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Withrow > Tumors of Skin and SQ Tissues > Flashcards

Tumors of Skin and SQ Tissues Flashcards

1
Q

<p>What is the overall incidence of skin tumors in dogs and cats and what percentage is considered to be malignant?</p>

A

<p>- Overall incidence 25.5 to 43% - difficult based on literature- 20 to 40% malignantRef: 1-6 and 2, 3</p>

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2
Q

<p>In dogs, what is the incidence of skin and connective tissue tumors in a survey of California counties from 1963 to 1966? Excluding melanomas?</p>

A

<p>- 150.4/100,000 (0.15%)- 90.4/100,000 (0.09%)</p>

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3
Q

<p>In cats, what is the incidence of skin and connective tissue tumors in a survey of California counties from 1963 to 1966? </p>

A

<p>- 51.7/100,000 (0.05%)</p>

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4
Q

<p>In a study of 3,564 cats that were examined by biopsy or necropsy during a 41-month period from January 1, 1986 through May 31, 1989, what percentage of cats were diagnosed with cutaneous neoplasia? In this study, skin tumors accounted for what percentage of all tumors that were diagnosed?</p>

A

<p>- 9.6%- 29.6%Ref: 5</p>

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5
Q

<p>Similar to previous studies, other studies report that what percentage of tumors arise from the skin in cats?</p>

A

<p>19.3% to 21%Ref: 6, 7</p>

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6
Q

<p>With the exception of basal cell tumors, what percentage of skin tumors are considered to be malignant in cats?</p>

A

<p>69.7 to 82%Ref: 6, 5</p>

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7
Q

<p>What is the incidence of cutaneous MCT in dogs?</p>

A

<p>16.8%</p>

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8
Q

<p>What is the incidence of cutaneous lipomas in dogs?</p>

A

<p>8.5%</p>

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9
Q

<p>What is the incidence of cutaneous histiocytoma in dogs?</p>

A

<p>8.4%</p>

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10
Q

<p>What is the incidence of cutaneous perianal gland adenoma in dogs?</p>

A

<p>7.8%</p>

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11
Q

<p>What is the incidence of cutaneous sebaceous gland hyperplasia/adenoma in dogs?</p>

A

<p>6.5%</p>

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12
Q

<p>What is the incidence of cutaneous SCC in dogs?</p>

A

<p>6%</p>

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13
Q

<p>What is the incidence of cutaneous melanoma in dogs?</p>

A

<p>5.6%</p>

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14
Q

<p>What is the incidence of cutaneous fibrosarcoma in dogs?</p>

A

<p>5.4%</p>

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15
Q

<p>What is the incidence of cutaneous basal cell tumor in dogs?</p>

A

<p>5%</p>

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16
Q

<p>What is the incidence of cutaneous peripheral nerve sheath tumor in dogs?</p>

A

<p>4.3%</p>

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17
Q

<p>What is the incidence of cutaneous papilloma in dogs?</p>

A

<p>2.8%</p>

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18
Q

<p>What is the incidence of cutaneous sweat gland adenocarcinoma in dogs?</p>

A

<p>1.1%</p>

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19
Q

<p>What is the incidence of cutaneous sebaceous adenocarcinoma in dogs?</p>

A

<p>0.5%</p>

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20
Q

<p>What are the 4 most common tumors in dogs?</p>

A

<p>MCT, lipoma, histiocytoma, perianal gland adenoma (in order)</p>

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21
Q

<p>What is the incidence of cutaneous basal cell tumor in cats?</p>

A

<p>23%</p>

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22
Q

<p>What is the incidence of cutaneous fibrosarcoma in cats?</p>

A

<p>17.8%</p>

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23
Q

<p>What is the incidence of cutaneous mast cell tumor in cats?</p>

A

<p>16.5%</p>

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24
Q

<p>What is the incidence of cutaneous SCC in cats?</p>

A

<p>10.4%</p>

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25
Q

<p>What is the incidence of cutaneous apocrine adenoma in cats?</p>

A

<p>3.4%</p>

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26
Q

<p>What is the incidence of cutaneous lipoma in cats?</p>

A

<p>3.3%</p>

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27
Q

<p>What is the incidence of cutaneous hemangiosarcoma in cats?</p>

A

<p>2.9%</p>

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28
Q

<p>What is the incidence of cutaneous sebaceous adenoma in cats?</p>

A

<p>2.8%</p>

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29
Q

<p>What is the incidence of cutaneous fibroma in cats?</p>

A

<p>2.7%</p>

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30
Q

<p>What isthe incidenceof cutaneous hemangioma and melanoma in cats?</p>

A

<p>1.7%</p>

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31
Q

<p>What is the incidence of cutaneous malignant fibrous histiocytoma in cats?</p>

A

<p>0.7%</p>

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32
Q

<p>What are the 4 most common cutaneous tumors in cats?</p>

A

<p>Basal cell tumor, FSA, MCT, SCC (in order); they make up approximately 70% of skin tumors in cats</p>

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33
Q

<p>What factors have been associated with increased risk of skin cancer?</p>

A

<p>Ionizing radiation, thermal injury, UV radiation, papillomavirus infection, immunosuppression</p>

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34
Q

<p>White cats in California have an \_\_\_ increased risk of developing cutaneous SCC due to solar exposure. What are the most common locations?In another study of 61 cats with cutaneous SCC, what percentage of cats were white and what percentage spent time outside?</p>

A

<p>13.4xHead, neck95%96%Ref: 18, 23</p>

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35
Q

<p>What viral infection can lead to cutaneous tumors in dogs? What cells are affected?</p>

A

<p>Papillomavirus; keratinocytes (papillomaviruses are only able to replicate in terminally differentiated cells an can stimulate increases proliferation and terminal differentiation)</p>

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36
Q

<p>How does neoplastic transformation arise in cells infected with papillomavirus?</p>

A

<p>Neoplastic transformation arises from the viral effects on cell proliferation, integration into the genoma, and interaction of the viral proteins with cellular proteins, particularly the destabilization of p53 by viral protein E6 and the inhibition of pRB by viral protein E7. Disruption of p53 results in increased levels of p16 protein, which can be detected with IHC.</p>

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37
Q

<p>The presence of what tumor can be seen in dogs and cats infected with papillomavirus?</p>

A

<p>SCC, usually invasive and metastatic</p>

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38
Q

<p>What virus has been detected in dogs and cats with oral and cutaneous SCC?</p>

A

<p>Papillomavirus; these SCC cases are usually invasive and metastatic</p>

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39
Q

<p>What are two presentations in cats infected with papillomavirus?</p>

A

<p>Viral plaques -> can turn into SCCFibropapillomas or feline sarcoids</p>

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40
Q

<p>Although papillomavirus can be detected with IHC in the majority of feline viral plaques, what happens as the plaques progress to SCC? What can be used instead?</p>

A

<p>Ability to detect it using IHC for Ag decreasesPCR</p>

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41
Q

<p>In cats, \_\_\_% of UV protected SCC test positive for papillomavirus using PCR vs \_\_\_% of UV exposed SCC.</p>

A

<p>76%42%</p>

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42
Q

<p>In a study of cats with Bowen's in situ carcinoma, what % of lesions tested were positive for papillomavirus using PCR?</p>

A

<p>25%</p>

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43
Q

<p>What strains of human papillomavirus have been found in cats?</p>

A

<p>5, 21, 38</p>

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44
Q

<p>What protein has been found to be elevated in cats with viral plaques, Bowenoid tumors, and non-solar induced invasive SCC, consistent with the presence of papillomavirus? This is compared to cats with trichomonas (control) and solar induced SCC.</p>

A

<p>p16</p>

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45
Q

<p>Humans that have received organ transplants have a \_\_\_\_ increased risk for developing SCC</p>

A

<p>100xAlso, humans that are immunosuppressed are at increased risk for developing SCC</p>

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46
Q

<p>In humans, basal cell carcinomas can arise from mutations in which signaling pathway?</p>

