent Placement for Palliative Treatment of Pulmonary Carcinoma with Bronchial Obstruction in a Cat
successful palliation to get rt - lived 323 d
mets to liver and lung
Hydropulsion as Palliative, Long-Term, Last-Resort Treatment of Nasal Carcinoma in a Dog and a Cat
used for resolution of clinical signs
dislodged the tumor
Computed tomography imaging characteristics of canine nasal chondrosarcoma
“ring-and-arc” or “popcorn” calcification in canine nasal tumors may suggest prioritizing chondrosarcoma as a diagnosis
Treatment of advanced-stage canine nasal carcinomas with toceranib phosphate
Stage III and IV only
OST 139d 4.5 mths
Epistaxis associated with longer survival 116d 4mths vs without 83d <3mth
CB rate 72.2%
ct findings of orofacial tumors
Epithelial tumors may have increased blood volume and blood flow compared to mesenchymal tumors
post IMRT findings of sinonasal tumros
in field failure is the most common pattern for local recurrence
some sub volume of tumors within the GTV that makes it radio resistant
Clinical-dosimetric relationship between lacrimal gland dose and keratoconjunctivitis sicca in dogs with sinonasal tumors treated with radiation therapy
20% developed kcs
Minimum dose to develop kcs 23.75 gy
No eyes <20 gy developed kcs
Outcomes and adverse effects associated with stereotactic body radiation therapy in dogs with nasal tumors
3 daily 9-10 Gy or once 20 Gy
MST any cause 388d; 58% d/t local disease progression.
another study showed up to 542d mst with multimodal treatment
another study showed 354d
745d with two courses of srt
AE acute: skin 26%, oral 30%, eye 26%, KCS 4%
AE late (>6 mo): unilateral cataract 18%
SRT associated with lower acute AE than fRT
(Palladia) as a primary or adjuvant agent in the treatment of canine nasal carcinoma
Fractionated 42 Gy RT (10 fractions)
CR/PR rate 80% in palladia+RT group and 69% in RT alone which is significantly better than palladia alone at 22%
CB rate better in palladia + RT 97% than RT alone 80%
MST palladia + RT 615d,
RT alone 368d,
palladia alone 298d - NOT sig different
Palladia with RT did not result in more AE
Canine intranasal tumours treated with alternating carboplatin and doxorubin in conjunction with oral piroxicam
mst
pfi
ae
Response rate
MST 8 mths for any tumor
carcinoma - 280 d - 9 mths
TCC - 5 mths
SCC/undiff - 2 months
sarcoma - 448 d - 15 mths
PFi 211 d
AE in 69% of dogs and 28% of treatments 24% Gr III or IV
RR 55%
Retrospective evaluation of intranasal carcinomas in cats treated with external-beam radiotherapy
palliative verse SRT verse fRT
Pfs pRT = 198d - 6.6 mth
OST pRT = 284 d - 9 mth
Pfs SRT= 504d - 17 mth
OST SRT = 721d - 24 mth
PFS fRT 269 d - 9 mth
OST fRT 452d - 15 mth
Second course of RT improved outcome - 824 -27 mths vs 434 d - 14 mth
most common nasal tumor in cats
Lymphoma is the most commonly diagnosed tumor type in the feline nasal cavity and sinuses, followed by epithelial neo- plasms (carcinoma, adenocarcinoma, SCC)
majority of cases were B-cell (68%) and 20% were T-cell, with 12% having a mixed population of B- and T-cells
ct findings of feline nasal tumors
osteolysis of paranasal bones, extension of disease into the orbit of facial soft tissues, the presence of a space-occupying mass, and turbinate destruction may suggest a CT diagnosis of neoplasia over rhinitis
met rate of nasal cancer in cats
low
~17%
RT for feline nasal tumors
mst 12 mths 44% alive at 1 year and 16% 2 year
what virus has been associated with nasal cancer in people
HPV has been identified in 25% to 49% of oropharyngeal head and neck cancers and is associated with a sig- nificant survival difference compared with HPV-negative oropha- ryngeal cancers
what molecular marker in people has been shown to be associated with worse dfs in people
with nasal tumors???
