Tumors or GI tract Flashcards by K P

What is the 4th most common site of D/C tumors

Oral tumors

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Oral tumors occur more in what species and sex

Dog, Male

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Oral tumor presenting complaint

middle aged -> older
visible mass: difficulty eating, oral bleeding, halitosis
Recent dental hx

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Genetic predisposition to oral tumors

Boxers, GSD, Goldens, Cockers, Mini poodle, German SHP, Gordon Setter, Chows, Weimaraner

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Oral tumor differential diagnosis - Dog

Melanoma. SCC. Fibrosarcoma.
OSA.
Odontogenic tumors (epulides)

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Oral tumor differential diagnosis - Cat

SCC. Fibrosarcoma.

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Oral tumor Work up & Staging

Cytology - ineffective
Biopsy
Radiographs - low yield
Lnn Staging w/ FNA
3 view thoracic met check (ALL)

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Oral tumor biopsies

proliferative mass - shave biopsy

Non proliferative mass - incisional

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Oral Malignant melanoma

Black or melanotic melanoma
80% mets (high malignancy - lungs/lnn)
thorough staging! Biopsy

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Oral Malignant melanoma biggest failure

systemic mets

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Oral SCC

locally invasive, low mets.

Cats: paraneoplastic hyperCa. Sublingual site preferred

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Oral Fibrosarcoma

Young, large breeds

very invasive but looks benign - don’t believe fibroma histopath.

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Oral Fibrosarcoma biggest failure

recurrent disease: didn’t resect it all

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Odontogenic tumor origin

periodontal ligament

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3 types of odontogenic tumors

Acanthomatous ameloblastoma
Peripheral odontogenic fibroma
Feline inductive odontogenic tumor

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Acanthomatous ameloblastoma

locally invasive (bone) no mets
very aggressive sx required - 1 cm margins
Shetland and sheep dogs, rare in cats

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Peripheral odontogenic fibroma

slow, benign - no bone involvement
common in dogs
cryotherapy

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Feline Inductive odontogenic tumor

young cats (8-18m)
locally invasive

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Treatment of oral tumors

Aggressive Sx excision - almost all have bone involvement

2cm margins for malignancies

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Radiation and chemo or oral tumors

Adjunct RT - melanoma!, SCC, Acanthomatous ameloblastoma, FSA.
Chemo not commonly used

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Oral positive prognostic indicators

Smaller tumor
Rostral location
Complete resection
No evidence of preop mets

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Esophageal tumors

Rare.
Older animals
S. lupi - sarcomas
esophageal obstruction, stricture, 2˚ aspiration pneumonia

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Differential diagnosis of esophageal tumors

SCC

Leiomyosarcoma

feline esophageal SCC tumor

females.

Middle 1/3rd, caudal to thoracic inlet

Esophageal work up and staging

Imagining - megaesophageus? Esophagoscopy (GS)- biopsy fecal

Esophageal tumor therapy

Surgery! best for low grade leiomyosarcomas RT - limited Palliation - feeding tube

Esophageal tumor prognosis

Very poor | benign/low grade/LSA can be okay

Drug to resolve S. lupi infection

Dormectin

Gastric tumors

uncommon males chronic gastritis, helicobacter Asymptomatic until blocking outflow - anorexia/hematemesis

Gastric tumor genetic predilection

Belgian shepherd, chows | Benign - beagles

Gastric Tumor dog differentials

Big 2 Adenocarcinoma (70-80%) Leiomyosarcoma

Gastric tumor Cat differentials

Big 1 | Lymphoma

Cat systemic status w/ gastric lymphoma

negative FeLV | possible concurrent LSA in small intestine

Gastric ademocarcinoma

predictable - pyloric antrum/lesser curvature Scirrhous (leather) High met rate (anywhere) deeply ulcerative

Gastric work up and staging

Non specific lab Abdominal US (decreased motility) ENDOSCOPY - biopsy

Gastric leiomyomas

well circumscribed, submucosal mass | cardiac location - benign

Gastric tumor Treatment

Surgical excision partial gastrectomy gastroduodenostomy/jejunostomy (bilroth 1 or 2) - high morbidity

Gastric tumor prognosis

surgical excision, tumor type/grade, mets.

ACA Gastric tumor prognosis

poor - majority dead in 6m

LSA Gastric tumor prognosis

Doesn't respond to chemo, | resect and chemo might not be needed

Leiomyosarcoma Gastric tumor prognosis

12-21m | Cured with aggressive surgery

Intestinal tumors

older animals, same presentation as gastric tumors

Intestinal tumor Dog

uncommon Large intestine! Collie, GSD, male

Intestinal tumor cat

uncommon | Small intestine!

Intestinal tumor work up/staging

similar to gastric - Goal: rule out LSA (no sx tx) endoscopy (understand limits) US guided FNA/cytology

Intestinal tumor differential diagnosis dog

Big 3 LSA > ACA > Leiomyosarcoma GIST

Intestinal Tumor differential diagnosis cat

Big 3 LSA, ACA, MCT no order

Intestinal tumor treatment

Exploratory laparotomy - R&A except LSA 4-8cm margins assess mesenteric and regional lnn

LSA intestinal tumor DOG

T cell, multifocal not good remission or survival Neg prog. factors: Failed to achieve remission

LSA intestinal Tumor CAT

responds well to chemo | prognostic factor: response to tx

ACA intestinal tumor dog

44% met rate - stage! | female neg prognosis?

ACA intestinal tumor cat

72% mets on dx | neg prognostic: histo subtype and mets

MCT intestinal tumor dog

100% mortality in 2m. 100% met rate. BAD

MCT intestinal tumor cat

poor - euthanize/death | *solitary MCT w/o mets have good survival

Leiomyosarcoma intestinal tumor

old data. 8m MST dogs cat - very uncommon

Gastrointestinal Stromal Tumor (GISTs)

IHC can differentiate from leiomyosarcoma from cells of cajal (GI pacemaker) express c-kit predilection for cecum die from septic peritonitis (ruptured mass)