A

<p>Hedgehog</p>

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47
Q

<p>Which reciprocal translocation has been reported in a dog with a basal cell tumor? What gene is involved?</p>

A

<p>t(10;35)Chromosome 10 contains the gene GLI1, which is the effector transcription factor of the HH signaling pathwayTranslocations result in chimeric fusion of proteins that have an overall oncogenic effect</p>

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48
Q

<p>What two aberrant karyotypes have been found in cats with basal cell tumors?</p>

A

<p>Trisomy E3Monosomy E3</p>

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49
Q

<p>Out of 24 cats with BCT, how many were positive using IHC for expression of the apoptotic regulatory proteins Bcl-2 and Bax? Which one of these is specific for human BCC?</p>

A

<p>Bcl-2 expressed in 23/24 catsBax expressed in 7/24 catsBcl-2</p>

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50
Q

<p>Mutation in what gene is commonly found in humans with cutaneous SCC?</p>

A

<p>p53</p>

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51
Q

<p>A series of 3 IHC studies of p53 in canine cutaneous SCC revealed that \_\_\_% were positive for overexpression of this gene.</p>

A

<p>29.5%</p>

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52
Q

<p>A series of 3 IHC studies of p53 in feline cutaneous SCC revealed that \_\_\_% were positive for overexpression of this gene. What other form of solar induced change can result in overexpression of p53 in cats?</p>

A

<p>47.5%Actinic keratosis</p>

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53
Q

<p>What prevents positive IHC staining when p53 is present in its wild-type form?</p>

A

<p>Its short half life</p>

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54
Q

<p>In dogs, which protein is expressed at much lower levels in SCC vs benign cutaneous neoplasms?</p>

A

<p>p27 -> responsible for maintaining cells in G0</p>

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55
Q

<p>What protein has been shown to be present in the nucleus of 100% of dogs with trichoepitheliomas and pilomatricomas (hair follicle tumors)?</p>

A

<p>B-catenin; this represents pathway activation</p>

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56
Q

<p>Cyclin \_\_\_ is present in \_\_\_% of feline SCC and \_\_\_% of canine SCC?</p>

A

<p>Cyclin A - important for cell cycle regulation90% of feline SCC44% of canine SCC</p>

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57
Q

<p>Which cyclin is rarely expressed in skin tumors of any type?</p>

A

<p>Cyclin D1</p>

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58
Q

<p>A mutation in what gene is associated with development of renal cystadenocarcinoma and nodular dermatofibrosis? What does the gene code for? Most common dog breed seen? What's another dog breed?</p>

A

<p>Birt-Hogg-Dube gene; codes for folliculin protein, which is a tumor suppressor proteinGerman Shepherd dog #1Alsatians</p>

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59
Q

<p>The use of which TKI has been associated with development of actinic keratosis and invasive SCC in humans? Which receptors are blocked with this TKI?</p>

A

<p>Sorafenib - blocks Raf, VEGFR, PDGFR</p>

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60
Q

<p>Which two factors are potentially synergistic towards the development of cutaneous SCC in dogs and cats?</p>

A

<p>UV light exposure and papillomavirus infection</p>

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61
Q

<p>What diagnostic technique is recommended to obtain a diagnosis for lesions that appear malignant or are non-diagnostic on cytology?</p>

A

<p>Biopsy- because of all the information you can obtain (histopath, grade, IHC, PCR etc). Tru-Cut or needle biopsies are not recommended as tissues obtained are small and limit the info you may get. Multiple punch biopsies or incisional biopsies are preferred.</p>

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62
Q

<p>In dogs with skin tumors, advanced imaging such as US and CT increases the stage of the primary tumor in what % of patients?</p>

A

<p>69%</p>

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63
Q

<p>What is the mainstay treatment for local control of cutaneous tumors?</p>

A

<p>Surgery</p>

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64
Q

<p>What tumors are considered to be basal cell tumors?</p>

A

<p>Basal cell carcinomas (malignant version) and basal cell epitheliomas (benign version)</p>

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65
Q

<p>Which two tumor types are no longer considered basal cell tumors?</p>

A

<p>TrichoblastomasSolid-cystic ductular sweat gland tumors (adenomas and carcinomas)</p>

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66
Q

<p>Where do basal cell tumors arise from?</p>

A

<p>Stem cells in the outer follicular root sheath that present variable differentiation; origin is not absolutely determined</p>

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67
Q

<p>What are basosquamous cell carcinomas? What is the incidence of these tumors in dogs and cats?</p>

A

<p>Tumors with characteristics of both BCC and SCC; immunohistochemically, they are more closely related to BCC.Incidence is unknown</p>

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68
Q

<p>What types of cells are seen on cytology samples from BCC?</p>

A

<p>Inflammatory cells, squamous cells, sebaceous epithelial cells, melanin, melanophagesWell differentiated fibroblasts, reactice fibroblasts, and mast cells can also be present</p>

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69
Q

<p>When evaluating a BCC with cytology alone, how are they collectively called?</p>

A

<p>Cutaneous basilar epithelial neoplasms; because the subtypes cannot be identified using cytology alone</p>

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70
Q

<p>What IHC marker is specific for BCC in humans?</p>

A

<p>BerEP4 - very specific membrane glycoprotein markerUsed to differentiate a BCC from a SCC or a solid-cystic ductular sweat gland epithelial tumor in humans</p>

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71
Q

<p>What IHC marker can be used to differentiate a sweat gland epithelial tumor in humans?</p>

A

<p>Cytokeratin 8 - expressed in sweat gland epithelial tumors</p>

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72
Q

<p>What % of skin tumor are BCT in dogs and cats?</p>

A

<p>Dogs: 5.5 to 8.4%; unclear if trichoblastomas includedCats: 10 to 26%</p>

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73
Q

<p>What 2 dog breeds and 1 cat breed have been reported to be at increased risk for developing BCC?</p>

A

<p>Cocker spanielsPoodlesSiameseOne study found no breed association</p>

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74
Q

<p>How do BCC clinically appear?</p>

A

<p>Plaques or nodules, often darkly pigmented (may resemble melanoma)Overlying skin may be alopecic, intact, or ulcerated</p>

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75
Q

<p>What is the median age of dogs and mean age of cats at the time of BCC diagnosis?</p>

A

<p>Dogs - 9 yearsCats - 9.6 to 10.8 years</p>

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76
Q

<p>What are the the BCC histologic subtypes?</p>

A

<p>Solid, keratinizing, clear cell</p>

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77
Q

<p>Are BCC considered a low-grade malignancy or high-grade?</p>

A

<p>Low-grade</p>

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78
Q

<p>BCC recurrence rate and metastatic behavior in dogs? What can be useful in differentiating BCC that can potentially recur from those that cannot?</p>

A

<p>Can recur after sx excision but no reports of metastasisMorphometric analysis of cell nuclei </p>

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79
Q

<p>Although now thought of as rare, what is the reported second most common solid tumor in cats after mammary carcinoma?</p>

A

<p>BCC - this is likely not true as these are now considered to be rare after they were changed to being either apocrine ductular carcinomas or trichoblastomas</p>

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80
Q

<p>In cats, what % of previously called BCC are now called apocrine ductular carcinoma and trichoblastoma? </p>

A

<p>Solid cystic apocrine ductular carcinoma 60% Trichoblastoma 40%Literature still calls them BCT</p>

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81
Q

<p>What are common locations for BCC in cats?</p>

A

<p>Head and neck; can occur anywhere in the body though</p>

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82
Q

<p>Although the majority of BCT in cats appear to have a benign behavior, what % is considered malignant? Based on what 6 criteria?</p>

A

<p>10% (10/97 cats in one paper)Stromal invasion, lymphovascular invasion (5 cats), necrosis, high mitotic index, LN mets (1 cat), pulmonary mets (1 cat)Despite this, met rate appears to be lowRef: 79, 82</p>

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83
Q

<p>\_\_\_\_\_\_\_\_\_ was able to predict recurrence of BCC in one study of 23 cats.</p>

