Tumors of the GI Tract Flashcards
Most common oral tumors in cats?
- SCC !!!!
- Fibrosarcoma
- Benign odontogenic tumors
Most common oral tumors in dogs?
- MELANOMA !!!!
- SCC
- Fibrosarcoma
- OSA
- Benign odontogenic tumors
Presenting complaint and signalment in patients with oral tumors?
- Often LARGE at presentation especially if caudally located
- Bleeding, halitosis, difficulty eating
- Loose of displaced tooth
- Hx of recent tooth extraction
- 1 bad tooth in a mouth of good teeth = cancer
How to work up and stage an oral tumor?
- Incisional biopsy/ Incisional “Shave” biopsy if proliferative
- Full body CT (for dogs) > Dental rads
- SLN mapping > FNA from LN (50% don’t go to regional LN)
- 3 view chest rads for mets
DONT BIOPSY THROUGH THE LIP
DONT DO EXCISIONAL BIOPSY
TUMOR SIZE MOST IMPT VARIABLE
Why is a full body CT indicated for dogs with oral tumors?
Melanoma is HIGHLY MALIGNANT
metastasis in 80% of cases - to brain, lungs, toes, everywhere
How to definitively diagnose amelanotic melanoma?
IHC from incisional biopsy
How does oral SCC differ from melanoma in regards to invasion and metastasis?
SCC is locally invasive like melanoma (both destroy bone), but metastasis rate is low unlike melanoma
Risk factors for oral SCC in cats?
- Flea collars
- Smoke exposure
- Excessive canned tuna
Most common site for oral SCC in cats?
SUBLINGUAL
Check under the tongue!!
What dog breeds are more at risk for fibrosarcoma?
YOUNGER (7-8yrs) goldens and labs
How does oral Fibrosarcoma differ from oral melanoma in regards to invasion and metastasis?
- Both destroy bone, but Fibrosarcoma has a lower met rate (still 30% so check lungs and LNs)
- BEWARE: Histologically low-grade but biologically high grade variant (LOOKS BENIGN ON HISTO BUT ITS REALLY MALIGANT)
__________ has a unique variant known as a Histologically low-grade but biologically high grade variant
Oral fibrosarcoma
fake out!! Looks benign but don’t believe it!
Almost all oral tumors invade bone and require aggressive surgical excision, what is the only exception?
Peripheral odontogenic fibromas (Benign, slow growing, seen in dogs not cats)
What breed is predisposed to acanthomatous ameloblastomas?
Sheep dogs (usually located rostrally unlike other oral tumors)
List the odontogenic tumors (Used to be Epulides)
- acanthomatous ameloblastomas
- Peripheral odontogenic fibromas
- Feline inductive odontogenic tumor
Gold standard treatment option for dogs and cats with oral tumors?
- Aggressive surgical excision with 2cm margins (Always do incisional biopsy first!!!)
- +/- RT
- NSAIDs!!! Esp for cat oral SCC tumors
- Chemo usually not effective bc large tumors and melanoma is chemo resistant
- almost all oral tumors cause bone invasion EXCEPTION is peripheral odontogenic fibroma
List the POSITIVE prognostic indicators associated with oral tumors
- Smaller > larger
- Rostrally located > caudally located
- Histologically complete resection
- No evidence of pre op mets
How has NSAIDs been shown to be beneficial in treatment of oral SCC in cats?
Shown to double MST
What parasite can cause esophageal tumors, and in what regions?
Spirocerci lupi (SE US, Israel, Africa)
causes sarcomas
Most common esophageal tumor?
SCC
Ddx: Leiomyosarcoma
Where are esophageal tumors in cats normally located?
Middle 1/3rd of the esophagus, just caudal to thoracic outlet
How to work up an stage for esophageal tumors?
- Survey rads
- Positive contrast esophagram
- Esophagoscopy
- Fecal if suspect spirocerci lupi
Treatment options for esophageal tumors?
- Surgery preferred but challenging, poor healing
- Palliation with feeding tube or stent
- If due to S.lupi tx with Doramectin
Prognosis for esophageal tumors in cats and dogs?
Generally very poor - palliative care with feeding tube or stent
