tumor specific LC part 3 Flashcards

1
Q

most common tumor of the nasal planum in cats

A

SCC

rare in dogs

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2
Q

cause of nasal planum scc

A

UV induced
may be malignant transformation from keratosis or carcinoma in situ

typically cats have white coat

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3
Q

breeds associated with scc

A

cats - white cats

dogs - goldens and labs 50-76% of cases

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4
Q

treatment of nasal planum scc

A

nasal planum resection
may need to remove incisive or maxillary bone sit sarcoma or mct

px is good but may recur or met

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5
Q

what is most important for recurrence of nasal plant tumors

A

complete resection
even with rt some dogs had recurrence within 9 weeks

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6
Q

nasal planecotmy in cats with scc recurrence, dfi, mst

A

less than 10% of cats had recurrence
DFI 426 - 594 d ~14-20 mo
mst 530 - 673 days ~18-22 mo

surgical curettage and diathermy has been used with rr of 6% for cosmesis

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7
Q

median time to recurrence in patients treated with primary RT or adjuvant RT

nasal squame????

A

2-3 months

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8
Q

orthovoltage rt in cats for scc pf
megvoltage rt in cats for scc pfi
protons rt in cats for scc

A

ortho - 1 year pf 60%
mega - pfi 361-916 d ~12-30 mo; mst 961(32 mo)
protons - mst 946d (11.5 mo) pf rate 64%

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9
Q

prognostic factors for cats with nasal planum scc treated with rt

A

ortho - stage and proliferative fraction
mega - larger size had 5.5 - 6 risk of dying

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10
Q

strontium penetration

A

depth of 3 mm

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11
Q

response in cats with nasal planum scc treated with strontium

A

cr - 88%
recurrence - 20%
new lesions in diff location - 33%
MPFI 1710 (~4.5 yr)
1 year df 89%
3 year df 82%
MST 3076 (8.5 yr)

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12
Q

intralesional chemo for feline nasal planum scc

A

carbo typically
cr 73%
local recurrence 30%
PFS 16 mth

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13
Q

electro chemo for feline nasal planum scc

A

CR 75%-86%
dfi 7-36 mths

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14
Q

cryosurgery for feline scc

A

must be smaller than 5 mm, superficial, non invasive
response rate 81%
local recurrence 17% - 73%

DFI 6mth - 26.7 mth

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15
Q

Photodynamic therapy

A

use of applied light after the administration of a photosensitizer.

The photosensitizer is activated by the light to form free radicals, which results in the induction of cell death. damages and restricts microvasculature inducing immune response

Due to the limited penetration of light into the tissue, the treatment depth is considered 5 mm or less

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16
Q

photodynamic therapy using 5-aminolevulinic acid (5-ALA) as a photosensitizer in cats with nasal planum scc

A

ORR 96% 49-85% CR
51% recurrence

rate of CR was dependent on stage

CR was noted in 100% of noninvasive tumors measuring <1.5 cm in diameter, 56% of invasive tumors measuring <1.5 cm in diam- eter, and 18% of invasive tumors measuring >1.5 cm in diameter

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17
Q

what is photodynamic therapy used for

A

nasal planum scc, K9 urinary tumros, equine sarcoids

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18
Q

what are the photosensitizers used in PDT

A

5-ALA and mTHPC

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19
Q

Nasal tumor SRT- what true
a. sarcomas do better than carcinomas
b. most common side effect oronasal fistula
c. IMRT leads to improved ST for stage I-VI Adams

A

a. all carcinoma vs all sarcoma - no difference in survival but grouping scc,carcin and undifferentiated carcinoma was worse
b. oronasal fistula can happen with srt - risk worse with surgery
c. stage 4 worse but overall mst improved compared to standard therapy 305 d vs

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20
Q

sinonasal tumor distribution

A

older >10 but report in dogs young as 9 mths
1% of tumors overall
medium to large breeds may be more affected

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21
Q

risk factors for sinonasal tumors

A

dolichocephalic breeds (long-nosed) or dogs living in urban envi- ronments, with resultant increased nasal filtering of pollutants, may be at higher risk for developing nasal cancer

tobacco smoke- conflicting reports

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22
Q

carcinomas make up what percent of sinonasal tumors

A

2/3 - adenocarcinoma, scc, undifferentiated carcinoma

sarcomas - fibrosarc, chondorsarc, osa, and undifferentiated make up most of the rest

rarely - mct, lsa, tvt

extremely rare - hsa, melanoma, neuroendocrine carcinoma, nerve sheath, neuroblastoma, histocytoma, MLO, rhabdo, leiomyo

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23
Q

met rate of nasal tumors

A

generally low but may be higher at death 40-50% - regional LN and lungs

less commonly bones, kidney, liver, skin, and Brain

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24
Q

mutations seen in sinonasal tumors

A

60% adenocarcinomas had mutated p53
COX-2 in epithelial tumors
50% EGFR in carcinomas
90% VEGR in carcinomas - tkis good tx
71% PDGFRα 40% PDGFRb - tkis good tx

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25
Q

average time to dx from start of cs in dogs with nasal tumors

A

2-3 mths
epistaxis, discharge, facial deformity, unwilling to open mouth, sneezing, dsypnea, starter, exophthalmos, ocular discharge

if caudal can cause neurologic sx -seizures, acute blindness, behavior change, paresis, circling, and obtundation
absence of this does not rule out cribriform plate involvement

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26
Q

differentials for nasal tumors non neoplastic

A

aspergillus fungal rhinitis
material rhinitis
idiopathic rhinitis
nasal parasite
bleeding disorders,
hypertension,
foreign body,
trauma,
developmental anomalies (e.g., cystic Rathke’s clefts

** if facial deformity almost always cancer

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27
Q

mri vs ct for nasal tumors

A

both good
mri cheaper
determining extent of tumor margins on MRI resulted in a higher tumor volume (18%) in 5/6 dogs and greater likelihood of detecting meningeal involvement. However, 5/6 dogs were classified as the same stage whether determined by CT or MRI

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28
Q

ct and mri findings suspicious for cancer

A

boney destruction
destruction of the sphenoid sinus
abnormal st in the retrobulbar space
nasopharyngeal invasion
hyperostosis of the lateral maxilla

a mass is not specific for neoplasia - inflammatory dz, polyps, fungal infections

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29
Q

PET CT markers for sinonasal tumors

A

18F-FDG as well as biomarkers of resistance to radiation, including 18F-FLT for proliferation and 61Cu-ATSM for hypoxia

PET/CT failed to reliably predict areas of residual tumor or recurrence that could be targeted with a boost dose of radiation to improve tumor control

Tumor volume measured by PET-CT and radiation-induced changes in tumor proliferation as shown by FLT uptake may be predictive of tumor behavior and clinical outcome

