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RUSVM SAM 2 > Urogenital Tumors > Flashcards

Urogenital Tumors Flashcards

1
Q

What is the most common bladder tumor?

What would be your other DDX?

A

Transitional cell carcinoma

SCC
ACA
Rhabdomyosarcoma
Fibroma

Polyploid cystitis (non neoplastic)

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2
Q

What are etiologies of bladder neoplasia?

A

Topical insecticide and herbicide exposure

Environmental pollution

Obesity - overweight females 28x risk

Cyclophosphamide (acrolen)

Female
Breed

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3
Q

What breeds have highest predisposition to bladder neoplasias?

A

Scottish terrier

Westies

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4
Q

T/F: newer spot-on flea control products with fipronil have higher risk of TCC

A

False

These new products are safer and NOT associated with TCC

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5
Q

What are ways that you can reduce risk of bladder neoplasia in pets?

A

Limit exposure to lawn chemicals
Avoid older flea/tick products

Feed veggies 3x/week to high risk breeds —> has shown to reduced risk of TCC

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6
Q

TCC is most commonly found where ?

A

Trigone of the bladder

—> urine tends to sit in this part of bladder (pooling at lowest point) —> toxin build up

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7
Q

T/F: TCCs tend to be locally invasive

A

True

56% have concomitant urethral involvement

29% prostate involvement

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8
Q

Clinical signs commonly associated with TCC?

A

Hematuria
Dysuria
PU
Lameness - bone met

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9
Q

Workup for TCC?

A

PE

  • palpable mass in bladder
  • rectal-> thickened urethra/iliac lymph node

MDB/ UA —> traumatic catheterizaiton is preferred sampling method
Thoracic rads
Contrast cystography

Cystosonography - preferred
Cystoscopy with biopsy —> assess for resectability

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10
Q

What can be used as a screening tool for TCC in at risk breeds in the absence of clinical signs

A

BRAF mutation detection asssay

—> can detect mutation in malignant cells that are shed in the URINE

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11
Q

What are the surgical treatment options for invasive bladder tumors?

A

Partial or complete cystectomy

Laser ablation

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12
Q

What are the surgical treatment options for less-invasive TCC?

A

Cystotomy tube

Transurethral stenting

Transurethral resection —> high intra-op complication rate with no survivial benitif

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13
Q

Indications for a partial cystectomy?

A

Localized bladder neoplasia where tumor can be excised with 1-2cm margins

  • generally for solitary masses at the apex of the bladder that do not have regional or systemic mets*

40-70% of bladder excised

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14
Q

Complications to partial cystectomy?

A

Bladder dehiscence
Pollakiuria
Recurrence of TCC

Surgical tumor seeding (theoretical?)

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15
Q

How is laser ablation therapy done for TCC and what is the outcome?

A

Cystotomy/urethrotomy with laser ablation of entire mucosal surface area without serosal penetration

PO piroxicam and mitoxantrone

All dogs have resolution of clinical signs (disease free interval 200days)
MST = 299days

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16
Q

What is the purpose of urethral stenting with TCC?

A

Obstructive carcinoma of the urethra —> place a urethral stent to relieve obstruction

Can cause severe incontinence in 26% of cases

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17
Q

What is the role of NSAIDS in treatment of TCC?

A

COX1 expressed in normal urinary bladder epithelium

COX2 expressed on neoplastic epithelium —> suggests this is involved in tumor cell growth —> inhibition by NSAIDS (eg prioxciam) is the mechanism of the anti-neoplastic effect

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18
Q

Prioxicam is AKA

A

Feldane

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19
Q

T/F: all dogs with TCC should receive NSAIDS if possible

A

True

20
Q

What are the most effective chemotherapy protocols for TCC?

A

Cisplatin, methotrexate, cyclophosphamide or 5FU

ONLY palliative

21
Q

What is the most common chemotherapy protocol used in clinics?

A

Mitoxantrone with prioxicam

22
Q

What is metronomic chemotherapy used with TCC?

A

Chlorambucil

MST 221days

23
Q

What are the treatment outcomes from shortest to longest survival time?

A

Trigonal surgery (2.5m) Palliative chemo (6m) < Piroxicam alone (6.5m) < palliative stenting with chemo < chemo+prioxicam = laser ablation+chemo (8m) < radiation + chemo < surgery+chemo (2yr)

24
Q

T/F: feline bladder neoplasia are common and usually TCC

A

False

Rare but are usually TCC

25
Q

Signalment for mammary gland tumors

A

Female > male

Mean age
Cats : 10-12yrs
Dogs: 7-13yr

26
Q

Breed predisposition for mammary gland tumors in cats?