EGFR
what breeds are over represented for larygotracheal tumors
arctic breeds - husky, alaskan malamute
what cat breeds associated with larynx tracheal tumors
siames, dsh - lsa
DLH adenocarcinoma
tumor types found in the canine larynx
Rhabdomyosarcoma, SCC, adenocarcinoma, osteosarcoma (OSA), chondrosarcoma (CSA), fibrosarcoma, mast cell tumor (MCT), solitary extramedullary plasmacytoma, and granular cell tumor have been reported in the canine larynx
you dogs develop what in the trachea
benign masses
tracheal chondromas, osteochondromas, and osteochondral dyspla- sia
location and tumor type of tracheal lesions in the dog
Tracheal malignancies are more commonly located on the ventral wall, and adenocarcinoma, MCTs, extramedullary plasmacytoma, OSA, CSA, and lymphoma have all been reported
Feline laryngeal tumors
SCC, lymphoma, adenocarci- noma, and poorly differentiated round cell tumors
Benign laryngeal masses have also been reported, such as lymphoplasmacytic inflammation, lymphoid hyperplasia, and polypoid laryngitis
feline tracheal tumors
Primary masses of the trachea in cats include lymphoma, SCC, histiocytic sarcoma, neuroendocrine carcinoma, and adenocarcinoma
Lymphoplasmacytic inflammation, lymphoid hyperplasia, and epithelial polyp have also been reported
Treatment of genitourinary carcinoma in dogs using nonsteroidal anti-inflammatory drugs, mitoxantrone, and radiation therapy
PFI - 260 d
MST - 510 d - 17 mths
mild clinical signs and lack of prostate involvement were associated with favorable prognosis
permanent urinary incontinence in 31%
Total prostatectomy as a treatment for prostatic carcinoma
permanent urinary incontinence in 35%
Poor prognostic factor extracapsular tumor extension
OMST 231d - 7.6 mth
1 year survival 32%
2 year survival 12 %
metastases of prostatic adenocarcinoma
where
rate
diffuse - peritoneal cavity (liver spleen kidney, carcinomatosis, etc) or lungs or bone
via hematogenous or lymph
report of 2 dogs with cutaneous metastasis - multiple skin nodules on ventral abdomen, inguinal, sq, cutaneous nodular lesions
40% lung mets;
80% mets @necropsy;
22-42% bone mets
Definitive-intent intensity-modulated radiation therapy for treatment of canine prostatic carcinoma
Definitive intent IMRT 48 to 54 Gy total 2.5-2.8Gy daily +/- NSAID and Chemo
OST 563 d -18.7 mth
PFI 220 d
ost longer with chemo 241-8 mth d vs 25 d
ost longer if no mets 109 3.5 mth d vs 388d 13mth
ae- acute diarrhea low grade
late stricture, hind limb edema in 3 dogs
negative prognostic factors for prostatic carcinoma
significant clinical signs
extracapsular extension
metastasis at diagnosis
masitinib and expression of its specific targets c-Kit, PDGFR-α, PDGFR-β, and Lyn in canine prostate cancer cell lines
Masitinib increased apoptosis while decreasing cell counts and cell viability in a dose and application interval dependent manner (increased benefit at 12 h dosing)
Supports use of mastinib in vivo study for prostatic cancer
is it common for prostatic carcinoma to have basal cell or urothelial markers
no will have absent or weak basal cell or urothelial markers such as p63, high molecular weight cytokeratin, or Uroplakin 3
prostatic carcinoma can have what type of invasion
extension into benign ducts and glands “intraductal carcinoma” - 44% of p in one study
Sertoli cell tumour paraneoplastic syndrome other than hyperestrogenism
pancytopenia
historically associated with poor prognosis
with surgery is may resolve pancytopenia and improve outcome
Sheltie with testicular tumor and feminization and pancytopenia
Sertoli cell tumor
What are the different testicular tumors and what cells do they arise from?
Sertoli-sustentacular cells in seminiferous tubules;
interstitial-leydig cells b/w tubules;
Seminioma-germinal epith of seminiferous tubules
What is the metastatic rate of testicular tumors?
<15% seminoma, sertoli;
Leydig very rare
Sites of metastasis may include regional lymph nodes (LNs), eyes, brain, lungs, kidney, spleen, liver, adrenal glands, pancreas, skin, and peritoneum
What are risk factors for testicular tumors?
Age, breed, cryptorchoid ( seminoma/sertoili cell) , environment (carcinogen exposure)
Which testicular tumors express c-KIT
Interstitial/Leydig - all pos
seminomas - all pos in one paper - other paper showed SE subtype (PLAP+) only were ckit pos
but sertoli - one paper some pos one paper none pos
subtypes of Sertoli cell tumors
subclassified on the basis of expression of placental alkaline phosphatase (PLAP) as classical seminoma (SE) or spermatocytic seminoma (SS; PLAP negative)
What are some IHC for testicular tumors?