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30
Q

Adams staging for sinonasal tumors
and survival differences

A

stage 1 - mst 23.4 mth
stage 4 - mst 6.7 mths

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31
Q

met rate in sinonasal tumors

A

10-24% to local LN - mostly carcinomas
2-10% pulmonary mets

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32
Q

mst sinonasal tumors no treatment

A

95 days
epistaxis worse mst 88 vs 224 days

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33
Q

negative prognostic factors for sinonasal tumors

A

epistaxis, age >10, duration of signs, advanced stage, mets, histo carcinoma, scc, undifferentiated worse, expression of survivin, failure to relieve cs

prognostic factors in the treatment of canine sinonasal tumors remains controversial

treatment with rt on m-f schedule > mwf

extension past the cribriform did not change outcome but cribriform involvement did

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34
Q

mst of surgery sinonasal tumors

A

boney invasion occurs early and curative surgery is likely impossible
mst after sx 3-6 mths (similar to no tx)

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35
Q

mst of definitive fractionated rt for sinonasal tumors

A

8 - 20 mths
dose 42 - 54 gy in 10 - 18 fx

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36
Q

toxicity of fractionated rt to sinonasal tumors

A

acute - oral mucositis, keratoconjunctivitis and blepharitis, rhinitis, desquamation

late cataracts, kcs, atrophy of the cornea, uveitis, retinal hemorrhage/degeneration, brain necrosis, optic nerve degeneration, seizures, osteonecrosis, skin fibrosis

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37
Q

what is the life limiting problem for nasal tumors

A

locally aggressive - invade and recur

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38
Q

definitive rt following by sx of residual disease

A

mst 47 mth vs 19 mth for rt alone
another study with different protocol showed MST of 457

increased incidence of late effects, including rhinitis (bacterial and fungal), osteomyelitis, and fistula formation, but MST was the longest

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39
Q

gemcitabine as a radiosensitizer for sinonasal carcinoma

A

Gemcitabine was given intravenously at a dosage of 50 mg/m2 twice weekly before daily RT

significant hematologic toxicity (neutropenia) and local acute tissue com- plications

not a good option for tx

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40
Q

low-dose cisplatin (7.5 mg/m2 given intravenously every other day) administered in conjunction with definitive RT

A

well tolerated and did not appear to cause an increase in acute or late radiation effects

efficacy is unknown

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41
Q

Use of firocoxib, a COX-2 inhibitor, was evalu- ated in combination with RT

A

under powered
Quality of life was improved
no difference in outcomes

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42
Q

srt for nasal tumors

A

total 24 - 36 gy given over 1-3 tx
improved cs
mst 8.5- 19.5 mth - based on total dose

tumor stage was not prognostic in any of these SRT studies

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43
Q

severe late complications can include

A

oronasal fistula formation, seizures, ocular changes, skin necrosis, and osteonecrosis

reported in 3% to 40% of dogs

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44
Q

palliative rt outcome nasla tumors

A

improved cs in 66-100% of dogs with limited se
mst 146 - 512 days ~5-17mo

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45
Q

prognostic factors for nasal tumors treated with palliative rt

A

Tumor stage (stage 1) and duration of clinical signs (>90 days) have been correlated with longer survival in cases receiving this type of radiation

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46
Q

can dogs with nasal tumor get rt again

A

yes

small study dogs received 50 gy at first then 36gy after about 500 days , 2nd psi 282 d

mst after two rt protocols 927 days - 31 mth

second study reports a MST of 453 days 15mth in 37 dogs that were reirradiated after a coarsely fractionated radiation protocol

acute se limited
all had late SE and late se did lead to euth in some - sudden blindness

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47
Q

chemo alone for nasal tumors

A

cisplatin RR 27% - mst 5 mths
carbo/doxo/prioxicam RR 75%- mst 8 mths (if tcc worse 5 mth, if scc or undiff carc 2 month, if sarcoma better 15 mth)
palladia RR 71% - st 8 mths

can get TCC IN NASAL CAVITY!!!!

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48
Q

electrochemo for nasal tumors

A

RR 90%
MST 16.9

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49
Q

RT + adjunctive Palladia
RR
ST

A

RR - 80% vs RT alone (69%), toceranib alone (22%)

ST between groups not stat sig
10 mth palladia alone, 20 months palladia and rt, 12 mths rt alone

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50
Q

When all treatments fail to control epistaxis in nasal tumors

A

unilateral or bilat- eral carotid artery ligation can palliate symptoms in dogs for up to 3 months or longer without damage to the brain

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51
Q

mst nasal sarcoma treated with fractionated rt

A

MST was 444 days (15 months)

palliative 305 days - 10 mth
definitive MST 523 days - 17mth

prognosis of sinonasal osteosarcoma treated with RT is not clear

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52
Q

nasla lymphoma with rt +/- chemo

A

MST was 375 days for intermediate/large cell and 823 days 27 mths for the small cell group

no difference in MST for dogs treated with RT and chemotherapy versus chemotherapy alone

90% of dogs treated with RT improved clinically

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53
Q

Angiofibroma in nasal cavity

A

histologically benign but locally aggressive vascular nasopharyngeal tumor character- ized by a proliferation of irregular appearing blood vessels that are surrounded by a connective tissue stroma

no mets

Surgery tx

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54
Q

Where is SCC mostly located on the dog & cat?

A

Dog-nailbed; Cat-nasal planum, eyelids, pinnea

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55
Q

Which is more aggressive dog or cat nasal planum SCC?

A

Dog

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56
Q

What is the survival time with stage4 sinonasal tumors?

A

Cribiform lysis; 6.7months vs. 23.4 months

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57
Q

What is the survival time with epistaxis?

A

88 days (3 mo) vs. 224days (8 mo)

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58
Q

On MRI is turbinate lysis is diagnostic for neoplasia also is MRI better than CT?

A

no but cribriform lysis on mri was always neoplastic

MRI is no better than CT unless brain extension

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59
Q

Is sx helpful with sinonasal disease

A

No survival with sx+RT not better then MeV RT alone; RT then sx MST 47 months but high late effects

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60
Q

What is the survival with any RT protocol alone for sinonasal tumors?

A

8-19.7 months; IMRT spares eyes best with best control

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61
Q

What is the tx and survival for feline nasal adenoCA?

A

12months 1yr survival 44% with RT

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62
Q

What are risk factors for developing lung cancer?

A

Smoking, plutonium and other RT, anthracosis

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63
Q

What is the etiology and survival with feline multiple digit masses?

A

Usually met from SCC in lung; amp digits MST 67days

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64
Q

What are prognostic factors for lung cancer?

A

Size, stage, grade, mets, effusion, signs, disease post-op
Cat-only grade

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65
Q

What is the survival lung tumor with ln mets?

A

60-126 days (2-4 mo)
12-15 months if neg

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66
Q

What is the survival with stage for lung cancer?

A

T1 26months, T2 7months, T3 3months

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67
Q

What is the survival by grade of lung tumors?

A

Low grade 16 months, high grade 6 months

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68
Q

What is the MST for SCC lung cancer?

A

8 mth

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69
Q

What is the survival if surgery could not remove the entire lung tumor?

A

28 days vs. 330 if surgery complete

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70
Q

What is prognostic in cats with lung tumors and what is the survival?

A

Grade, low grade 25 months vs. high grade 2.5months

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71
Q

What are the criteria to perform a metestectomy?