A

<p>Nucleomorphometric analysisRef: 83</p>

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84
Q

<p>What is the treatment of choice for cats with BCC? What other treatments have been reported?</p>

A

<p>Surgery is TOC; RT and doxorubicin -> unknown survival impact</p>

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85
Q

<p>What are papillomas?</p>

A

<p>Benign epidermal proliferative lesions often associated with papillomavirus infection.</p>

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86
Q

<p>Cutaneous papillomas are typically found in younger dogs, with an average age of \_\_\_ years.</p>

A

<p>3.2 years</p>

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87
Q

<p>What 3 treatment options are available for dogs with papilloma?</p>

A

<p>Sx resectionBenign neglect - can go away on their ownAzithromycinRef: 86</p>

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88
Q

<p>What type of papilloma is seen in cats?</p>

A

<p>Fibropapilloma - demonstrate proliferation of mesenchymal cells covered by hyperplastic epithelium. Evaluation for PV demonstrated an apparent non-productive infection of the mesenchymal cells (Ref: 87)</p>

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89
Q

<p>Feline papillomas are more similar to \_\_\_\_\_\_\_ than papillomas.</p>

A

<p>Equine sarcoids</p>

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90
Q

<p>What is the definition and difference between SCC in situ, actinic keratosis, and Bowen's carcinoma?</p>

A

<p>SCC in situ - carcinoma that has not penetrated the basement membrane of the epithelium. Can occur anywhere in the body, haired and non-haired skin.AK - SCC in situ that arises as a consequence of UV exposure; usually lightly haired skin.Bowen's carcinoma, Bowenoid carcinoma in situ, multicentric papillomavirus-induced SCC - multiple carcinoma in situ. Can occur anywhere in the body, haired and non-haired skin. This is usually seen in cats, with only a few reports of it in dogs. Solitary lesions are uncommon.All of these are IN SITU</p>

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91
Q

<p>Where do AK lesions usually occur and what histopathologic changes can be seen in these lesions?</p>

A

<p>Lightly haired skin with UV exposureSolar elastosis and fibrosis of the skin > consistent with chronic UV exposure</p>

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92
Q

<p>What can happen with untreated carcinoma in situ?</p>

A

<p>They can become invasive and put the patient at risk for metastasis</p>

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93
Q

<p>How does BISC usually behave?</p>

A

<p>Typically patients will continue to develop new lesions over time, but metastasis appears to be uncommon</p>

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94
Q

<p>What is the median DFI and MST in cats with carcinoma in situ treated with surgery (TOC)?</p>

A

<p>DFI - 594dMST - 675dRef: 23; study of 39 cats</p>

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95
Q

<p>What topical treatment can be used in cats with Bowen's carcinoma? What is the treatment regimen?</p>

A

<p>Imiquimod cream 5%5/12 cats had at least 1 lesion disappear (CR)Treatment regimen: SID (mostly) or 3x/week</p>

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96
Q

<p>Besides surgery and Imiquimod cream, what other treatment options (4) are available for cats with SCC in situ?</p>

A

<p>Palliative RT - can control dz for 8 monthsPhotodynamic therapy - up to 100% RRStrontium 90 plesiotherapyEtretinate - showed promise but d/c</p>

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97
Q

<p>What was the response rate, recurrence rate, and overall MST seen in a study of 14 cats with nasal planum SCC in situ that were treated with strontium 90?</p>

A

<p>Response rate 100%No recurrenceMST >3,000 days</p>

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98
Q

<p>What is the metastatic behavior (high or low? met rate?) in cats with SCC in situ or AK?</p>

A

<p>Low; in a study of 61 cats with tumors in the nasal planum and pinnae -> 1.6% (1 cat) to regional LN mets at the time of recurrence</p>

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99
Q

<p>What topical treatment has been used in cats for SCC in situ and BISC, but did not demonstrate clinical efficacy?</p>

A

<p>13-cis-retinoic acid</p>

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100
Q

<p>What has been associated with prognosis in cats with carcinoma in situ?</p>

A

<p>Tumor stage</p>

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101
Q

<p>What is the definition of squamous cell carcinoma?</p>

A

<p>Malignant tumors of the epidermis in which the cells demonstrate differentiation to squamous cells (keratinocytes)</p>

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102
Q

<p>What is the median age in dogs and cats diagnosed with SCC?</p>

A

<p>Dogs - 10 to 11 yearsCats - >10 years</p>

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103
Q

<p>What is the predilection site in cats with SCC?</p>

A

<p>Head, particularly lightly haired areas in white cats.Reflects the role of UV light exposure</p>

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104
Q

<p>What feline breeds (3) have a decreased risk for developing SCC?</p>

A

<p>SiameseHimalayanPersian</p>

105
Q

<p>What canine breeds (2) may be predisposed to develop nasal planum SCC?</p>

A

<p>LabradorsGolden Retrievers</p>

106
Q

<p>What canine breeds may be predisposed to develop cutaneous SCC?</p>

A

<p>BloodhoundsBasset houndsStandard poodlesLabs and goldens -> nasal planum SCC</p>

107
Q

<p>What is the clinical presentation of cutaneous SCC?</p>

A

<p>Very variablePlaquelike to papillaryCrateriform to fungiformMay be erythemic, ulcerated, or covered with a crust</p>

108
Q

<p>What paraneoplastic syndrome has been reported in cats with cutaneous SCC?</p>

A

<p>Hypercalcemia</p>

109
Q

<p>What is the metastatic rate at the time of death in cats with invasive nasal planum SCC? What are the sites?</p>

A

<p>40% (6/15 cats)Regional lymph nodes, lungsLN are more common*</p>

110
Q

<p>What is the metastatic rate in dogs with invasive nasal planum SCC? What are the sites?</p>

A

<p>23.5% (4/17 dogs)Regional LN (mandibular) - mets to distant sites not reported</p>

111
Q

<p>What is the metastatic behavior in dogs with cutaneous SCC/how many cases are reported in literature? Sites?</p>

A

<p>Very uncommon4 cases reported in literaturelung, liver, bone</p>

112
Q

<p>Treatment of choice for cutaneous SCC?</p>

A

<p>Surgery; results in excellent long-term control in both spp</p>

113
Q

<p>In a series of 61 cats with SCC that were treated with surgery, RT, and cryotherapy, which of these treatment options resulted in the longest median DFI? What was the DFI?</p>

A

<p>Surgery; DFI 594 days*many of the cats did not have invasive dz</p>

114
Q

<p>What treatment modality is effective for the treatment of nasal planum SCC in cats, but not in dogs?</p>

A

<p>RT</p>

115
Q

<p>Besides surgery, what other treatment modalities are effective for the treatment of nasal planum SCC?</p>

A

<p>RT Strontium</p>

<p>90 plesiotherapy</p>

<p>Proton therapy</p>

<p>Intralesional carboplatin/sterile sesame oil</p>

<p>Chemotherapy:Intralesional carbo, bleomycin, mitoxantrone, actinomycin D, cisplatin</p>

116
Q

<p>What was the 1-year survival rate in a study of 90 cats with nasal planum SCC that were treated with orthovoltage definitive RT (10 x 4Gy)? What was found to be predictive for PFS in this study?</p>

A

<p>60% 1 year survival rateHistologic tumor stageRef: 101</p>

117
Q

<p>What was the 1-year PFS rate in a study of 90 cats with nasal planum SCC that had stage T1 and T3 tumors when treated with definitive RT (10 x 4Gy)?</p>

A

<p>T1 - 85% 1 yr PFS rateT3 - 45.5% 1 yr PFS rateRef: 101</p>

118
Q

<p>In a study of 15 cats with nasal planum carcinoma, proton RT with a dose equivalent to 40Gy yielded a CR of \_\_\_% and a PR of \_\_\_%. The 1-year PFS in this study was \_\_\_% and the MST was \_\_\_ days.</p>

A

<p>60% CR33% PR6.6% SD (no response, 1 cat)1-year PFS 64% MST 946 days (2.6 years)</p>