GATA-4 (sertoli, interstitial), - not germinal tissue like seminoma
MelanA- steroid producing cells -Leydig cell tumors (100%), Sertoli cell tumors (93%), and adrenocortical adenomas (92%)
immunohistochemical panel of E-cadherin, GATA-4, INH-alpha, KIT, NSE, PGP 9.5, and melan A
sertoli: inhibin alpha, GATA-4, melan A, NSE, E cadherin, vimentin
seminoma; Ckit Ki67, PGP9.5, vimentin
Leydig; Melan A, inhibin alpha, Gata 4, vimentin
What testicular tumor has a paraneoplastic syndrome and is it reversible?
Sertoli-hyperestrogenism - more than 50% of affected dogs display signs of estrogen overproduction
reverses 1-3 months post-op unless mets
What can you measure in the serum to diagnosis hyperestrogenism?
17β
not all dogs with signs of feminization have absolute increases in estradiol-17β
What is the tx and prognosis for dogs with testicular tumors?
Castration curative;
Mets can do RT or chemo-MST 5-31months
Where does prostate cancer arise?
Ductal/uroethelial epith not acinar so androgen neg
Is mineralization in the prostate pathognomic for neoplasia?
No, intact dogs mineralization from BPH, prostatitis,
if Neutered highly specific
What is the tx and prognosis with prostatic CA?
Surgery alone MST<5months;
surgery and adjuvant chemo/nsaids 8 mth
piroxicam 7months;
No tx 30days
What 2 cancers cause hyperestrogenism that can lead to bone marrow hypoplasia?
Male sertoli cell tumors & female granulosa cell tumor
characteristics of 3 most common testicular tumors - Withrow chart
dont memorize just review
breeds associated with testicular tumor types
seminoma - GSD and Belgian malinois
other: boxer, afgan hound, weimaraner, shetland sheepdog, collie, maltese
Flat-coated retrievers, Rottweilers, Bouvier de Flandres, and Leonbergers may have a reduced risk of developing testicular tumors
in what testicle is cryptorchid more likely
right - more likely to be retained
age of dogs with cryptorchidism that develop tumors
younger than non cryptorchid
6-10
Aggressive testicular tumors did express high levels of what proliferation markers
TERT, p53, PCNA, and Ki67
AgNOR high in metastatic and invasive seminomas
Laminin and testicular tumors
extracellular matrix protein involved that plays a role in anchor- ing cells to the basement membrane
As tumors became more invasive, laminin expression became fragmented or lost in Sertoli cell tumors and seminomas, and this correlated with increasing proliferative activity as assessed by PCNA scoring, Ki67 index, and mitotic index
Connexin 43
gap junction protein of the testis
expression may aid in differentiating neoplastic Sertoli cells from seminomas
p53 and testicular tumors
increased p53 expression has been associated with tumor progression
may be an indicator of tumor aggression
VEGF and MVD in seminomas
higher in diffuse seminomas compared with more well-differentiated intra- tubular seminomas, potentially providing a histologic indicator of malignant behavior
signs of hyperestrogenism
bilateral symmetric alopecia, cutaneous hyperpigmentation, epidermal thinning, squamous metaplasia of the prostatic epithelium, gynecomastia, galactorrhea, attraction of other males, preputial atrophy, atrophy of the nonneoplastic testicle, and bone marrow suppression
17% of dogs with scrotal Sertoli cell tumors developed feminization
Feline testicular tumors
Sertoli cell tumor, seminoma, interstitial cell tumor, and teratoma have been reported
Breeds that may be at increased risk of developing PCA
Bouvier des Flandres, Doberman pinscher, Shetland sheep- dog, Scottish terrier, beagle, miniature poodle, German short- haired pointer, Airedale terrier, and Norwegian elkhound
American cocker spaniel, miniature poodle, and dachshund may be at decreased risk for developing PCA
Risk Factors for PCA
More aggressive tumors may develop in castrated males with
a higher risk of metastasis
Natural Behavior of PCA
local invasion with a high propensity for regional and distant metastasis
braf in pca
Activating mutations in the BRAF gene, which lead to constitutive MAPK signaling, were found in the majority of PCA in dogs
cox 2 in PCA
Cyclooxgyenase-2 (COX-2) and downstream prostaglandin E2 expression may play a role in carcinogenesis and progression in PCA
Expression of COX-2 was noted in 75% of PCAs in one study, whereas none of the normal prostate tissue stained positively
what cytokines and hormones may play a role in establishing skeletal metastasis of prostatic carcinoma
PTHrp and TGF-β
BUT PCA metastases are more commonly osteoblastic in nature
complications of prostatectomy
most common complication is urinary incontinence, occurring in 33% to 35% of dogs
3D conformal RT (CRT) or intensity-modulated RT (IMRT) with image-guided RT (IGRT) for pCA
54 to 58 Gy in 20 fractions
PFI 317 days 10.5 mth
MST 654 days 22mth
late rt AE of prostatic rt
urethral, ureteral, and rectal stricture
For dogs with skeletal metastasis, palliative options include
systemic analgesics, RT, bisphosphonates, and
samarium-153– ethylenediamine–tetramethylene–phosphonic acid
Feline Prostate Tumors
rare
Metastasis appears common and sites of spread can include pancreas, lung, and LNs
most cats died within 3 months of diagnosis
most common cancer of the penis
scc and TVT
tumors of the os penis
Ossifying fibroma, benign mesenchymoma, multilobular osteochondrosarcoma and osteosarcoma can arise from the penile bone
osa od th Eos penis can recurr after marginal excisions and met
Which mutation occurs in ~50% of K9 HSA?