A

Disease control >300 days; Less than 3 lesions on CXR, Long doubling time >40 days, no other mets

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72
Q

What causes ovine pulmonary adenocarcinoma?

A

Virus JSRV, originate in alveolar type2 & clara cells

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73
Q

What is the most common site for chondrosarcoma in the dog?

A

Nasal cavity-MST 210-580days (~7- 19 mo) various tx

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74
Q

Cat has incidental 3 cm primary pulmonary mass what to tell owner

A

px good despite histopath

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75
Q

frontal sinus carcinoma met rate

A

12%

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76
Q

frontal sinus tx with pallida and piroxicam

A
  • subjective regression in skull deformity in 80%
    MST 184 d ~6 mo
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77
Q

Use of a cyclical hypofractionated radiotherapy regime (‘QUAD shot’) for the treatment of feline sinonasal carcinomas

A

4Gy x 4 delivered within 48 hours

OST 460d, 15mth 1 yr 80%, 2 yr 0%, 4 euthanized d/t tumor related causes
No AE

CB in 6/7 cats

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78
Q

Diagnosis of feline mesenchymal nasal hamartoma by squash preparation cytology

A

pretence of osteoblast like and osteoclast like cells on cyto associated with mesenchymal nasal hamartoma on histo

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79
Q

primary pulmonary adenocarcinoma after surgical resection in small-breed dogs
PFI
MST

A

MPFI 754 d (25 mo)
MST 716 d (23 mo)

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80
Q

prognostic factors for primary pulmonary adenocarcinoma after surgical resection in small-breed dogs

A

Tumor size was associated with progression free interval in all cases

> 7 cm was negatively associated with OST

> 5 <7 cm and margins where associated with PFI on multivariate

UNIVARIATE ; clinical signs, lymph node metastasis, margin, and histologic grade were associated with PFI, and age, clinical signs, margin, and lymph node metastasis were associated with OST

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81
Q

primary lung tumors in dogs and cats and environmental radon activity

A

Primary pulmonary neoplasia (PPN) rate is higher in dogs and cats residing in counties with a high radon exposure risk (Environmental Protection Agency [EPA]zone 1) compared to zones 2 (moderate radon exposure risk) and 3 (low radon expo-sure risk).

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82
Q

histopathologic types of primary pulmonary neoplasia and outcomes MST

A

Pulmonary carcinoma most common 87.1% then sarcoma 7.6%

5.9% of sarcoma classified as HS with sig worse MST of 300 vs 399d for carcinoma

Dogs with neuroendocrine tumors (1.5%) best MST of 498d

No difference for carcinoma based on stage or adjuvant chemotherapy

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83
Q

modified human lung cancer stage classification in dogs with surgically excised primary pulmonary carcinomas

MST for stages
prognostic factors

A

incomplete excision (241d - 8 mth vs 758d 25mth)
LN mets (95 3mth vs 731d 24mth)
grade (I = 41 1.5 mth, 2 = 268 9mth, 3 = 731d- 24mth)
T stage (T1= NR, T2 = 731d 24mth, T3=522d 17mth, T4=158d 5mth)

chemo did not change outcome

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84
Q

Tolerability and outcome of palliative treatment for metastatic pulmonary carcinoma in cats

A

chemo, steroids, NSAIDs, or no tx
MST 64 days
Presence of respiratory signs decreased survival
Treatment tolerated, response not really evaluated (table shows mostly SD in cats with recheck cxr or PD; no PR/CR)

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85
Q

Bronchial Stent Placement for Palliative Treatment of Pulmonary Carcinoma with Bronchial Obstruction in a Cat

A

successful palliation to get rt - lived 323 d
mets to liver and lung

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86
Q

Hydropulsion as Palliative, Long-Term, Last-Resort Treatment of Nasal Carcinoma in a Dog and a Cat

A

used for resolution of clinical signs
dislodged the tumor

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87
Q

Computed tomography imaging characteristics of canine nasal chondrosarcoma

A

“ring-and-arc” or “popcorn” calcification in canine nasal tumors may suggest prioritizing chondrosarcoma as a diagnosis

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88
Q

Treatment of advanced-stage canine nasal carcinomas with toceranib phosphate

A

Stage III and IV only
OST 139d 4.5 mths

Epistaxis associated with longer survival 116d 4mths vs without 83d <3mth
CB rate 72.2%

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89
Q

ct findings of orofacial tumors

A

Epithelial tumors may have increased blood volume and blood flow compared to mesenchymal tumors

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90
Q

post IMRT findings of sinonasal tumros

A

in field failure is the most common pattern for local recurrence

some sub volume of tumors within the GTV that makes it radio resistant

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91
Q

Clinical-dosimetric relationship between lacrimal gland dose and keratoconjunctivitis sicca in dogs with sinonasal tumors treated with radiation therapy

A

20% developed kcs
Minimum dose to develop kcs 23.75 gy
No eyes <20 gy developed kcs

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92
Q

Outcomes and adverse effects associated with stereotactic body radiation therapy in dogs with nasal tumors

A

3 daily 9-10 Gy or once 20 Gy

MST any cause 388d; 58% d/t local disease progression.
another study showed up to 542d mst with multimodal treatment
another study showed 354d
745d with two courses of srt

AE acute: skin 26%, oral 30%, eye 26%, KCS 4%
AE late (>6 mo): unilateral cataract 18%

SRT associated with lower acute AE than fRT

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93
Q

(Palladia) as a primary or adjuvant agent in the treatment of canine nasal carcinoma

A

Fractionated 42 Gy RT (10 fractions)

CR/PR rate 80% in palladia+RT group and 69% in RT alone which is significantly better than palladia alone at 22%
CB rate better in palladia + RT 97% than RT alone 80%

MST palladia + RT 615d,
RT alone 368d,
palladia alone 298d - NOT sig different
Palladia with RT did not result in more AE

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94
Q

Canine intranasal tumours treated with alternating carboplatin and doxorubin in conjunction with oral piroxicam

mst
pfi
ae
Response rate

A

MST 8 mths for any tumor
carcinoma - 280 d - 9 mths
TCC - 5 mths
SCC/undiff - 2 months
sarcoma - 448 d - 15 mths

PFi 211 d
AE in 69% of dogs and 28% of treatments 24% Gr III or IV

RR 55%

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95
Q

Retrospective evaluation of intranasal carcinomas in cats treated with external-beam radiotherapy

palliative verse SRT verse fRT

A

Pfs pRT = 198d - 6.6 mth
OST pRT = 284 d - 9 mth

Pfs SRT= 504d - 17 mth
OST SRT = 721d - 24 mth

PFS fRT 269 d - 9 mth
OST fRT 452d - 15 mth

Second course of RT improved outcome - 824 -27 mths vs 434 d - 14 mth

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96
Q

most common nasal tumor in cats

A

Lymphoma is the most commonly diagnosed tumor type in the feline nasal cavity and sinuses, followed by epithelial neo- plasms (carcinoma, adenocarcinoma, SCC)

majority of cases were B-cell (68%) and 20% were T-cell, with 12% having a mixed population of B- and T-cells

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97
Q

ct findings of feline nasal tumors

A

osteolysis of paranasal bones, extension of disease into the orbit of facial soft tissues, the presence of a space-occupying mass, and turbinate destruction may suggest a CT diagnosis of neoplasia over rhinitis

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98
Q

met rate of nasal cancer in cats

A

low
~17%

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99
Q

RT for feline nasal tumors

A

mst 12 mths 44% alive at 1 year and 16% 2 year

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100
Q

what virus has been associated with nasal cancer in people

A

HPV has been identified in 25% to 49% of oropharyngeal head and neck cancers and is associated with a sig- nificant survival difference compared with HPV-negative oropha- ryngeal cancers

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101
Q

what molecular marker in people has been shown to be associated with worse dfs in people

with nasal tumors???

