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Sem 6: SAM 2 > Tumors of the GI Tract > Flashcards

Tumors of the GI Tract Flashcards

1
Q

Most common oral tumors in cats?

A
  1. SCC !!!!
  2. Fibrosarcoma
  3. Benign odontogenic tumors
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2
Q

Most common oral tumors in dogs?

A
  1. MELANOMA !!!!
  2. SCC
  3. Fibrosarcoma
  4. OSA
  5. Benign odontogenic tumors
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3
Q

Presenting complaint and signalment in patients with oral tumors?

A
  • 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
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4
Q

How to work up and stage an oral tumor?

A
  • 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

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5
Q

Why is a full body CT indicated for dogs with oral tumors?

A

Melanoma is HIGHLY MALIGNANT

metastasis in 80% of cases - to brain, lungs, toes, everywhere

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6
Q

How to definitively diagnose amelanotic melanoma?

A

IHC from incisional biopsy

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7
Q

How does oral SCC differ from melanoma in regards to invasion and metastasis?

A

SCC is locally invasive like melanoma (both destroy bone), but metastasis rate is low unlike melanoma

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8
Q

Risk factors for oral SCC in cats?

A

- Flea collars
- Smoke exposure
- Excessive canned tuna

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9
Q

Most common site for oral SCC in cats?

A

SUBLINGUAL

Check under the tongue!!

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10
Q

What dog breeds are more at risk for fibrosarcoma?

A

YOUNGER (7-8yrs) goldens and labs

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11
Q

How does oral Fibrosarcoma differ from oral melanoma in regards to invasion and metastasis?

A
  • 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)
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11
Q

__________ has a unique variant known as a Histologically low-grade but biologically high grade variant

A

Oral fibrosarcoma

fake out!! Looks benign but don’t believe it!

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12
Q

Almost all oral tumors invade bone and require aggressive surgical excision, what is the only exception?

A

Peripheral odontogenic fibromas (Benign, slow growing, seen in dogs not cats)

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13
Q

What breed is predisposed to acanthomatous ameloblastomas?

A

Sheep dogs (usually located rostrally unlike other oral tumors)

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14
Q

List the odontogenic tumors (Used to be Epulides)

A
  1. acanthomatous ameloblastomas
  2. Peripheral odontogenic fibromas
  3. Feline inductive odontogenic tumor
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15
Q

Gold standard treatment option for dogs and cats with oral tumors?

A
  • 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
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16
Q

List the POSITIVE prognostic indicators associated with oral tumors

A
  1. Smaller > larger
  2. Rostrally located > caudally located
  3. Histologically complete resection
  4. No evidence of pre op mets
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17
Q

How has NSAIDs been shown to be beneficial in treatment of oral SCC in cats?

A

Shown to double MST

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18
Q

What parasite can cause esophageal tumors, and in what regions?

A

Spirocerci lupi (SE US, Israel, Africa)

causes sarcomas

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19
Q

Most common esophageal tumor?

A

SCC

Ddx: Leiomyosarcoma

20
Q

Where are esophageal tumors in cats normally located?

A

Middle 1/3rd of the esophagus, just caudal to thoracic outlet

21
Q

How to work up an stage for esophageal tumors?

A
  • Survey rads
  • Positive contrast esophagram
  • Esophagoscopy
  • Fecal if suspect spirocerci lupi
22
Q

Treatment options for esophageal tumors?

A
  • Surgery preferred but challenging, poor healing
  • Palliation with feeding tube or stent
  • If due to S.lupi tx with Doramectin
23
Q

Prognosis for esophageal tumors in cats and dogs?

A

Generally very poor - palliative care with feeding tube or stent

24
Q

What dog breeds are predisposed to gastric tumors?

A

Belgian shephards, Chow Chows

(Beagles get benign gastric leiomyoma)

25
Q

Most common presenting complaint and signalment in patients with esophageal tumors?

A
  • Most asymp until tumor is massive enough to effect outflow
  • Anorexia common
  • Hematemesis
26
Q

Most common gastric tumors in dogs vs cats?