PTEN → AKT/mTOR disruption
SQ HSA response rate to chemo im assuming
40%
HSA tx after doxorubicin
no benefit to palladia
ctx may help
Rottie with spleen hs
remove spleen start CCNU
what is the prognostic for dermal HSA
uv induced
ventral location
breed
Dog with pericardial effusion analysis of fluid - not definitive of neoplasia
mesothelioma, heart base mass, HSA
Canine most common secondary brain tumor
hsa
renal hsa prognosis
9 months
What are risk factors for cHSA?
RT
UV
What are some mutations in HSA?
VHL ( inc HIF->VEGF), bFGF, Ang1, p53, PTEN, PI3k/mTOR, pdL1
What are IHC for HSA?
Von Willebrand factor8, cKIT, claudin5
What % of nontraumatic hemoabdomens & what % requiring transufusions were HSA?
60-70%
93% requiring transfusions
What are prognostic factors for HSA?
Stage, grade, heart mass, collapse, cardiac troponinI
What is the prognosis for HSA?
Spleen 3 months sx alone, 6months with chemo
Heart 1-4months,
Renal 9 months,
Retroperitoneal 1 month,
Cutaneous long-term; SQ&muscle unclear
What is the tx and outcome for heart hsa
sx + dox 164 d - 5 mth
aortic body do better with pericardectomy - 720 d 24 mths vs 42 days
Gene expression profiles of beta-adrenergic receptors in canine vascular tumors
Hsa over expressed beta AR subtypes 1-3
Canine splenic hemangiosarcoma cells express and activate luteinizing hormone receptors in vitro
High luteinizing hormone may be associated with cell proliferation
May be why spayed and castrated dogs are more likely to develop hsa
In vitro effects of doxorubicin and tetrathiomolybdate on canine hemangiosarcoma cells
The addition of tetrathiomolybdate increased ROS formation and apoptosis
Ascorbic acid inhibited this
Tumour necrosis factor-related apoptosis-inducing ligand (TRAIL) induces apoptosis in canine hemangiosarcoma cells in vitro
TRAIL is an apoptosis inducing cytokine
Trail isoleucine zippered - induced apoptosis in all cell lines and increased activation of caspase 3 and 8 and adp-ribose polymerase degradation
Recombinant human trail worked but on specific cell lines
DOES The addition of metronomic chemotherapy improve outcome for canine splenic haemangiosarcoma
NO
Doxo alone or with MTD cytoxan vs Doxo followed by MC cytoxan
No differences between groups
Canine Intrapelvic Hemangiosarcoma
Arose from intrapelvic musculature
PFS 92 days, OST 165 days - 5 mths
CS- lameness, urethral obstruction and hemoperitoneum
Pericardial Hemangiosarcoma
pericardial effusion - blood
hsa in pericardium - no hb mass
Pulmonary Mets noted 12 days post op, survived 18 days
Primary Hemangiosarcoma of the Falciform Fat (ligament)
OST 339 d, 1 yr survival 50%
4 dogs treated with chemo who had sig longer MST 394d vs 83d in 3 with surgery alone
Diagnostic value of the ultrasonographic description of a splenic mass or nodule as cavitated in 106 dogs with nontraumatic hemoabdomen
Poor diagnostic utility in identifying hsa or malignancy
SN 42% SP 51%
Ppv 55%
Npv 38%
Adjuvant carboplatin for treatment of splenic hemangiosarcoma in dogs vs doxo
Mst 160 d for carbo and 139 for doxo
( not stat sig)
Increased monocytes following surgery is neg prog - 265 d vs 66 day with inc monocytes
Development and validation of a multivariable model and online decision-support calculator to aid in preoperative discrimination of benign from malignant splenic masses in dogs
found 8 variable - TP, presence or absence of >2 nRBCs/100WBCs, us mass diameter, number of liver nodules, presence of multiple splenic masses, degree of homogeneity in the splenic mass, amount of effusion, mesenteric ommental or peritoneal nodules
double two-thirds rule for diagnosing hemangiosarcoma in dogs with nontraumatic hemoperitoneum due to a ruptured splenic mass - 3 paperss
JAVMA 2022
73% malignant
87.3% HSA
_____________
VCO2020
63% malignant
60% HSA
______________
VCO2020 UK
60% malignant tumors
66% being HSA
breed based association is strong predictor of malignancy
Retrospective evaluation of thrombocytopenia and tumor stage as prognostic indicators in dogs with splenic hemangiosarcoma
Stage 3 disease and perioperative thrombocytopenia associated with shorter PFI and OST.