A

EGFR

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102
Q

what breeds are over represented for larygotracheal tumors

A

arctic breeds - husky, alaskan malamute

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103
Q

what cat breeds associated with larynx tracheal tumors

A

siames, dsh - lsa
DLH adenocarcinoma

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104
Q

tumor types found in the canine larynx

A

Rhabdomyosarcoma, SCC, adenocarcinoma, osteosarcoma (OSA), chondrosarcoma (CSA), fibrosarcoma, mast cell tumor (MCT), solitary extramedullary plasmacytoma, and granular cell tumor have been reported in the canine larynx

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105
Q

you dogs develop what in the trachea

A

benign masses
tracheal chondromas, osteochondromas, and osteochondral dyspla- sia

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106
Q

location and tumor type of tracheal lesions in the dog

A

Tracheal malignancies are more commonly located on the ventral wall, and adenocarcinoma, MCTs, extramedullary plasmacytoma, OSA, CSA, and lymphoma have all been reported

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107
Q

Feline laryngeal tumors

A

SCC, lymphoma, adenocarci- noma, and poorly differentiated round cell tumors

Benign laryngeal masses have also been reported, such as lymphoplasmacytic inflammation, lymphoid hyperplasia, and polypoid laryngitis

108
Q

feline tracheal tumors

A

Primary masses of the trachea in cats include lymphoma, SCC, histiocytic sarcoma, neuroendocrine carcinoma, and adenocarcinoma

Lymphoplasmacytic inflammation, lymphoid hyperplasia, and epithelial polyp have also been reported

109
Q

Treatment of genitourinary carcinoma in dogs using nonsteroidal anti-inflammatory drugs, mitoxantrone, and radiation therapy

A

PFI - 260 d
MST - 510 d - 17 mths

mild clinical signs and lack of prostate involvement were associated with favorable prognosis

permanent urinary incontinence in 31%

110
Q

Total prostatectomy as a treatment for prostatic carcinoma

A

permanent urinary incontinence in 35%

Poor prognostic factor extracapsular tumor extension

OMST 231d - 7.6 mth

1 year survival 32%
2 year survival 12 %

111
Q

metastases of prostatic adenocarcinoma
where
rate

A

diffuse - peritoneal cavity (liver spleen kidney, carcinomatosis, etc) or lungs or bone
via hematogenous or lymph

report of 2 dogs with cutaneous metastasis - multiple skin nodules on ventral abdomen, inguinal, sq, cutaneous nodular lesions

40% lung mets;
80% mets @necropsy;
22-42% bone mets

112
Q

Definitive-intent intensity-modulated radiation therapy for treatment of canine prostatic carcinoma

A

Definitive intent IMRT 48 to 54 Gy total 2.5-2.8Gy daily +/- NSAID and Chemo

OST 563 d -18.7 mth
PFI 220 d
ost longer with chemo 241-8 mth d vs 25 d
ost longer if no mets 109 3.5 mth d vs 388d 13mth

ae- acute diarrhea low grade
late stricture, hind limb edema in 3 dogs

113
Q

negative prognostic factors for prostatic carcinoma

A

significant clinical signs
extracapsular extension
metastasis at diagnosis

114
Q

masitinib and expression of its specific targets c-Kit, PDGFR-α, PDGFR-β, and Lyn in canine prostate cancer cell lines

A

Masitinib increased apoptosis while decreasing cell counts and cell viability in a dose and application interval dependent manner (increased benefit at 12 h dosing)

Supports use of mastinib in vivo study for prostatic cancer

115
Q

is it common for prostatic carcinoma to have basal cell or urothelial markers

A

no will have absent or weak basal cell or urothelial markers such as p63, high molecular weight cytokeratin, or Uroplakin 3

116
Q

prostatic carcinoma can have what type of invasion

A

extension into benign ducts and glands “intraductal carcinoma” - 44% of p in one study

117
Q

Sertoli cell tumour paraneoplastic syndrome other than hyperestrogenism

A

pancytopenia

historically associated with poor prognosis
with surgery is may resolve pancytopenia and improve outcome

118
Q

Sheltie with testicular tumor and feminization and pancytopenia

A

Sertoli cell tumor

119
Q

What are the different testicular tumors and what cells do they arise from?

A

Sertoli-sustentacular cells in seminiferous tubules;
interstitial-leydig cells b/w tubules;
Seminioma-germinal epith of seminiferous tubules

120
Q

What is the metastatic rate of testicular tumors?

A

<15% seminoma, sertoli;
Leydig very rare

Sites of metastasis may include regional lymph nodes (LNs), eyes, brain, lungs, kidney, spleen, liver, adrenal glands, pancreas, skin, and peritoneum

121
Q

What are risk factors for testicular tumors?

A

Age, breed, cryptorchoid ( seminoma/sertoili cell) , environment (carcinogen exposure)

122
Q

Which testicular tumors express c-KIT

A

Interstitial/Leydig - all pos
seminomas - all pos in one paper - other paper showed SE subtype (PLAP+) only were ckit pos
but sertoli - one paper some pos one paper none pos

123
Q

subtypes of Sertoli cell tumors

A

subclassified on the basis of expression of placental alkaline phosphatase (PLAP) as classical seminoma (SE) or spermatocytic seminoma (SS; PLAP negative)

124
Q

What are some IHC for testicular tumors?

A

GATA-4 (sertoli, interstitial), - not germinal tissue like seminoma
MelanA- steroid producing cells -Leydig cell tumors (100%), Sertoli cell tumors (93%), and adrenocortical adenomas (92%)

immunohistochemical panel of E-cadherin, GATA-4, INH-alpha, KIT, NSE, PGP 9.5, and melan A

sertoli: inhibin alpha, GATA-4, melan A, NSE, E cadherin, vimentin

seminoma; Ckit Ki67, PGP9.5, vimentin

Leydig; Melan A, inhibin alpha, Gata 4, vimentin

125
Q

What testicular tumor has a paraneoplastic syndrome and is it reversible?

A

Sertoli-hyperestrogenism - more than 50% of affected dogs display signs of estrogen overproduction
reverses 1-3 months post-op unless mets

126
Q

What can you measure in the serum to diagnosis hyperestrogenism?

A

17β

not all dogs with signs of feminization have absolute increases in estradiol-17β

127
Q

What is the tx and prognosis for dogs with testicular tumors?