119
Q

<p>A study evaluating the use of strontrium-90 plesiotherapy in 49 cats with with invasive SCC of the nasal planum yielded an overall RR of \_\_\_% and a CR of \_\_\_%. The median dose delivered was \_\_\_Gy and \_\_\_% developed recurrence with a median time to recurrence of \_\_\_ days. The median PFS was \_\_\_ days and the overall MST was \_\_\_ days. </p>

A

<p>Overal RR 98%CR 88%128 GyRR 28.5%Median time to recurrence 308 daysMedian PFS 1710 daysMST 3076 daysRef: 94</p>

120
Q

<p>Another study evaluating hypofractionated strontium in 15 cats with nasal planum SCC showed the CR was \_\_\_% and the PR was \_\_\_%. The recurrence rate in the cats that had a CR was \_\_\_%. The total dose delivered was \_\_\_Gy.</p>

A

<p>CR 86%PR 13.3%RR 0% at median follow up time of 652 days50GyRef: 104</p>

121
Q

<p>In a group of 4 dogs with nasal planum SCC treated with RT alone, only \_\_\_ dog achieved a durable remission. In this same study, \_\_\_ dogs were treated with a combination of surgery and RT, \_\_\_% of dogs had local recurrence at a median time of \_\_\_ weeks.</p>

A

<p>1 dog achieved a durable remission 7 dogs tx with sx + RT, 100% had local recurrence at a median time of 9 weeks.</p>

<p>Ref: 98</p>

122
Q

<p>What was the local recurrence rate in a study of 8 dogs with nasal planum SCCtreated with either orthovoltage RT or radon 222 implants?</p>

A

<p>100%</p>

<p>Ref: 106</p>

123
Q

<p>What chemotherapy drugs have been used for the treatment of nasal planum SCC in dogs and cats?</p>

A

<p>Intralesional carbo, bleomycin, mitoxantrone, actinomycin D, cisplatin</p>

<p>Cats: intralesional carboplatin/sterile sesame oil, bleomycin, mitoxantrone</p>

<p>Dogs: cisplatin, bleomycin, actinomycin-D, mitoxantrone</p>

124
Q

<p>In one study, intralesional carboplatin/sterile sesame oil in cats with SCC has a CR of \_\_\_% and 1-year PFD of \_\_\_%.</p>

A

<p>CR 73%</p>

<p>1-yr PFS 55%</p>

<p>Ref: 107</p>

125
Q

<p>In a study, 2 dogs with metastatic SCC were treated with cisplatin chemotherapy. One of the dog had metastasis to the axillary LN and lungs; what type of response did this patient had and what was the PFI?</p>

<p>The other dog (metastatic sites not mentioned in Withrow) had whay type of response and what was the PFI?</p>

A

<p><strong>First dog</strong>: PR consisting of a marked reduction in the number and size of the lung nodules as well as reduction in size of the axillary LB; PFI was 4.5 months.</p>

<p><strong>Second dog</strong>: CR; PFI >22 months (died of tumor unrelated causes).</p>

<p></p>

<p>Ref: 108</p>

126
Q

<p>The use of actinomycin-D in two dogs with SCC has been reported. One dog had \_\_\_ after 1 dose and the other dog had a \_\_\_ and receiveced a total of 6 doses.</p>

<p>(PD, SD, PR, CR)</p>

A

<p>SD, PR</p>

<p>Ref: 110</p>

127
Q

<p>What is the overall response rate of mitoxantrone in dogs and cats with SCC?</p>

A

<p>Dogs: 44.4% (4/9 dogs)</p>

<p>Cats: 12.5% (4/32 cats)</p>

<p>Ref: 111, 112</p>

128
Q

<p>When bleomycin chemotherapy is used in dogs and cats wtih SCC, how is the response? (short lived or long lived)</p>

A

<p>Short-lived</p>

<p>Red: 109</p>

129
Q

<p>What tumors of the skin and SQ tissues are categorized as tumors with adnexal differentiation (7)? Which of these has only been reported in dogs and which ones have a malignant counterpart (2)?</p>

A

<p>Infundibular keratinizing acanthomas*</p>

<p>Tricholemmoma*</p>

<p>Trichoblastoma</p>

<p>Trichoepitheliomas</p>

<p>Malignant trichoepithelioma*</p>

<p>Pilomatricomas</p>

<p>Malignant pilomatricomas*</p>

<p>*Only in dogs</p>

<p>Malignant counterparts: malignant trichoepithelioma and malignant pilomatricoma</p>

130
Q

<p>Where do tumors with adnexal differentiation arise from? Are these typically benign or malignant? Main treatment?</p>

A

<p>Majority arises from the hair follicle</p>

<p>Usually benign</p>

<p>Surgery</p>

131
Q

<p>What other names are used for IKA?</p>

A

<p>Intracutaneous keratinizing epithelioma, keratoacanthoma, squamous papilloma</p>

132
Q

<p>What dog breeds may be at increased risk for the development of infundibular keratinizing acanthomas (IKA)?</p>

A

<p>Nordic breeds; particularly Norweigan elkhounds</p>

<p>Belgian sheepdogs</p>

<p>Lhasa Apso</p>

<p>German shepherd dogs</p>

<p>Terriers</p>

133
Q

<p>IKAs are benign common tumors in dogs. Although the peak incidence of IKAs is from \_\_\_ to \_\_\_ years of age, they can also occur in dogs younger than \_\_\_ years.</p>

A

<p>Peak: 4 to 9 years</p>

<p><4 years</p>

134
Q

<p>What are common locations for IKAs (6) and what is a special physical characteristic they may have?</p>

A

<p>Back, neck, sides of thorax, tail, shoulders, limbs</p>

<p>Central pore communicating with the surface</p>

<p>A dog can have multiple tumors</p>

135
Q

<p>What happens when an IKAruptures?</p>

A

<p>Rupture allows for keratinized tissue into the adjacent dermis and this creates a marked inflammatory response</p>

136
Q

<p>Besides surgery, what other therapy could potentially be beneficial in dogs with IKAs?</p>

A

<p>Isotretinoin at a dose of 1.7-3.7 mg/kg/day</p>

137
Q

<p>When isotretinoin therapy is used in dogs with IKA, what is the ORR, CR and PR?</p>

A

<p>ORR: 42.8% (3/7 dogs)</p>

<p>CR: 14.2% (1/7 dogs)</p>

<p>PR: 28.5% (2/7 dogs)</p>

<p>Ref: 115</p>

138
Q

<p>What are tricholemommas? Describe theirgross appearance.</p>

<p>What is the most common location?</p>

A

<p>Rare benign tumor of dogs</p>

<p>Gross appearance: well-encapsulated mass in dermis or SQ tissues</p>

<p>There may be hair loss in the overlying skin</p>

<p>Most common location: head</p>

139
Q

<p>Trichoblastoma, which are common benign tumors in dogs and cats,is the new designation for which previous tumors in dogs and cats?</p>

A

<p>Dogs - basal cell tumor</p>

<p>Cats: Spindle cell variant basal cell tumor</p>

140
Q

<p>What histologic characteristic is seen with trichoblastomas?</p>

A

<p>Differentiation to the hair germ of the developing follicle</p>

141
Q

<p>What is the mean age of dogs and at trichoblastoma diagnosis?</p>

<p></p>

A

<p>Dogs 7 years</p>

<p>Cats 10 years</p>

142
Q

<p>What dog breeds are at increased risk for the development of trichoblastomas (2)?</p>

A

<p>Poodles</p>

<p>Setters</p>

143
Q

<p>In one large review of follicular tumors and tumor-like lesions presenting to a VTH, trichoblastomas comprised \_\_\_% of the samples in the 308 canine follicular lesions and \_\_\_% of the samples in the 50 follicular lesions from cats. They represented\_\_\_% and \_\_\_% of all canine and feline biopsies, respectively</p>