A

DSH and Siamese

27
Q

Dog Breed predisposition for mammary glad tumors?

A 
Pointers
Brittany Spaniel 
English springer spaniel 
Labrador Retreiver 
Great Pyrenees 
Samoyed 
Airedale terrier 
Miniature and toy poodle 
Dashunds 
Keeshond
28
Q

Presenting complains for mammary tumors?

A

Visible/ palpable mass —> can be associated with glandular tissue or nipple

Ulceration is common in cats

29
Q

Most mammary tumors occur in what glands most commonly?/

A

60-70% mammary neoplasia occurs in mammary glands 4 or 5

30
Q

T/F: Mammary glad tumors in dogs are more commonly malignant

A

False

50:50 benign:malignant

31
Q

T/F: mammary gland tumors in cats are most commonly malignant

A

True

85-95% malignant

32
Q

Top DDx for mammary gland tumor in dog?

A

Benign - adenoma

Malignant - carcinoma or sarcoma

33
Q

Top DDX for mammary gland tumors in cats

A

CARCINOMA
- adenocarcinoma with tubular, papillary, solid, and cribriform subtypes

Sarcoma, SCC, and mucinous are less common

34
Q

Clinical signs associated with inflammatory carcinoma?

A 
Pain 
Anorexia 
Weight loss 
Generalized weakness 
PU/PD
35
Q

How do inflammatory carcinomas appear?

A

Unique and aggressive variant

Diffusely sowed with poor demarcation between normal and abnormal tissue

Most have advanced stage dz at presentation

36
Q

What are risk factors for mammary tumors in felines?

A

Age —> 7-14yrs

Breed/genetics —> Siamese

Hormonal exposure
—> intact queen 7x higher risk (OHE reduces risk before 6months reduces risk 91%)
—> progestin exposure increase risk 3.4x

37
Q

What are risk factors for mammary tumors in canines?

A

Age: 7-9 mostly benign; 9+ most likely malignant

Breed: purebred and smaller breeds more common

Hormonal: OHE prior to first estrus only have 0.5% risk, prior to second 8%, prior to third 26%, after this no benefit

Bodyweight during puberty - underweight = protective

38
Q

Work up for mammary gland tumors ?

A

MDB - unrewarding

FNA/cytology - high potential for false neg , good to rule out inflammatory carcinoma and mets to LN
—> if positive = animal positive
—> if negative = biopsy (excisional in dog, incisional in cat)

3view thoracic rads

Abdominal U/S for full staging

39
Q

How do you surgically treat mammary tumors in dogs?

A

Single mammary tumor —> wide excision to remove tumor

  • lumpectomy <0.5cm, movable, and benign
  • mastectomy >1cm, fixed or movable

Multiple mammary tumors —> regional mastectomy or staged bilateral mastectomy

ALWAYS DO OHE when removing MGTs

40
Q

How do you surgically treat mammary tumors in cats?

A

Single session bilateral radical mastectomy with excision of axillary and inguinal LN

ALWAYS do OHE

41
Q

What adjunctive chemo can you give in mammary gland tumors in cats? And when would you recommend it?

A

Recommended for cats with tumors >3cm (LN positive or negative)

Doxorubicin with NSAID or cyclophosphamide

42
Q

When is chemo recommended in dogs with mammary gland tumors?

A

Large tumors
Positive LN
Histology suggests aggressive tumor

43
Q

Prognostic factors for feline mammary gland tumors

A

*** tumor size —> IMP for assessing risk for mets and need for adjunctive treatment

Lymph node

Dose of surgery: more aggressive = better outcome

Breed: DSH better outcome vs purebred and Siamese

Histological grade

Age- older worse

44
Q

Prognostic factors for canine mammary gland tumors?

A

Tumor size

Lymph node —— significant negative factor if involved

45
Q

DDX for vaginal tumors?

A

Benign smooth muscle - leiomyoma (hormone dependent)

Leiomyosarcoma

46
Q

Top DDX for testicular tumors?

A

Interstitial cell tumor (functional)

Seminoma — high risk (16x) in cryptorchid testide

Sertoli cell tumor — 8.8x higher risk in cryptorchid testicle

RUSVM SAM 2 (44 decks)

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