A

Castration curative;
Mets can do RT or chemo-MST 5-31months

128
Q

Where does prostate cancer arise?

A

Ductal/uroethelial epith not acinar so androgen neg

129
Q

Is mineralization in the prostate pathognomic for neoplasia?

A

No, intact dogs mineralization from BPH, prostatitis,

if Neutered highly specific

130
Q

What is the tx and prognosis with prostatic CA?

A

Surgery alone MST<5months;
surgery and adjuvant chemo/nsaids 8 mth
piroxicam 7months;
No tx 30days

131
Q

What 2 cancers cause hyperestrogenism that can lead to bone marrow hypoplasia?

A

Male sertoli cell tumors & female granulosa cell tumor

132
Q

characteristics of 3 most common testicular tumors - Withrow chart

A

dont memorize just review

133
Q

breeds associated with testicular tumor types

A

seminoma - GSD and Belgian malinois

other: boxer, afgan hound, weimaraner, shetland sheepdog, collie, maltese

Flat-coated retrievers, Rottweilers, Bouvier de Flandres, and Leonbergers may have a reduced risk of developing testicular tumors

134
Q

in what testicle is cryptorchid more likely

A

right - more likely to be retained

135
Q

age of dogs with cryptorchidism that develop tumors

A

younger than non cryptorchid
6-10

136
Q

Aggressive testicular tumors did express high levels of what proliferation markers

A

TERT, p53, PCNA, and Ki67

AgNOR high in metastatic and invasive seminomas

137
Q

Laminin and testicular tumors

A

extracellular matrix protein involved that plays a role in anchor- ing cells to the basement membrane

As tumors became more invasive, laminin expression became fragmented or lost in Sertoli cell tumors and seminomas, and this correlated with increasing proliferative activity as assessed by PCNA scoring, Ki67 index, and mitotic index

138
Q

Connexin 43

A

gap junction protein of the testis
expression may aid in differentiating neoplastic Sertoli cells from seminomas

139
Q

p53 and testicular tumors

A

increased p53 expression has been associated with tumor progression

may be an indicator of tumor aggression

140
Q

VEGF and MVD in seminomas

A

higher in diffuse seminomas compared with more well-differentiated intra- tubular seminomas, potentially providing a histologic indicator of malignant behavior

141
Q

signs of hyperestrogenism

A

bilateral symmetric alopecia, cutaneous hyperpigmentation, epidermal thinning, squamous metaplasia of the prostatic epithelium, gynecomastia, galactorrhea, attraction of other males, preputial atrophy, atrophy of the nonneoplastic testicle, and bone marrow suppression

17% of dogs with scrotal Sertoli cell tumors developed feminization

142
Q

Feline testicular tumors

A

Sertoli cell tumor, seminoma, interstitial cell tumor, and teratoma have been reported

143
Q

Breeds that may be at increased risk of developing PCA

A

Bouvier des Flandres, Doberman pinscher, Shetland sheep- dog, Scottish terrier, beagle, miniature poodle, German short- haired pointer, Airedale terrier, and Norwegian elkhound

American cocker spaniel, miniature poodle, and dachshund may be at decreased risk for developing PCA

144
Q

Risk Factors for PCA

A

More aggressive tumors may develop in castrated males with
a higher risk of metastasis

145
Q

Natural Behavior of PCA

A

local invasion with a high propensity for regional and distant metastasis

146
Q

braf in pca

A

Activating mutations in the BRAF gene, which lead to constitutive MAPK signaling, were found in the majority of PCA in dogs

147
Q

cox 2 in PCA

A

Cyclooxgyenase-2 (COX-2) and downstream prostaglandin E2 expression may play a role in carcinogenesis and progression in PCA

Expression of COX-2 was noted in 75% of PCAs in one study, whereas none of the normal prostate tissue stained positively

148
Q

what cytokines and hormones may play a role in establishing skeletal metastasis of prostatic carcinoma

A

PTHrp and TGF-β

BUT PCA metastases are more commonly osteoblastic in nature

149
Q

complications of prostatectomy

A

most common complication is urinary incontinence, occurring in 33% to 35% of dogs

150
Q

3D conformal RT (CRT) or intensity-modulated RT (IMRT) with image-guided RT (IGRT) for pCA

A

54 to 58 Gy in 20 fractions

PFI 317 days 10.5 mth
MST 654 days 22mth

151
Q

late rt AE of prostatic rt

A

urethral, ureteral, and rectal stricture

152
Q

For dogs with skeletal metastasis, palliative options include

A

systemic analgesics, RT, bisphosphonates, and
samarium-153– ethylenediamine–tetramethylene–phosphonic acid

153
Q

Feline Prostate Tumors

A

rare
Metastasis appears common and sites of spread can include pancreas, lung, and LNs
most cats died within 3 months of diagnosis

154
Q

most common cancer of the penis

A

scc and TVT

155
Q

tumors of the os penis

A

Ossifying fibroma, benign mesenchymoma, multilobular osteochondrosarcoma and osteosarcoma can arise from the penile bone

osa od th Eos penis can recurr after marginal excisions and met

156
Q

Which mutation occurs in ~50% of K9 HSA?

A

PTEN → AKT/mTOR disruption

157
Q

SQ HSA response rate to chemo im assuming

A

40%

158
Q

HSA tx after doxorubicin

A

no benefit to palladia

ctx may help

159
Q

Rottie with spleen hs

A

remove spleen start CCNU

160
Q

what is the prognostic for dermal HSA

A

uv induced
ventral location
breed

161
Q

Dog with pericardial effusion analysis of fluid - not definitive of neoplasia

A

mesothelioma, heart base mass, HSA

162
Q

Canine most common secondary brain tumor

A

hsa

163
Q

renal hsa prognosis

A

9 months

164
Q

What are risk factors for cHSA?

A

RT
UV

165
Q

What are some mutations in HSA?

A

VHL ( inc HIF->VEGF), bFGF, Ang1, p53, PTEN, PI3k/mTOR, pdL1

166
Q

What are IHC for HSA?

A

Von Willebrand factor8, cKIT, claudin5

167
Q

What % of nontraumatic hemoabdomens & what % requiring transufusions were HSA?

A

60-70%
93% requiring transfusions

168
Q

What are prognostic factors for HSA?

A

Stage, grade, heart mass, collapse, cardiac troponinI

169
Q

What is the prognosis for HSA?