Hct NOT associated
Prevalence, distribution, and clinical characteristics of hemangiosarcoma-associated skeletal muscle metastases
dogs included had visceral or muscular hsa
24.6% skeletal mets detected - all had mets to >1 other site
60% with smm had lameness or reluctance to walk
Whole body ct recommended for staging with hsa due to smm
Adjuvant anthracycline-based vs metronomic vs no medical treatment for dogs with metastatic splenic hemangiosarcoma
Mtd doxo > metronomic > splenectomy
ST 140 d >58 d> 40 d
Doxo had higher toxicity rate
Assessing major influences on decision-making and outcome for dogs presenting emergently with nontraumatic hemoabdomen
QOL most important to owners for decision making.
SX improves survival if non-malignant hemoabd (239d vs 39d palliative care) but not if malignant (MST 81d)
Impact of repeated cycles of EGF bispecific angiotoxin (eBAT) administered at a reduced interval from doxorubicin chemotherapy in dogs with splenic haemangiosarcoma
eBAT = EGF targeted antitoxin
eBAT = bispecific epidermal growth factor angiotoxin consisting of human EGF targeting EGFR, human amino terminal transferase ATF of urokinase targeting urokinase plasminogen activator receptor UPAR, and a genetically modified deimmunized Pseudomonas exotoxin
Initial trial found that eBAT was safe and potentially effective when administered post splenectomy in 1 cycle of 3 treatment followed by doxorubicin
No dose limiting toxicity
6 mo survival 70% with 6/23 alive >450d (stage I & II HSA)
This study found no benefit for additional doses while including stage III
Retrospective comparison of first-line adjuvant anthracycline vs metronomic-based chemotherapy protocols in the treatment of stage I and II canine splenic haemangiosarcoma
Ost 200 d 6.6 mth and TTP 185d
Stage i longer than stage ii 338 d - 11mth vs 151 d 5 mth
Mst for doxo 154d
Mst for metronomic + chemo 338 d
Mst for metronomic 225d 7.5mth
Difference was NOT statistically significant for mst or ttp
This study suggests that adjuvant MC in canine splenic HSA may result in a similar outcome when compared to other treatment protocols
predictors of hsa of splenic masses
bodyweight
breed
hemoabdomen
incidental findings
met dz
anemia
thrombocytopenia
on multivariate
only hemoab
breed
what breeds are associated with hsa diagnosis base dont eh presence of a splenic mass
Terriers and brachycephalic dogs, Spaniels, Poodles, Dachshunds, Beagles - unlikely to have HSA
German Shepards very likely to have HSA (75%)
Retrievers and mountain breeds 46%
Sighthounds and Collies 42%
Timely adjuvant chemotherapy improves outcome in dogs with non-metastatic splenic hemangiosarcoma
Time to metastasis and OST significant longer in p who received chemotherapy </= 21 days following splenectomy
Evaluation of the anti-tumour activity of Coriolus versicolor polysaccharopeptide (I’m-Yunity) alone or in combination with doxorubicin for canine splenic hemangiosarcoma
Dogs treated with PSP alone, female dogs, decreased HCT at diagnosis, and stage III disease associated with poor outcome
Addition of PSP to dox post splenectomy did not improve survival
This study shows the PSP alone does not improve survival compared to splenectomy alone as suggested by the pilot with a larger population
Urinary bladder hemangiosarcoma in a cat treated with partial cystectomy and adjuvant metronomic cyclophosphamide and thalidomide
risk factors for splenic hsa
German shepherds, golden retrievers, Labrador retrievers, and other large-breed dogs are overrepresented in several case series
male
spayed > unspayed - not validated
risk factors for cutaneous hsa
the skin along the ventral abdomen and conjunctiva in short-haired and lightly pigmented breeds - light exposure
what do hsa arise from
Hx thought to be peripheral endothelial cells, recent molecular data suggest that HSA may arise from bone marrow progenitor cells that undergo dysregulated maturation and sub- sequently move to peripheral vascular sites to form tumors