A

Dogs:
1. Adenocarcinoma
2. Benign Leiomyoma (2nd most common)
3. Leiomyosarcoma
4. LSA
5. GIST

Cats:
1. LYMPHOMA

27
Q

Most common location for a gastric adenocarcinoma?

A

pyloric antrum / lesser curvature of stomach

28
Q

What is the met rate for gastric adenocarcinomas?

A

75%

(HIGHHHH met rate, mets everywhere!)

29
Q

A sheepdog comes in with a mass on the rostral mandible. How to work up and treat?

A
  • Wedge/Incisional biopsy to confirm acanthomatous ameloblastoma vs other
  • Surgical removal via rostral mandibulectomy (good prognosis bc rostrally located)
30
Q

Top differential for a mass found at the pyloric antrum in a Chow Chow or Belgian shepherd?

A

Gastric adenocarcinoma

31
Q

A 12 yr old cat is presenting with a week history of anorexia and vomiting. You perform AUS and see mucosal wall thickening of the stomach and suspect a gastric tumor. What is the most likely diagnosis?

A

Gastric lymphoma
(most common gastric tumor in cats)

32
Q

How to work up and stage for a gastric tumor?

A
  • Endoscopy to assess resectability (ACA usually extensive/diffuse, Leiomyomas/Leiomyosarcomas are well circumscribed SUBmucosal masses, located @ cardia)
  • Biopsy collected on endoscopy
  • Positive contrast gastrogram
  • CBC/Chem, FNA 57% accuracy
33
Q

Treatment plan for a gastric tumor in a dog?

A
  • Surgical excision via partial gastrectomy curative for Leiomyoma, and recommended for ACA and Leiomyosarcoma only if localized w no mets
  • Gastric ACA usually bad, high met rate w poor prognosis/not a candidate for sx
34
Q

Treatment plan for a gastric tumor in a cat?

A
  • Lymphoma most common gastric tumors, which can’t be removed with surgery
  • Palliative tx with chemo (poor px)
35
Q

Are SI tumors or LI tumors more common in dogs?

A

LI tumors more common in dogs

(SI > LI tumors in cats)

36
Q

What dog breeds are predisposed to intestinal tumors?

A

Collies, GSDs (LI > SI)
Males > females

37
Q

DDx for an intestinal tumor in dogs?

A
  1. LSA/Lymphoma
  2. Adenocarcinoma
  3. Leiomyosarcoma
  4. MCT
  5. GIST
38
Q

DDx for an intestinal tumor in cats?

A
  1. LSA/Lymphoma
  2. Adenocarcinoma
  3. MCT
39
Q

How to work up and stage for an intestinal tumor in dogs and cats?

A
  • US guided FNA/Cytology has good diagnostic yield
  • LN staging for mets
  • All intestinal tumors in dogs have terrible prognosis (< 1yr even w sx) except GIST
  • All intestinal tumors in cats have terrible px (< 1 yr even w sx) except MCT if solitary

(Endoscopic biopsy interpretation MISDIAGNOSED intestinal lymphoma as IBD)

40
Q

What is the prognosis for an intestinal MCT in dogs?

A

REALLY BAD

100% metastasis rate 😫

(cats get less aggressive MCTs than dogs)

41
Q

Where is GIST most commonly located?

A

Cecum

42
Q

What is the most common cecal tumor in dogs?

A

GIST

43
Q

What is the prognosis for a patient with GIST?

A
  • If not dead from septic peritonitis secondary to cecal rupture, 3 yrs with surgical excision + Palladia
44
Q

What chemotherapy agent can be used in treatment of GIST?

A

Palladia - targets c-kit expressed by GIST

45
Q

What diagnostic test is important in differentiating GIST vs leiomyosarcoma?

A
  • IHC !
46
Q

List tumors that can be treated with Palladia

A
  • MCT (expresses c-kit)
  • GIST in dogs (expresses c-kit)
  • Sinonasal carcinomas in dogs (expresses VEGF)
47
Q

What margins should be taken when performing sx excision for an intestinal tumor?

A

4-8cm

Sem 6: SAM 2 (34 decks)

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