A

Spleen 3 months sx alone, 6months with chemo
Heart 1-4months,
Renal 9 months,
Retroperitoneal 1 month,
Cutaneous long-term; SQ&muscle unclear

170
Q

What is the tx and outcome for heart hsa

A

sx + dox 164 d - 5 mth
aortic body do better with pericardectomy - 720 d 24 mths vs 42 days

171
Q

Gene expression profiles of beta-adrenergic receptors in canine vascular tumors

A

Hsa over expressed beta AR subtypes 1-3

172
Q

Canine splenic hemangiosarcoma cells express and activate luteinizing hormone receptors in vitro

A

High luteinizing hormone may be associated with cell proliferation

May be why spayed and castrated dogs are more likely to develop hsa

173
Q

In vitro effects of doxorubicin and tetrathiomolybdate on canine hemangiosarcoma cells

A

The addition of tetrathiomolybdate increased ROS formation and apoptosis

Ascorbic acid inhibited this

174
Q

Tumour necrosis factor-related apoptosis-inducing ligand (TRAIL) induces apoptosis in canine hemangiosarcoma cells in vitro

A

TRAIL is an apoptosis inducing cytokine

Trail isoleucine zippered - induced apoptosis in all cell lines and increased activation of caspase 3 and 8 and adp-ribose polymerase degradation

Recombinant human trail worked but on specific cell lines

175
Q

DOES The addition of metronomic chemotherapy improve outcome for canine splenic haemangiosarcoma

A

NO

Doxo alone or with MTD cytoxan vs Doxo followed by MC cytoxan
No differences between groups

176
Q

Canine Intrapelvic Hemangiosarcoma

A

Arose from intrapelvic musculature
PFS 92 days, OST 165 days - 5 mths

CS- lameness, urethral obstruction and hemoperitoneum

177
Q

Pericardial Hemangiosarcoma

A

pericardial effusion - blood
hsa in pericardium - no hb mass
Pulmonary Mets noted 12 days post op, survived 18 days

178
Q

Primary Hemangiosarcoma of the Falciform Fat (ligament)

A

OST 339 d, 1 yr survival 50%

4 dogs treated with chemo who had sig longer MST 394d vs 83d in 3 with surgery alone

179
Q

Diagnostic value of the ultrasonographic description of a splenic mass or nodule as cavitated in 106 dogs with nontraumatic hemoabdomen

A

Poor diagnostic utility in identifying hsa or malignancy
SN 42% SP 51%
Ppv 55%
Npv 38%

180
Q

Adjuvant carboplatin for treatment of splenic hemangiosarcoma in dogs vs doxo

A

Mst 160 d for carbo and 139 for doxo
( not stat sig)

Increased monocytes following surgery is neg prog - 265 d vs 66 day with inc monocytes

181
Q

Development and validation of a multivariable model and online decision-support calculator to aid in preoperative discrimination of benign from malignant splenic masses in dogs

A

found 8 variable - TP, presence or absence of >2 nRBCs/100WBCs, us mass diameter, number of liver nodules, presence of multiple splenic masses, degree of homogeneity in the splenic mass, amount of effusion, mesenteric ommental or peritoneal nodules

182
Q

double two-thirds rule for diagnosing hemangiosarcoma in dogs with nontraumatic hemoperitoneum due to a ruptured splenic mass - 3 paperss

A

JAVMA 2022
73% malignant
87.3% HSA
_____________
VCO2020
63% malignant
60% HSA
______________
VCO2020 UK
60% malignant tumors
66% being HSA
breed based association is strong predictor of malignancy

183
Q

Retrospective evaluation of thrombocytopenia and tumor stage as prognostic indicators in dogs with splenic hemangiosarcoma

A

Stage 3 disease and perioperative thrombocytopenia associated with shorter PFI and OST.
Hct NOT associated

184
Q

Prevalence, distribution, and clinical characteristics of hemangiosarcoma-associated skeletal muscle metastases

A

dogs included had visceral or muscular hsa
24.6% skeletal mets detected - all had mets to >1 other site
60% with smm had lameness or reluctance to walk
Whole body ct recommended for staging with hsa due to smm

185
Q

Adjuvant anthracycline-based vs metronomic vs no medical treatment for dogs with metastatic splenic hemangiosarcoma

A

Mtd doxo > metronomic > splenectomy
ST 140 d >58 d> 40 d
Doxo had higher toxicity rate

186
Q

Assessing major influences on decision-making and outcome for dogs presenting emergently with nontraumatic hemoabdomen

A

QOL most important to owners for decision making.

SX improves survival if non-malignant hemoabd (239d vs 39d palliative care) but not if malignant (MST 81d)

187
Q

Impact of repeated cycles of EGF bispecific angiotoxin (eBAT) administered at a reduced interval from doxorubicin chemotherapy in dogs with splenic haemangiosarcoma

A

eBAT = EGF targeted antitoxin

eBAT = bispecific epidermal growth factor angiotoxin consisting of human EGF targeting EGFR, human amino terminal transferase ATF of urokinase targeting urokinase plasminogen activator receptor UPAR, and a genetically modified deimmunized Pseudomonas exotoxin

Initial trial found that eBAT was safe and potentially effective when administered post splenectomy in 1 cycle of 3 treatment followed by doxorubicin
No dose limiting toxicity
6 mo survival 70% with 6/23 alive >450d (stage I & II HSA)

This study found no benefit for additional doses while including stage III

188
Q

Retrospective comparison of first-line adjuvant anthracycline vs metronomic-based chemotherapy protocols in the treatment of stage I and II canine splenic haemangiosarcoma

A

Ost 200 d 6.6 mth and TTP 185d

Stage i longer than stage ii 338 d - 11mth vs 151 d 5 mth

Mst for doxo 154d
Mst for metronomic + chemo 338 d
Mst for metronomic 225d 7.5mth
Difference was NOT statistically significant for mst or ttp

This study suggests that adjuvant MC in canine splenic HSA may result in a similar outcome when compared to other treatment protocols

189
Q

predictors of hsa of splenic masses

A

bodyweight
breed
hemoabdomen
incidental findings
met dz
anemia
thrombocytopenia

on multivariate
only hemoab
breed

190
Q

what breeds are associated with hsa diagnosis base dont eh presence of a splenic mass

A

Terriers and brachycephalic dogs, Spaniels, Poodles, Dachshunds, Beagles - unlikely to have HSA

German Shepards very likely to have HSA (75%)
Retrievers and mountain breeds 46%
Sighthounds and Collies 42%

191
Q

Timely adjuvant chemotherapy improves outcome in dogs with non-metastatic splenic hemangiosarcoma

A

Time to metastasis and OST significant longer in p who received chemotherapy </= 21 days following splenectomy

192
Q

Evaluation of the anti-tumour activity of Coriolus versicolor polysaccharopeptide (I’m-Yunity) alone or in combination with doxorubicin for canine splenic hemangiosarcoma

A

Dogs treated with PSP alone, female dogs, decreased HCT at diagnosis, and stage III disease associated with poor outcome
Addition of PSP to dox post splenectomy did not improve survival
This study shows the PSP alone does not improve survival compared to splenectomy alone as suggested by the pilot with a larger population

193
Q

Urinary bladder hemangiosarcoma in a cat treated with partial cystectomy and adjuvant metronomic cyclophosphamide and thalidomide

A
194
Q

risk factors for splenic hsa

A

German shepherds, golden retrievers, Labrador retrievers, and other large-breed dogs are overrepresented in several case series

male

spayed > unspayed - not validated

195
Q

risk factors for cutaneous hsa

A

the skin along the ventral abdomen and conjunctiva in short-haired and lightly pigmented breeds - light exposure