probable heterogeneity within this tumor type
what proteins are over expressed in hsa compared to normal
pRB, cyclin D1, Bcl2, and survivin are overexpressed in HSA
differentials for splenic mass
lymphoma, nonangiomatous/nonlymphomatous sarcomas and nonneoplastic etiologies (e.g., nodular hyperplasia, extramedullary hematopoiesis, hematoma
most common location of hsa in the cat
cutaneous > visceral liver more than others (e.g., spleen, liver, intestine) locations are the most commonly reported primary sites for HSA
reported in heart, thoracic cavity, eyelid or conjunctiva, digit, and nasal cavity
most common metastatic sites hsa
liver, omentum, and lungs
staging of hsa
pulmonary metastatic disease on cxr of hsa
nodular to interstitial coalescing miliary pattern
rt and heart base hsa
Hypofractionated RT has been evaluated for dogs with cardiac HSA and in a pilot study appeared to reduce the frequency of cardiac tamponade, leading to an MST of 2.5 months
yunnan baiyao and hsa
YB led to dose- and time-dependent cell death via caspase- mediated apoptosis in three canine HSA cell lines
YB and epsilon- aminocaproic acid in dogs with presumed cardiac HSA suggested no benefit in terms of time to recurrence of hemopericardium or overall survival time
no coag benefits seen
prognosis feline hsa
poor
die from recurrence or mets
77 - 197 d
cutaneous - 9 mths - 4 yrs
SQ hsa cats problem with surgery
high rates of incomplete excision 50-94%
and local recurrence 50-80%
thymoma natural behavior
Thymomas are carcinomas and thus should be considered malignant tumors - thymic epithelial cells with mast cells and mature lymphocytes
in cats the cystic form is most common
mets are uncommon in both species but up to 20% in cats with cystic thymomas
dog with edema of the head, neck, and thoracic limbs - next step ?
cxr looking for mass - cranial vena cava syndrome
paraneoplastic with thymoma
67% of dogs
Myasthenia graves, exfoliative dermatitis, erythema multiform, hypercalcemia, T cell lymphocytosis, anemia, myocarditis, polymosytis
MOST common - MG and megaesophagus in dogs -megaesophagus and aspiration pneumonia have been reported in as many as 40% of dogs with thymoma. Hypercalcemia has been reported in 34%
exfoliative dermatitis in cats are the most common
dog with thymoma what is the chance it has another tumor
27% of dogs will have a concurrent second tumor
hyper ca in thymoma cause
Hypercalcemia has been reported in 34%
PTHrp
US appearance of thymoma
Cranial mediastinal masses with a cystic appearance and heterogeneous echogenicity were significantly more likely to be thymomas than lymphomas in one study
cytology of thymoma
presence of neoplastic epithelial cells. These are often accompanied by mast cells and variable numbers of small mature lymphocytes.
often non diagnostic - neoplastic
epithelial cells were cytologically evident in only 61% of cases
Hassal’s corpuscles
A unique feature of thymoma, Hassal’s
corpuscles, are cytoplasmic structures present in thymocytes that can be used to aid on cytologic diagnosis
best seen on H/E formalin fixed samples
thymoma flow
CD4+ CD8+
In one study, all cases of thymoma included 10% or more of lymphocytes coexpressing CD4 and CD8, whereas six of seven lymphomas contained fewer than 2% of CD4+CD8+ lymphocytes
*prior q was interpreting flow plot
stage in human thymoma - Masaoka–Koga
thymoma sx alone
cat - MST 1825 d 89% 1 YEAR 74% 3 yr
dog - MST 635-790 d 64% 1 YEAR 42% 3 YR
thymoma no treatment
76 d
RR of thymoma to RT in dogs and cats
50 - 75%
mst 248 - dog - 8 mth
mst 720 - cats - 24 mth
most p had sx followed by rt
hypofractionated RT alone thymoma (48–49 Gy total dose, once weekly, for 6–7 weeks)
overall response rate was 50% and the 1-year survival rate was 75%
chemo and rt good for txt for thymoma?