A

<p>25.6% of the canine follicular lesions submited; 2% of all skin biopsies</p>

<p>26% of the feline follicular lesions submited; 1.5% of all skin biopsies</p>

144
Q

<p>What are the most common locations for trichoblastomas in dogs and cats?</p>

A

<p>Dogs: head,neck</p>

<p>Cats: Head, neck, limbs, trunk</p>

145
Q

<p>What are the six subtypes of trichoblastomas and how do they behave?</p>

A

<p>Ribbon, medusoid, trabecular, spindle, granular cell, and clear cell</p>

<p>Benign behavior</p>

146
Q

<p>What are trichoepitheliomas; are they common or uncommon? What are their main gross andhistopathologic characteristics?</p>

<p></p>

A

<p>Benign uncommon dermal tumors that can originate in the dermis but can extend into the subcutis. Histopathologically, they demonstratedifferentiation into all segments of the hair follicle.</p>

<p>Surface can be ulcerated or alopecic.</p>

<p>Present in dogs and cats.</p>

<p></p>

147
Q

<p>In the previously mentionedlarge review of follicular tumors and tumor-like lesions presenting to a VTH, trichoepitheliomas comprised approximately \_\_\_% of all tumors.</p>

A

<p>4%</p>

148
Q

<p>Whatdog (4) and cat (1) breeds are predisposed to the development of trichoepitheliomas? Which dog breeds (2) may present with multiple tumors?</p>

A

<p><strong>Dogs:</strong> Basset hounds, coonhounds, English springer spaniels, setters</p>

<p><strong>Cats</strong>: Persioan</p>

<p><strong>Multiple tumors:</strong> Basset hounds and English springer spaniels</p>

149
Q

<p>What are 3ways malignant trichoepitheliomas can be differentiated from their benign counterpart? What is another name for malignant trichoepithelioma and from what tumor can it be difficult to differentiate it from?</p>

A

<p>(1) invasion into the surrounding tissues and lymphatic involvement,(2) muchhigher mitotic index, (3) high metastatic rate to LN and lungs</p>

<p>Matrical carcinoma</p>

<p>Difficult to differentiate from malignant pilomatricoma</p>

150
Q

<p>Malignant trichoepithelioma or matrical carcinomas can be difficult to differentiate from whichtumor?</p>

A

<p>Malignant pilomatrixoma (pilomatricoma)</p>

151
Q

<p>What are pilomatricomas? Are they common or uncommon? What are alternative names for this type of tumor?</p>

A

<p>Benign uncommon follicular tumors of mainly dogs that demonstrate only matrical differentiation</p>

<p>Alternative names: necrotizing and calcifying epitheliomas of Malherbe, pilomatrixomas</p>

<p>Extremely rare in cats (only 1 case reported)</p>

152
Q

<p>Pilomatricomas are uncommon tumors that represented \_\_\_% of the follicular lesions and \_\_\_% of all skin biopsiesin the previously mentioned large study of follicular tumors and tumor-like lesions.</p>

A

<p>13% of the follicular lesions</p>

<p>1% of all skin biopsies</p>

<p>Extremely rare in cats (only 1 case reported)</p>

<p></p>

<p>Ref: 112</p>

153
Q

<p>What is analternative namefor malignant pilomatrixoma?</p>

A

<p>Pilomatrix carcinoma</p>

154
Q

<p>What dog breeds (7) are predisposed for the development of pilomatricomas?</p>

A

<p>Kerry blue terrier, soft-coated Wheaton terrier, Bouvier de Flandres, Standard poodle, Old English sheepdog, Bichon Frise, Airedale terrier</p>

155
Q

<p>How are malignant pilomatricomas differentiated from their benign counterpart (3)?</p>

A

<p>(1) Invasion into underdlying tissues, particularly bone, (2)histologic characteristics,and (3) presence of metastasis.</p>

156
Q

<p>What histologic characteristicsare present in malignant pilomatricomas?</p>

A

<p>Trabeculae of basaloid cells, abrupt keratinization, “ghost” or “shadow” cells, etc.</p>

<p>Malignancy is generally distinguished histologically from benign processes by: lack of differentiation, atypical histologic structure, anaplasia, erratic or rapid growth, increased mitotic index, infiltrative growth, and—the definitive criterion—metastasis.The diagnosis of malignant pilomatricoma is best made when lymphatic invasion can be identified, usually at the periphery of the tumor.</p>

157
Q

<p>What is the average age for diagnosis, gross appearance, andmost common locations for pilomatricomas?</p>

A

<p>Average age 6.5 years</p>

<p>Gross appearance: well-circumscribed and very firm due to ossification</p>

<p>Neck, back, trunk</p>

158
Q

<p>Although malignant pilomatricomasare thought to be rare, in a study of pilomatricomas diagnosed over a 2 year period, \_\_\_% were considered malignant based on histopathology. Out of cases reviewed, \_\_\_ had evidence of metastasis, with \_\_\_% having metastasis to the bones.</p>

A

<p>30.7% (4/13 dogs)</p>

<p>Evidence of metastasis:91.6% (11/12)</p>

<p>Metastasis to bones: ~50%</p>

<p>Ref: 123</p>

159
Q

<p>What are metastatic locations for malignant pilomatricomas?</p>

A

<p>Lungs, bone, lymph node, mammary gland, skin</p>

160
Q

<p>A case report of the use of surgery, followed by radiation therapy to control a recurrent malignant pilomatricoma, prevented local recurrence until \_\_\_ months later, when diffuse pulmonary metastasis was noted.</p>

A

<p>14 months</p>

<p>Ref: 124</p>

161
Q

<p>Mention the skin tumors of glandular origin (9)</p>

A

<p>Sebaceous adenoma</p>

<p>Sebaceous ductal adenoma</p>

<p>Sebaceous epithelioma</p>

<p>Sebaceous gland carcinoma</p>

<p>Apocrine gland adenoma and carcinoma</p>

<p>Solid cystic apocrine ductal adenoma</p>

<p>Eccecrine adenoma and carcinoma</p>

<p>Neuroendocrine carcinoma</p>

<p>Renal cystadenocarcinoma and nodular dermatofibrosis</p>

162
Q

<p>Sebaceous hyperplasia, sebaceous adenoma, sebaceous ductal adenoma, and sebaceous epithelioma are very common in what spp and rare in what spp?</p>

A

<p>Common in dogs, rare in cats</p>

<p>The division between these tumors is arbitrary</p>

163
Q

<p>A review of 172 tumors of sebaceous gland originrevealed a propensityof the\_\_\_ sex for \_\_\_. What 4breeds were overrepresented?</p>

A

<p>Female, sebaceous hyperplasia</p>

<p>Miniature schnauzers, beagles, poodles, cocker spaniels</p>

164
Q

<p>What dog breeds (3)may be predisposed todevelopof benign sebaceous tumors?</p>

A

<p>Coonhounds, Nordic breeds, some terriers</p>

165
Q

<p>Although benign sebaceous tumors can occur in young dogs, peak occurrence ranges from \_\_\_ to \_\_\_ years of age.</p>

A

<p>7 to 13 years</p>

166
Q

<p>What are the 3 most common locations for benign sebaceous tumors?</p>

A

<p>Limbs, trunk, eyelids</p>

167
Q

<p>Which of the following "benign" sebaceous tumors of glandular origin has been reported to recur locally,invade ajacent lymphatic vessels, spread to distant sites,and is therefore sometimes considered a low-grade malignancy?</p>

<p>a. Sebaceous hyperplasia</p>

<p>b. Sebaceous adenoma</p>

<p>c. Sebaceous ductal adenoma</p>

<p>d. Sebaceous epithelioma</p>

A

<p>Sebaceous epithelioma</p>

<p>May recurr locally and lymphatic metastasis has been reported anecdotally. Because lymphatic invasion may occasionally be noted at the margins of this tumor, they are sometimes considered a low-grade malignancy</p>

168
Q

<p>Sebaceous epitheliomas have been reported to metastasize in 1 dog to which 2 places?</p>

A

<p>Lungs, CNS</p>

<p>Ref: 129</p>

169
Q

<p>Although sebaceous gland carcinomas are uncommon in both dogs and cats, they aremost frequently reported in spp with what signalment?</p>