196
Q

what do hsa arise from

A

Hx thought to be peripheral endothelial cells, recent molecular data suggest that HSA may arise from bone marrow progenitor cells that undergo dysregulated maturation and sub- sequently move to peripheral vascular sites to form tumors

probable heterogeneity within this tumor type

197
Q

what proteins are over expressed in hsa compared to normal

A

pRB, cyclin D1, Bcl2, and survivin are overexpressed in HSA

198
Q

differentials for splenic mass

A

lymphoma, nonangiomatous/nonlymphomatous sarcomas and nonneoplastic etiologies (e.g., nodular hyperplasia, extramedullary hematopoiesis, hematoma

199
Q

most common location of hsa in the cat

A

cutaneous > visceral liver more than others (e.g., spleen, liver, intestine) locations are the most commonly reported primary sites for HSA

reported in heart, thoracic cavity, eyelid or conjunctiva, digit, and nasal cavity

200
Q

most common metastatic sites hsa

A

liver, omentum, and lungs

201
Q

staging of hsa

A
202
Q

pulmonary metastatic disease on cxr of hsa

A

nodular to interstitial coalescing miliary pattern

203
Q

rt and heart base hsa

A

Hypofractionated RT has been evaluated for dogs with cardiac HSA and in a pilot study appeared to reduce the frequency of cardiac tamponade, leading to an MST of 2.5 months

204
Q

yunnan baiyao and hsa

A

YB led to dose- and time-dependent cell death via caspase- mediated apoptosis in three canine HSA cell lines

YB and epsilon- aminocaproic acid in dogs with presumed cardiac HSA suggested no benefit in terms of time to recurrence of hemopericardium or overall survival time

no coag benefits seen

205
Q

prognosis feline hsa

A

poor
die from recurrence or mets

77 - 197 d

cutaneous - 9 mths - 4 yrs

206
Q

SQ hsa cats problem with surgery

A

high rates of incomplete excision 50-94%
and local recurrence 50-80%

207
Q

thymoma natural behavior

A

Thymomas are carcinomas and thus should be considered malignant tumors - thymic epithelial cells with mast cells and mature lymphocytes

in cats the cystic form is most common

mets are uncommon in both species but up to 20% in cats with cystic thymomas

208
Q

dog with edema of the head, neck, and thoracic limbs - next step ?

A

cxr looking for mass - cranial vena cava syndrome

208
Q

paraneoplastic with thymoma

A

67% of dogs
Myasthenia graves, exfoliative dermatitis, erythema multiform, hypercalcemia, T cell lymphocytosis, anemia, myocarditis, polymosytis

MOST common - MG and megaesophagus in dogs -megaesophagus and aspiration pneumonia have been reported in as many as 40% of dogs with thymoma. Hypercalcemia has been reported in 34%

exfoliative dermatitis in cats are the most common

209
Q

dog with thymoma what is the chance it has another tumor

A

27% of dogs will have a concurrent second tumor

210
Q

hyper ca in thymoma cause

A

Hypercalcemia has been reported in 34%
PTHrp

211
Q

US appearance of thymoma

A

Cranial mediastinal masses with a cystic appearance and heterogeneous echogenicity were significantly more likely to be thymomas than lymphomas in one study

212
Q

cytology of thymoma

A

presence of neoplastic epithelial cells. These are often accompanied by mast cells and variable numbers of small mature lymphocytes.

often non diagnostic - neoplastic
epithelial cells were cytologically evident in only 61% of cases

213
Q

Hassal’s corpuscles

A

A unique feature of thymoma, Hassal’s
corpuscles, are cytoplasmic structures present in thymocytes that can be used to aid on cytologic diagnosis

best seen on H/E formalin fixed samples

214
Q

thymoma flow

A

CD4+ CD8+

In one study, all cases of thymoma included 10% or more of lymphocytes coexpressing CD4 and CD8, whereas six of seven lymphomas contained fewer than 2% of CD4+CD8+ lymphocytes

*prior q was interpreting flow plot

215
Q

stage in human thymoma - Masaoka–Koga

A
216
Q

thymoma sx alone

A

cat - MST 1825 d 89% 1 YEAR 74% 3 yr
dog - MST 635-790 d 64% 1 YEAR 42% 3 YR

217
Q

thymoma no treatment

A

76 d

218
Q

RR of thymoma to RT in dogs and cats

A

50 - 75%

mst 248 - dog - 8 mth
mst 720 - cats - 24 mth

most p had sx followed by rt

219
Q

hypofractionated RT alone thymoma (48–49 Gy total dose, once weekly, for 6–7 weeks)

A

overall response rate was 50% and the 1-year survival rate was 75%

220
Q

chemo and rt good for txt for thymoma?

A

Chemotherapy and RT can result in a reduction in the size of thymomas, but this effect may be the result of reduction in the nonneoplastic lymphocyte population in the thymus rather than a true anticancer effect

221
Q

prognostic factors thymoma

A

high percentage of lymphocytes was associated with longer STs.

Age, invasiveness of the tumor, and mitotic index had no effect on prognosis.

dogs classified as lower Masaoga–Koga stage (I or II) had significantly longer STs than dogs with stages II or higher

negative - MG - aspiration pneumonia/mega eso, resectability

222
Q

Outcomes of dogs with thymoma treated with intensity modulated stereotactic body radiation therapy or non-modulated hypofractionated radiation therapy

A

No difference in survival for hypofractionated non-modulated RT vs SRT but potentially less side effects for SRT (heart/lung) and reduced timeframe for completion may suggest SRT as favorable

Underpowered

SBRT - 250 d
NMRT - 155 d

223
Q

Histopathologic and clinicopathologic findings of thymoma

A

MST 449 days, 1 yr 52.6%, 2 yr 26.3%

Surgical excision of tumor associated with prolonged survival

Mets, MG, and moderate to marked cellular pleomorphism associated with reduced survival

224
Q

When are CD4/CD8 double negative? Double positive?

A

Neg when enter/in thymus and double positive-thymomas

225
Q

What species can be infected with TVT? What is a similar disease?

A

Canine, foxes, coyotes, jackals; Tasmanian Devil Facial Tumor

226
Q

How many chromosomes are in TVT? How many in normal dog?

A

57-64 and normally 76 plus x/y =78

227
Q

What are some molecular mutations with TVT?

A

Point mutation p53; insertion of LINE ahead of c-myc

228
Q

What is the immunologic progression of TVT

A

progressive phase - 1st progression phase takes 3-6months where TGF-B suppress IFNy and downregulates tumor MHC complexes; stationary phase
Then either regression or dissemination-if immunocompotent regresses by TILS produced IL-6 that works with IFNy to increase NK and MHC expression;

unlikely to spontaneous regress if present >9months - will happen within 3 months

229
Q

What is the tx for TVT?

A

Vincristine can be curative; Doxorubicin or RT for resistant cases; Sx not good

230
Q

What is paraneoplastic syndrome for TVT?