Chemotherapy and RT can result in a reduction in the size of thymomas, but this effect may be the result of reduction in the nonneoplastic lymphocyte population in the thymus rather than a true anticancer effect
prognostic factors thymoma
high percentage of lymphocytes was associated with longer STs.
Age, invasiveness of the tumor, and mitotic index had no effect on prognosis.
dogs classified as lower Masaoga–Koga stage (I or II) had significantly longer STs than dogs with stages II or higher
negative - MG - aspiration pneumonia/mega eso, resectability
Outcomes of dogs with thymoma treated with intensity modulated stereotactic body radiation therapy or non-modulated hypofractionated radiation therapy
No difference in survival for hypofractionated non-modulated RT vs SRT but potentially less side effects for SRT (heart/lung) and reduced timeframe for completion may suggest SRT as favorable
Underpowered
SBRT - 250 d
NMRT - 155 d
Histopathologic and clinicopathologic findings of thymoma
MST 449 days, 1 yr 52.6%, 2 yr 26.3%
Surgical excision of tumor associated with prolonged survival
Mets, MG, and moderate to marked cellular pleomorphism associated with reduced survival
When are CD4/CD8 double negative? Double positive?
Neg when enter/in thymus and double positive-thymomas
What species can be infected with TVT? What is a similar disease?
Canine, foxes, coyotes, jackals; Tasmanian Devil Facial Tumor
How many chromosomes are in TVT? How many in normal dog?
57-64 and normally 76 plus x/y =78
What are some molecular mutations with TVT?
Point mutation p53; insertion of LINE ahead of c-myc
What is the immunologic progression of TVT
progressive phase - 1st progression phase takes 3-6months where TGF-B suppress IFNy and downregulates tumor MHC complexes; stationary phase
Then either regression or dissemination-if immunocompotent regresses by TILS produced IL-6 that works with IFNy to increase NK and MHC expression;
unlikely to spontaneous regress if present >9months - will happen within 3 months
What is the tx for TVT?
Vincristine can be curative; Doxorubicin or RT for resistant cases; Sx not good
What is paraneoplastic syndrome for TVT?
erythrocytosis
test to diagnose tvt
LINE-c-myc mutation - PCR
cytology
biopsy
What treatment has the highest rate of recurrence for TVT
surgery
recurrence 30-75%
● SQ HSA – response to doxorubicin
o 38.8%
o Median duration of response 53 d
o Dogs that had sx lived longer – 207 d v no sx 83 d
dermal hsa poor prog indicators
Dogs w/ SQ involvement, hemoabdomen, or mets – worse prognosis
Splenic HSA – benefit of treatment w toceranib after doxorubicin
no benefit
DFI for all dogs 138 d and 161 d for TOC; MST 169 d for all dogs and 172 for TOC
Pooled vaccine for canine splenic HSA – most common AE? Immune response?
o Allogenic HSA vaccine induces humoral response to control antigen in vaccine (KLH) – all 6 dogs had Abs produced to KLH
o Vaccine was administered w adjuvant DOXO, MST was sig improved compared to historical controls
o Most common AE – transient diarrhea
o MST 182 d
Doxorubicin and CCNU for HSA
Stage II splenic HSA – sx, CCNU/doxo
o MST 158 d, 1-yr 16%
o Prognostic mitotic score - Mitotic score = 0 (MI <11) - MST 292 d 10 mths, 42% 1yr
Cat visceral HSA – most common surgical findings, metastatic disease in what %
Spontaneous hemoabdomen
▪ 46% neoplastic (60% HSA)
▪ 37% tumors in spleen
o Visceral HSA
▪ 33% met to lung at dx
MST 77d
cytology on blood smear fo hsa
o Acanthocytes, schistocytes, nonregen or regen anemia
perioperative mortality in dog with thymoma
20%
tvt distribution
tropical and subtropical areas, particularly in the southern United States, Central and South America, southeast Europe, Ireland, Japan, China, the Far East, the Middle East, and parts of Africa.