A

<p>Intact male dogs</p>

<p></p>

<p></p>

170
Q

<p>What is the most common location for sebaceous gland carcinomas?</p>

<p>What are common locations in dogs and cats?</p>

A

<p>Head</p>

<p>Dogs: head, neck</p>

<p>Cats: head, thorax, perineum</p>

171
Q

<p>What breeds are at increased risk for developing sebaceous gland carcinomas?</p>

A

<p>Cavalier King Charles, Cocker spaniel, terrier breeds</p>

172
Q

<p>Describe the biologic and metastatic behavior of cutaneous sebaceous gland carcinomas</p>

A

<p>Low grade malignancy, with reported metasasis beyond the lymph node reported in only one report</p>

173
Q

<p>Widespread metastasis beyond the regional LN has been reported in one dog withcutaneous sebaceous gland carcinoma.What were the places of metastasis (3)?</p>

A

<p>Bone, skin, and lungs</p>

174
Q

<p>What is the most common finding of malignancy in dogs/cats with sebaceous gland carcinoma?</p>

A

<p>Local infiltration</p>

175
Q

<p>Apocrine gland adenomas are considered fairly common in \_\_\_, although uncommon in \_\_\_. Grossly, these tumors may be \_\_\_. Feline apocrine gland adenomas have a high predilection for the \_\_\_.</p>

A

<p>Common in dogs, uncommon in cats</p>

<p>May be fluid filed</p>

<p>Head</p>

176
Q

<p>Apocrine ductal adenomas are \_\_\_ on palpation.</p>

A

<p>Firm</p>

177
Q

<p>Solid-cystic apocrine ductal adenomas are benign tumors that were previously designated as \_\_\_.</p>

A

<p>BCT</p>

178
Q

<p>Apocrine sweat gland tumors are relatively uncommon in \_\_\_ and represent \_\_\_% of all skin tumors. They are more common in \_\_\_ and represent \_\_\_% of all skin tumors.</p>

A

<p>Uncommon in dogs; 1.1% of all skin tumors</p>

<p>More common in cats; 3% of all skin tumors</p>

179
Q

<p>Apocrine sweat gland carcinomasoccur at a median age of \_\_\_ years in dogs and at \_\_\_ to \_\_\_ years in cats.</p>

A

<p>Median age in dogs9 years</p>

<p>6 to 17 years in cats</p>

180
Q

<p>What isthe most common location for apocrine gland carcinomain dogs and cats?</p>

A

<p>Dogs: front legs</p>

<p>Cats: head, limbs, abdomen</p>

<p></p>

181
Q

<p>How do apocrine gland carcinomas typicallylook grossly? What is a less common presentation and a term commonly used for it?</p>

A

<p>Usually solitary andnodular</p>

<p>May present as erosive and inflammatory skin disease, also known as inflammatory carcinoma</p>

182
Q

<p>What 2 dog breeds may be predisposed to develop apocrine gland carcinomas?</p>

A

<p>Golden retrievers, Treeing Walker coonhounds</p>

183
Q

<p>In series of apocrine gland tumors of44 dogs and 10 cats,\_\_\_ and \_\_\_ were considered malignant on histopathologic evaluation, respectively.</p>

A

<p>91% malignant in dogs</p>

<p>80% malignant in cats</p>

184
Q

<p>Local invasion of apocrine gland carcinomas is common, with \_\_\_% invading the capsule and/or stroma, \_\_\_% invading the vasculature, and \_\_\_% invading lymphatics.</p>

A

<p>Capsular/stromal invasion - 66%</p>

<p>Vasculature invasion - 11%</p>

<p>Lymphatic invasion - 22.5%</p>

<p>Ref: 133, 134</p>

185
Q

<p>What % of dogs with cutaneous apocrine gland carcinoma develop tumor recurrence and metastatic disease? What metastatic location has been reported?</p>

A

<p>local recurrence/continued growth - 4%</p>

<p>metastasis - 2%</p>

<p>lungs</p>

186
Q

<p>What are eccrine adenomas and carcinomas?</p>

A

<p>Tumors of the sweat glands of the foot pads</p>

<p>Rare in dogs and cats</p>

<p>No reports on their clinical behavior</p>

187
Q

<p>Neuroendocrine carcinomas are also known as \_\_\_\_\_.</p>

A

<p>Merkel cell carcinomas</p>

188
Q

<p>What are Merkel cells?</p>

A

<p>Thought to be part of the mechanoreceptors in the skin</p>

189
Q

<p>In humans, what virus has been associated with development of cutaneous neuroendocrine carcinomaor Merkel cell carcinoma?</p>

A

<p>Polyomavirus</p>

190
Q

<p>As opposed to humans, cutaneous neuroendocrine carcinomas are associated with what type of clinical disease course in dogs and cats?</p>

A

<p>Highly malignant in humans, but a more benign clinical course seen in vet med</p>

191
Q

<p>What are reported metastatic sites in dogs and cats with cutaneous neuroendocrine carcinoma?</p>

A

<p>Case report of cat with mets to lungs and case report of dog with multiple skin masses andwidespread metastasis within adbomen</p>

<p>Ref: 138, 139</p>

192
Q

<p>The use of which 3 chemotherapies haven been reported inadog with multiple cutaneousneuroendocrine carcinomas? Broadly, what response was seen?</p>

A

<p>Carboplatin, doxorubicin, metronomic chemotherapy</p>

<p>Progressive disease</p>

193
Q

<p>Histopathologic evaluation of canine cutaneous neuroendocrine carcinomas demonstratesexpression of which 7 immunohistochemical markers?</p>

A

<p>B-catenin, E-cadherin, chromogranin A, neurone-specific enolase, S100, c-Kit</p>

<p>*two cases only</p>

<p>Ref: 141</p>

194
Q

<p>In humans with neuroendocrine carcinoma, loss of expression of which 2 markers is associated with a more malignant disease behavior?</p>

A

<p>E-cadherin, B-catenin</p>

195
Q

<p>What is the only established effective treatment in patients with neuroendocrine carcinoma?</p>

A

<p>Surgery</p>

196
Q

<p>The syndrome of renal cystadenocarcinoma and nodular dermatofibrosis has been described in what 2 dog breeds?</p>

A

<p>German shepherds, Alsatians</p>

197
Q

<p>Grossly, how arelesions from dogs with renal cystadenocarcinoma and nodular dermatofibrosis described?</p>

A

<p>Multiple firm, haired masses distributed over the body</p>

198
Q

<p>Histopathologically, how are nodulesfrom dogs with renal cystadenocarcinoma and nodular dermatofibrosis described?</p>

A

<p>Nodules ofdense andirregular collagen</p>

199
Q

<p>When is surgery indicated in dogs withrenal cystadenocarcinoma and nodular dermatofibrosis?</p>

A

<p>Whenever the lesions cause a problem or disrupt normal function</p>

200
Q

<p>From what do dogs withrenal cystadenocarcinoma and nodular dermatofibrosis die of? On average, when do they die?</p>

A

<p>Renal failure or progressive renal cystadenocarcinoma</p>

<p>On average, 3 years after initial detection of the dermatofibrosis</p>

<p>Condition is lethal</p>

201
Q

<p>A case of nodular dermatofibrosis without any evidence of renal cysts or adenocarcinoma was reported in what dog breed?</p>

A

<p>Australian cattle dog</p>

<p>May represent a nonlethal version of the syndrome</p>

202
Q

<p>What are ceruminous glands?</p>

A

<p>Modified apocrine glands found in the external ear canal</p>

203
Q

<p>What is the most common malignant tumor of the ear canal in both dogs and cats?</p>

A

<p>Ceruminous gland adenocarcinoma</p>

204
Q

<p>In the largest publication of dogs and cats with tumors of the ear canal, out of 81 dogs, \_\_\_% and \_\_\_% of tumors were malignant and benign, respectively.</p>