A

erythrocytosis

231
Q

test to diagnose tvt

A

LINE-c-myc mutation - PCR
cytology
biopsy

232
Q

What treatment has the highest rate of recurrence for TVT

A

surgery
recurrence 30-75%

233
Q

● SQ HSA – response to doxorubicin

A

o 38.8%
o Median duration of response 53 d
o Dogs that had sx lived longer – 207 d v no sx 83 d

234
Q

dermal hsa poor prog indicators

A

Dogs w/ SQ involvement, hemoabdomen, or mets – worse prognosis

235
Q

Splenic HSA – benefit of treatment w toceranib after doxorubicin

A

no benefit
DFI for all dogs 138 d and 161 d for TOC; MST 169 d for all dogs and 172 for TOC

236
Q

Pooled vaccine for canine splenic HSA – most common AE? Immune response?

A

o Allogenic HSA vaccine induces humoral response to control antigen in vaccine (KLH) – all 6 dogs had Abs produced to KLH
o Vaccine was administered w adjuvant DOXO, MST was sig improved compared to historical controls
o Most common AE – transient diarrhea
o MST 182 d

237
Q

Doxorubicin and CCNU for HSA

A

Stage II splenic HSA – sx, CCNU/doxo
o MST 158 d, 1-yr 16%
o Prognostic mitotic score - Mitotic score = 0 (MI <11) - MST 292 d 10 mths, 42% 1yr

238
Q

Cat visceral HSA – most common surgical findings, metastatic disease in what %

A

Spontaneous hemoabdomen
▪ 46% neoplastic (60% HSA)
▪ 37% tumors in spleen
o Visceral HSA
▪ 33% met to lung at dx

MST 77d

239
Q

cytology on blood smear fo hsa

A

o Acanthocytes, schistocytes, nonregen or regen anemia

240
Q

perioperative mortality in dog with thymoma

A

20%

241
Q

tvt distribution

A

tropical and subtropical areas, particularly in the southern United States, Central and South America, southeast Europe, Ireland, Japan, China, the Far East, the Middle East, and parts of Africa.

North America, the prevalence of TVT is correlated with increased rain- fall and mean annual temperature

TVT is most common in dogs 2 to 5 years of age

242
Q

met rate of tvt

A

5-17% region ln, sq, skin, eyes, oral mucosa, liver, spleen, peritoneum, hypophysis, brain, bone marrow

243
Q

protein expression in tvt

A

p53, proliferating cell nuclear antigen (PCNA), Ki67, MYC, retinoblastoma (Rb), cyclin D1, matrix metalloproteases (MMPs) -2 and -9, and variably expresses S-100

243
Q

histo of tvt

A

TVT is commonly described as a round (or discrete) cell tumor and suggested to be of histiocytic origin

expression of vimentin, lysozyme, alpha-1-antitrypsin (AAT), and macrophage-specific ACM1

may be found with intracellular leishmania

244
Q

can dogs with tvt who get a cr become reinfected

A

maybe but Dogs recovered from TVT have serum- transferable immunity to reinfection and puppies born to bitches exposed to TVT are less susceptible to the disease

245
Q

rr of tvt to vinc

A

90-95%
resistant cases treated with dox

246
Q

RT for tvt

A

was able to induce CR in various protocols

247
Q

cytology from pericardial effusion what is your diagnosis

a. hemangiosarcoma
b. histolytic sarcoma
c. chemodectoma
d. mesothelioma
e. not malignant

A

d. mesothelioma - Clumps of neoplastic cells with binucleations, single to multiple prominent and variably shaped nucleoli, and cytoplasmic vacuoli. The presence of a thick brush border and the “mesothelial slits” suggest a mesothelial origin of cells - small slits or windows between the cells

a- blood and spindle cells
b - fried egg, vacuoles, multi nuc bizzare
c - neuroendocrine - naked nuclei or halo cells

248
Q

What are growth factors associated with mesothelioma?

A

VEGF, IGF-1, PDGF

249
Q

What is the tx and outcome with pericardial mesothelioma?

A

Pericardectomy survival 4-13 months; chemo may increase to 27; overall unknown

250
Q

What two tumors stain positive for cytokeratin & vimentin?

A

Mesothelioma and synovial cell sarcoma, ovarian CA, RCC tubulopapillary

251
Q

● What is most common form of mesothelioma

A

epithelial

252
Q

can you diagnose mesothelioma on cyto

A

o Can r/o LSA or infectious causes but cannot specifically diagnose mesothelioma
o Reactive mesothelial cells appear same as malignant epithelial– flattened cells w microvilli, desmosomes, and phagocytic potential

253
Q

Chemotherapy w intracavitary carboplatin vs. mitoxantrone

A

o Not enough power to determine difference?

254
Q

Intracavitary chemotherapy for pleural effusion v. without – any difference

A

MST for untreated – 25 d v. 332 d for dogs that had intracavitary mito and/or carbo

255
Q

Evaluation of intracavitary carboplatin chemotherapy for treatment of pleural carcinomatosis in cats

A

ineffective
died within 2 weeks

256
Q

Mediastinal Serous Cavity Mesothelioma (caudal mediastinum) in Two Dogs

ihc

A

strong cytoplasmic immunoreactivity to cytokeratin, strong cytoplasmic immunoreactivity to vimentin, weak cytoplasmic immunoreactivity to calretinin, PAS positive intracytoplasmic granules.

257
Q

Outcome of dogs treated with chemotherapy for mesothelioma

A

IC 12 (cis/carboplatin), IV 2 (carbo/doxo/mito alone or alternating), 1 MC after

Dogs who received chemotherapy had a sig. longer MST 366 days vs 74 days

Complete resolution of effusion after first chemo longer MST 415 d vs 160

258
Q

outcome of canine malignant mesothelioma:

A

ORR 37% after 3 weeks and 24% after 15 weeks

OMST 195 d; for chemo 234d and no chemo 29 d

All dog 1 year survival 22%
Treatment with any chemo only sig. prognostic factor

gave intracav or IV 5Fu, carbo, carbo/mito

259
Q

most common CS

A

tachypnea
dyspnea
pleural effusion

260
Q

cause of mesotheliom

A

asbestos
chronic inflammatory response also creates a distinct immunosuppressive tumor microenvironment, leading to infiltration with myeloid-derived suppressor cells, tumor-associ- ated macrophages, and regulatory T cells, which likely contributes to tumor progression

261
Q

most common mutations of mesothelioma

A

cyclin-dependent kinase inhibitor 2A (CDKN2A), BRCA1 association protein 1 (BAP1), and neurofibromin 2 (NF2)

262
Q

histologic forms of mesothelioma

A

epithelial, mesenchymal, biphasic , sclerosing mesenchymal form that looks like sts, cystic form reported in a dog

263
Q

on histo there is a A high-grade sarcomatous component adjacent to a low-grade cartilaginous component. what tumor does this indicate?

A

referred to as a bimorphic pattern, confirms the diagnosis of a dedifferentiated chondrosarcoma on histopathology

264
Q

A retrospective study on bone metastasis in dogs with advanced-stage solid cancer
where did they come from? what cancer type? what was the most common bone location?

A
  • mammary, spleen, tonsil
  • carcinoma or HSA
  • 19 had multiple bones with humerus and vertebrae most common
  • MST from time of bone met dx 30 days
    Lack of treatment associated with increased risk of death