North America, the prevalence of TVT is correlated with increased rain- fall and mean annual temperature
TVT is most common in dogs 2 to 5 years of age
met rate of tvt
5-17% region ln, sq, skin, eyes, oral mucosa, liver, spleen, peritoneum, hypophysis, brain, bone marrow
protein expression in tvt
p53, proliferating cell nuclear antigen (PCNA), Ki67, MYC, retinoblastoma (Rb), cyclin D1, matrix metalloproteases (MMPs) -2 and -9, and variably expresses S-100
histo of tvt
TVT is commonly described as a round (or discrete) cell tumor and suggested to be of histiocytic origin
expression of vimentin, lysozyme, alpha-1-antitrypsin (AAT), and macrophage-specific ACM1
may be found with intracellular leishmania
can dogs with tvt who get a cr become reinfected
maybe but Dogs recovered from TVT have serum- transferable immunity to reinfection and puppies born to bitches exposed to TVT are less susceptible to the disease
rr of tvt to vinc
90-95%
resistant cases treated with dox
RT for tvt
was able to induce CR in various protocols
cytology from pericardial effusion what is your diagnosis
a. hemangiosarcoma
b. histolytic sarcoma
c. chemodectoma
d. mesothelioma
e. not malignant
d. mesothelioma - Clumps of neoplastic cells with binucleations, single to multiple prominent and variably shaped nucleoli, and cytoplasmic vacuoli. The presence of a thick brush border and the “mesothelial slits” suggest a mesothelial origin of cells - small slits or windows between the cells
a- blood and spindle cells
b - fried egg, vacuoles, multi nuc bizzare
c - neuroendocrine - naked nuclei or halo cells
What are growth factors associated with mesothelioma?
VEGF, IGF-1, PDGF
What is the tx and outcome with pericardial mesothelioma?
Pericardectomy survival 4-13 months; chemo may increase to 27; overall unknown
What two tumors stain positive for cytokeratin & vimentin?
Mesothelioma and synovial cell sarcoma, ovarian CA, RCC tubulopapillary
● What is most common form of mesothelioma
epithelial
can you diagnose mesothelioma on cyto
o Can r/o LSA or infectious causes but cannot specifically diagnose mesothelioma
o Reactive mesothelial cells appear same as malignant epithelial– flattened cells w microvilli, desmosomes, and phagocytic potential
Chemotherapy w intracavitary carboplatin vs. mitoxantrone
o Not enough power to determine difference?
Intracavitary chemotherapy for pleural effusion v. without – any difference
MST for untreated – 25 d v. 332 d for dogs that had intracavitary mito and/or carbo
Evaluation of intracavitary carboplatin chemotherapy for treatment of pleural carcinomatosis in cats
ineffective
died within 2 weeks
Mediastinal Serous Cavity Mesothelioma (caudal mediastinum) in Two Dogs
ihc
strong cytoplasmic immunoreactivity to cytokeratin, strong cytoplasmic immunoreactivity to vimentin, weak cytoplasmic immunoreactivity to calretinin, PAS positive intracytoplasmic granules.
Outcome of dogs treated with chemotherapy for mesothelioma
IC 12 (cis/carboplatin), IV 2 (carbo/doxo/mito alone or alternating), 1 MC after
Dogs who received chemotherapy had a sig. longer MST 366 days vs 74 days
Complete resolution of effusion after first chemo longer MST 415 d vs 160
outcome of canine malignant mesothelioma:
ORR 37% after 3 weeks and 24% after 15 weeks
OMST 195 d; for chemo 234d and no chemo 29 d
All dog 1 year survival 22%
Treatment with any chemo only sig. prognostic factor
gave intracav or IV 5Fu, carbo, carbo/mito
most common CS
tachypnea
dyspnea
pleural effusion
cause of mesotheliom
asbestos
chronic inflammatory response also creates a distinct immunosuppressive tumor microenvironment, leading to infiltration with myeloid-derived suppressor cells, tumor-associ- ated macrophages, and regulatory T cells, which likely contributes to tumor progression
most common mutations of mesothelioma
cyclin-dependent kinase inhibitor 2A (CDKN2A), BRCA1 association protein 1 (BAP1), and neurofibromin 2 (NF2)
histologic forms of mesothelioma
epithelial, mesenchymal, biphasic , sclerosing mesenchymal form that looks like sts, cystic form reported in a dog
on histo there is a A high-grade sarcomatous component adjacent to a low-grade cartilaginous component. what tumor does this indicate?
referred to as a bimorphic pattern, confirms the diagnosis of a dedifferentiated chondrosarcoma on histopathology
A retrospective study on bone metastasis in dogs with advanced-stage solid cancer
where did they come from? what cancer type? what was the most common bone location?
- mammary, spleen, tonsil
- carcinoma or HSA
- 19 had multiple bones with humerus and vertebrae most common
- MST from time of bone met dx 30 days
Lack of treatment associated with increased risk of death