A

<p>59.3% malignant</p>

<p>40.7% benign</p>

<p>Ref: 147</p>

<p></p>

205
Q

<p>In the largest publication of dogs and cats with tumors of the ear canal, out of 64cats, \_\_\_% and \_\_\_% of tumors were malignant and benign, respectively.</p>

A

<p>87.5% malignant</p>

<p>12.5% benign</p>

<p>Ref: 147</p>

206
Q

<p>In the previously mentioned publication, what were the different types of benign tumors found in dogsin order from most common to least common.</p>

A

<p>Polyp- 8</p>

<p>Papilloma- 6</p>

<p>Sebaceous gland adenoma- 5</p>

<p>BCT - 5</p>

<p>Ceruminous gland adenoma - 4</p>

<p>Histiocytoma - 2</p>

<p>Plasmacytoma, melanoma, fibroma - 1 each</p>

207
Q

<p>In the previously mentioned publication, what were the different types of benign tumors found in cats in order from most common to least common.</p>

A

<p>Polyps - 4</p>

<p>Ceruminous gland adenoma - 3</p>

<p>Papilloma - 1</p>

208
Q

<p>In the previously mentioned publication, what were the different types of malignant tumors found in dogsin order from most common to least common.</p>

A

<p>Ceruminous gland adenocarcinoma - 23</p>

<p>Undifferentiated carcinoma - 9</p>

<p>Squamous cell carcinoma - 8</p>

<p>Round cell tumors - 3</p>

<p>Sarcoma - 2</p>

<p>Melanoma - 2</p>

<p>HSA - 2</p>

209
Q

<p>In the previously mentioned publication, what were the different types of malignant tumors found in cats in order from most common to least common.</p>

A

<p>Ceruminous gland adenocarcinoma - 22</p>

<p>Squamous cell carcinoma - 20</p>

<p>Carcinoma of undetermined origin - 13</p>

<p>Sebaceous gland adenocarcinoma - 1</p>

210
Q

<p>How are most tumors of the ear canal diagnosed?</p>

A

<p>Due to the mass effect, which may result in clinical signs such as chronic otitis or partial deafness</p>

211
Q

<p>What are common gross characteristics of ceruminous gland adenomas ans cysts? What 2 dog breeds are predisposed for the development of these? At what age are these usually diagnosed?</p>

A

<p>Exophytic and pedunculated growth; can be ulcerated</p>

<p>Cocker spaniels and poodles</p>

<p>9 years</p>

212
Q

<p>How do ceruminous gland cysts look in cats?</p>

A

<p>Darkly pigmented, sessile masses, that are usually smaller than 5mm in diameter and can be multiple</p>

213
Q

<p>What 2 dog breedsare reported to be at increased risk for development of ceruminous gland adenocarcinoma of the ear canal?</p>

A

<p>Cocker spaniels, German Shepherds</p>

214
Q

<p>When skull radiographs are performed in dogs and cats with malignant tumors of the ear canal, what % of dogs and cats have bulla bone lysis and sclerosis?</p>

A

<p>Dogs: 48% bulla lysis, 30% bulla sclerosis</p>

<p>Cats: 19% both bulla lysis and sclerosis</p>

<p>Ref: 147</p>

215
Q

<p>What neurologic clinical signs can be seen in dogs and cats with malignant tumors of the ear canal?</p>

A

<p>Facial paralysis, head tilting, circling</p>

216
Q

<p>In the largest study of ear canal tumors in dogs and cats, what characteristic was noted on malignant tumors, but was not present in benign?</p>

A

<p>Cartilage invasion</p>

<p>Ref: 147</p>

217
Q

<p>What is the overall metastatic rate in dogs with malignant tumors of the ear canal at the time of diangosis?</p>

A

<p>10% (3 lungs, 1 scapular, 1 LN)</p>

218
Q

<p>What % of dogs with malignant tumors of the ear canal haveregional LN metastasis at the time of diagnosis?</p>

A

<p>3% (1/30 dogs)</p>

<p>Ref: 147</p>

219
Q

<p>What overall % of dogs with malignant tumors of the ear canal have evidence of distant metastasis at the time of diagnosis? What are the reported distant metastatic sites?</p>

A

<p>11%</p>

<p>Lungs (3/35 dogs), bone/scapula (1/35 dogs)</p>

<p>Ref: 147</p>

220
Q

<p>What is the overall metastatic rate in cats with malignant tumors of the ear canal at the time of diagnosis? Most common location?</p>

A

<p>9% (4 mandibular, 1 PS)</p>

<p>Ref: 147</p>

221
Q

<p>What is the preferred surgical technique in px with tumors of the ear canal? Why?</p>

A

<p>TECA and lateral bulla osteotomy</p>

<p>Recurrance is less with this technique vs lateral ear canal ablation</p>

222
Q

<p>What is the local recurrence rate in dogs with ear canal tumors that undergo TECA and BO vs lateral ear canal ablation?</p>

<p></p>

A

<p>TECA/BO: 0% at 36 months (7 dogs)</p>

<p>Lateral ear canal ablation: 75% at 4 months (4 dogs)</p>

<p>Ref: 151, 153</p>

223
Q

<p>What is local the recurence rate and median DFIin cats with tumors of the ear canal that are treated with TECA/BO?</p>

A

<p>RR 25-27%, DFI 42 months (16 cats, 18 cats)</p>

<p>Ref: 151, 152, 153</p>

224
Q

<p>What is local the recurence rate and median DFIin cats with tumors of the ear canal that are treated with lateral ear canal resection?</p>

A

<p>RR 67%, DFI 10 months</p>

<p>Ref: 151, 152</p>

225
Q

<p>What is the reported MST incats with malignant tumors of the ear canalundergoing a TECA/B?</p>

A

<p>50.3 months</p>

<p>Ref: 153</p>

226
Q

<p>Treatment of 6 cats and 5 dogs with orthovoltage, 48Gy in 12 4Gy fractions, resulted in an estimated mean PFS of \_\_\_ months and a 1-year PFS of \_\_\_ months. In this study, how many px had previous surgery andwhat was the local recurrence rare, and what was the metastatic rate?</p>

A

<p>Mean PFS 39.5 months</p>

<p>1-year PFS 56%</p>

<p>6 had previous sx</p>

<p>36%</p>

<p>Ref: 150</p>

227
Q

<p>In cats with tumors of the ear canal, a MI of \_\_\_ or less predicts improved survival.</p>

A

<p>MI of 2 or <</p>

228
Q

<p>What negative prognostic factors have been identified in cats with malignant tumors of the ear canal (4)?</p>

A

<p>MI of 3 or ></p>

<p>Presence of neurologic clinical signs</p>

<p>SCC or cancer of unknown origin</p>

<p>Extension beyond the ear canal</p>

229
Q

<p>What negative prognostic factors have been identified in dogs with malignant tumors of the ear canal (1)?</p>

A

<p>Extension beyond the ear canal</p>

<p></p>

230
Q

<p>What is the MST in cats with malignant tumors of the ear canals with a MI of 2 or < versus 3 or >?</p>

A

<p>2 or < MST 180 months</p>

<p>3 or > MST 12 months</p>

231
Q

<p>What is the MST in cats with malignant tumors of the ear canals that have presence of neurologic clinical signs vs those that dont?</p>

A

<p>w/clinical signs 1.5 months</p>

<p>w/o 15.5</p>

232
Q

<p>What is the MST in cats with ear canalceruminous gland adenocarcinoma vs SCC vs of unknown origin?</p>

A

<p>Adenocarcinoma 49 months</p>

<p>SCC 3.8 months</p>

<p>Of unknown origin 5.7 months</p>

233
Q

<p>What is the MST of cats with ear tumors that extend beyond the ear canal vs those that dont?</p>

A

<p>Extension MST 4 months</p>

<p>No extension MST 21.7 months</p>

234
Q

<p>What is the MST of dogs with malignant tumors of the ear canal that extend beyond the canal vs of those that dont?</p>

A

<p>Extension 5.9 months</p>

<p>No extension 30 months</p>

235
Q

<p>Describe the staging system for primary tumors of the ear canal</p>

A

<p><strong>T1</strong> -tumor confinded to the external or horizontal ear canal</p>

<p><strong>T2</strong> - tumor extendinf beyond the tympanic membrane</p>

<p><strong>T3</strong> - tumor extending beyond the middle ear or presence of bone destruction</p>

236
Q

<p>What are the most common clinical signs in dogs with digital tumors (2)?</p>

A

<p>Presence of a mass</p>

<p>Lameness</p>

237
Q

<p>What is the median age of dogs diagnosed with cutaneousdigital tumors?</p>

A

<p>10 years</p>

238
Q

<p>What are the 3most common cutaneous digital tumors in dogs?</p>

A

<p>#1 Squamous cell carcinoma</p>

<p>#2 Melanoma</p>

<p>#3 STS</p>

239
Q

<p>In a large retrospective study of 362 dogs with digital tumors, \_\_\_% were SCC,\_\_\_% were melanoma, \_\_\_% were STS, and \_\_\_ were OSA.</p>

<p></p>

<p>Approximately \_\_\_% of dogs with digital SCC demonstrated involvement of multiple digits.</p>

A

<p>47.2% SCC; 3% demonstrate multiple digit involvement</p>

<p>23.8% melanoma</p>

<p>13.3% soft tissue sarcoma</p>

<p>3.3% osteosarcoma</p>

<p>Other tumors present: round cell sarcoma, adenocarcinoma, malignant adnexal tumors, HSA, plasmacytoma</p>

<p></p>

<p>Ref: 156-158</p>

240
Q

<p>What is the most common signalment indogswith digital cutaneous SCC in which multiple digits are affected?</p>

A

<p>Large breed dogs with black skin</p>

241
Q

<p>What canine breeds are predisposed to developing digital cutaneous SCC (7)?</p>

A

<p>Standard poodles, black Labradors, giant Schnauzers, Gordon setters, Rottweilers, Dachshunds, flat coated retriever</p>

<p>But especially, LARGE BLACK DOGS</p>

242
Q

<p>In a series of 60 cats with digital tumors, what were the 3 most commonly diagnosed and what % did they represent? What % did OSA and HSA represent?</p>

A

<p>#1 SCC - 25%</p>

<p>#2fibrosarcoma - 23.3%</p>

<p>#3 adenocarcinoma - 21.6%</p>

<p>#4 OSA andHSA - 8.3%</p>

<p>Ref: 160</p>

<p></p>

243
Q

<p>Catswith what 3types of digital tumors can have multiple digits affected? Which type of tumor causes this most commonly?</p>

A

<p>adenocarcinoma (30%), fibrosarcoma (14%)</p>

<p>reports of SCC</p>

244
Q

<p>In cats with digital tumors, there may be predilection for tumor development where?</p>

A

<p>Front feet</p>

245
Q

<p>Diagnosis of digital masses seems to be difficult based on a report that demonstrated an approximate \_\_\_% disagreement rate, with \_\_\_% of the changes in diagnosis being clinically significant.</p>

A

<p>20% disagreement rate in the diagnosis</p>

<p>75% clinically important</p>

<p>Ref: 163</p>

246
Q

<p>In dogs with digital SCC, the overall reported 1-year survival rate ranges from \_\_\_% to \_\_\_% and the 2-year survivalranges from \_\_\_% to \_\_\_%.</p>

A

<p>1-year survival rate 50 to 83%</p>

<p>2-year survival rate 18-62%</p>

<p></p>

<p>Ref: 156-158</p>

247
Q

<p>In dogs with digital SCC, what location has been associated with a more favorable prognosis?</p>

<p>When comparing the survival rates in dogs with digital SCC based on location, what arethe 1- and 2-year survival rates for dogs with SCC in this location vs other digital sites?</p>

A

<p>Subungual epithelium</p>

<p>1-year SR 95%, 2-year SR 74%</p>

<p>Other locations: 1-year SR 60%, 2-year SR 40%</p>

<p>Ref: 156</p>

248
Q

<p>In dogs with digital SCC, \_\_\_% have evidence of metastasis at diagnosis and an additional \_\_\_% develop metastasis.</p>

<p></p>

<p>What % of dogs with digital SCC have evidence of bone lysis on radiographs?</p>

A

<p>Mets at presentation 8.8%</p>

<p>Development of mets later on 23%</p>

<p>Bone lysis 80%</p>

<p>Ref: 155-158</p>

249
Q

<p>In dogs with digital melanoma, \_\_\_% have evidence of metastasis at diagnosis and an additional \_\_\_% develop metastasis.</p>

<p>Evidence of bone invasion is present on \_\_\_% of radiographs and \_\_\_% of histopathologic samples.</p>

A

<p>Mets at diagnosis 28%</p>

<p>Development of mets later on 39%</p>

<p>Bone lysis 21% on radiographs and 100% on histopathology</p>

<p>Ref: 155-158</p>

250
Q

<p>In dogs with digital melanoma, the overall reported 1-year survival rate ranges from \_\_\_% to \_\_\_% and the 2-year survivalranges from \_\_\_% to \_\_\_%.</p>

A

<p>1-year survival rate 42to 57%</p>

<p>2-year survival rate 13-36%</p>

<p></p>

<p>Ref: 156-158, 164</p>

251
Q

<p>In a series of 64 cats with digital carcinoma, what % of the lesions represented metastasis from primary lung tumors?</p>

<p>What isthe MST for cats with lung-digit syndrome vs the MST for those with primary digital carcinomas (days to weeks)?</p>

A

<p>88% represented metastasis; <em>only 13% were primary digital tumors</em></p>

<p>digit-lung syndrome MST: 5 weeks</p>

<p>primary digital SCC MST: 73 days to30 weeks</p>

<p>Ref: 160, 161</p>

252
Q

<p>In cats with digital SCC, \_\_\_% had metastasis to the draining lymph node and \_\_\_% had evidence of bone lysis on radiographs.</p>

A

<p>12.5% had mets (1/8 cats; only 3/8 had chest rads and no mets found)</p>

<p>75% bone lysis</p>

<p>Ref: 161</p>

<p>Small study of 8 cats; not all fully staged</p>

253
Q

<p>What is the reported MST for cats with digital SCC (days to weeks)?</p>

A

<p>MST 73 days to 30 weeks</p>

<p>Ref: 160, 161</p>

254
Q

<p>Of the 5 reported cases of cats with digital melanoma, \_\_\_% had metastatic disease. What were the 4 locations for metastasis?</p>

<p>The MST ranged from \_\_\_ to \_\_\_+ days.</p>

A

<p>80% had mets</p>

<p>Regional LN, lungs, bone, vertebrae</p>

<p>MST: ranged from 0 to 557+ days</p>

<p>Ref: 162</p>

255
Q

<p>What is the only treatment that has been shown to be effective for digital tumors?</p>

A

<p>Surgery; either toe amputation and if large, leg amputation</p>

256
Q

<p>The use of a xenogenic (murine) tyrosinase vaccine was evaluated in 58 dogs with digital melanoma. Prior to the vaccine 57dogs had surgical excision of the tumor, 3 received adjuvant chemotherapy, and 2 received RT. Approximately 28% of had regional or distant metastasis on presentation. What was the overall MST from the time of amputation and what were the 1-and 2-year survival rates?</p>

A

<p>Overal MST 476 days</p>

<p>1-yr SR 63% and 2-yr SR 32%</p>

<p>Dogs with distant mets had a significantly worse prognosis when compared to regional LN</p>

<p>Ref: 165</p>

257
Q

<p>What negative prognostic factor has been identified in dogs with digital melanoma?</p>

A

<p>Presence of distant metastasis</p>

<p>Ref: 165</p>

<p>Just this study found a negative prognostic indicator; others have not</p>

258
Q

<p>Overall, what factor has been associated with a more favorable outcome in dogs with digital tumors?</p>

A

<p>Surgical excision</p>

<p>Ref: 157</p>

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