Anal sac tumors Flashcards
(63 cards)
1
Q
What are most anal tumors (round cell, sarcoma, carcinoma)?
A
- Most are carcinomas
- Epithelial tissues
2
Q
Where do anal tumors tend to spread?
A
- Lymph nodes more, less via blood
- Sub-lumbar lymph nodes most often
3
Q
How would an anal sac apocrine gland adenocarcinoma tend to behave locally?
A
- Tend to stick together and are well circumscribed
- The bigger it is, the less obvious
4
Q
What are the three main anal tumors?
A
- Perianal adenoma
- Perianal gland carcinomas
- Anal sac carcinomas
5
Q
Perianal adenoma - who gets?
Malignant/benign?
A
- Benign
- Intact male dogs
6
Q
Perianal gland carcinomas - who gets?
Malignant/benign?
A
- Malignant (often more diffuse than perianal adenoma)
- Possible male predominance
7
Q
Anal sac carcinomas - who gets?
Malignant/benign?
A
- Malignant!
- Older dogs
- Lots of chondrodystrophic breeds (e.g. Springer spaniel, dachshund, malamute, cocker spaniel German Shepherd)
8
Q
How do anal sac carcinomas tend to present?
A
- Anal sac mass
- HYPERCALCEMIA!
9
Q
Staging for anal sac carcinomas
A
- CBC/Chem/UA
- Hypercalcemia due to PTHrp in 25-50%)
- Chest rads
- Image the abdomen (>50% have metastasized to lymph nodes at diagnosis)
- Image tumor
10
Q
Anal sac carcinoma hypercalcemia vs lymphoma
A
- Often NOT as sick as lymphomas, which change very acutely
11
Q
Surgery for anal sac carcinomas
A
- Remove mass and nodes
12
Q
Radiation therapy for anal sac carcinomas
A
- Seems to be the best for mass and nodes
13
Q
Chemotherapy for anal sac carcinomas
A
- Carboplatin/cisplatin
- TKI
- May not work as well
14
Q
Survival times for anal sac carcinomas
A
- Can be long
15
Q
Other perianal tumor possibilities
A
- Soft tissue sarcoma
- LSA
- Mast cell tumor
- Melanoma
- Squamous cell carcinoma
16
Q
Tumors on the inside presentation in general
A
- Could present with very vague signs
17
Q
Therapy options for tumor on the inside in general
A
- Surgery
- Radiation
- Chemotherapy
- Anti-angiogenic
18
Q
Surgery for internal tumors
A
- Works if tissue is expendable
19
Q
Radiation for internal tumors
A
- Tumor tissue has to sit still and surrounding tissues must tolerate radiation
20
Q
Chemotherapy for internal tumors
A
- Often poorly response
- Often the gut, kidney, and respiratory system are pretty resistant to toxic things already (MDR genes high there)
21
Q
Anti-angiogenic therapy for internal tumors
A
- In human med for GI carcinomas and lung
22
Q
What type of tumors do most organs give rise to?
A
- Carcinomas!
- GI tract including pancreas and liver
- Kidney/bladder
- Ovaries/uterus
- Testicles/prostate
- Adrenal glands
23
Q
Round cell or sarcomas in the abdominal organs - where do they arise?
A
- Spleen/lymph nodes
24
Q
Signalment for GIT tumors
A
- Usually middle aged or older
25
GIT presentation
- Depends on where in the GIT the tumor is
26
Gastric tumor presentation
- Weight loss, vomiting, melena
27
Small intestinal tumor presentation
- Melena, diarrhea, weight loss
28
Colon tumor presentation
- Diarrhea, weight loss, hematochezia
29
Hepatobiliary tumor presentation
- Weight loss
- Inappetance
- Vomiting
- PU/PD
30
Staging for GIT tumors
- NECESSARY!
- Abdominal imaging (ultrasound is best)
- Chest rads
- +/- cytology of mass and all other masses found
- Exploratory
31
Treatment for lymphoma in GIT
- Chemotherapy
32
Prognosis for adenocarcinoma of intestines
- Depends on surgical margins
33
Metastasis of GI adenocarcinoma
- >44% met but can be late
34
Chemo for GIT adenocarcinoma
- Often ineffective
- Doxorubicin, carboplatin
- Gemcitabine
- Metronomic chemotherapy
- TKI
35
Leiomyoma/leiomyosarcoma - where do you see theses?
- Often cecum
36
Leiomyoma/leiomyosarcoma prognosis
- Depends on surgical margins (in general, small intestine is better than large intestine)
37
Metastatic potential of leiomyoma/leiomyosarcoma
- Moderate
38
Chemo for leiomyoma/leiomyosarcoma
- May help
| - Doxorubicin
39
Gastrointestinal stromal tumors (GIST) metastatic potential
- Low metastatic potential
40
Treatment of GI stromal tumors
- Traditional chemotherapy not helpful but TKI can be effective even with gross disease present
41
Hepatic tumors - how to diagnose?
- BE WARY OF MAKING A DIAGNOSIS WITH ULTRASOUND
| - NEED A SAMPLE
42
Feline hepatic tumors - benign or malignant more common?
- Benign tumors more common
43
Canine hepatic tumors - benign or malignant more common?
- Malignant tumors more common but can be quite low grade
- Surgical removal if possible
- Chemo ineffective
44
What are the most common bladder tumors?
- Transitional cell carcinoma
45
Signalment for TCC
- Usually small breed older dog
- Scottish terriers and shelties are over-represented
- female tendency maybe?
46
Presentation for TCC
- Pollakiuria, stranguria, dysuria, urinary obstruction (if you treat like a UTI and doesn't get better, you need to look again)
47
Biologic behavior of TCC
- Unusual metastasis; it's possible (30-60%) but generally NOT detected initially and often not the cause of death
- Generally cause signs locally and can cause the death or euthanasia of the animal
48
Staging TCC
- Thoracic rads
- Abdominal imaging (ultrasound more common these days than contrast cystogram)
- CT (only for radiation)
- Biopsy or cytology
49
Surgical biopsy or cytology for TCC before treating?
- Ideally, yes!
| - Biopsy is great, but often do a urinary catheter and drain or poke
50
Prognosis for TCC surgery alone (complete resection)
- 12-13 months
| - Often can't do this
51
Prognosis for TCC: Surgery plus RT intraoperatively
15 months
52
Prognosis for TCC: NSAID alone
6 months
53
Prognosis for TCC: variety of chemo drugs possible
Carboplatin, vinblastine, metronomic chemo
- Mitoxantrone
54
Prognosis for TCC: Chemo PLUS NSAID
12 months
55
Palliative radiation for TCC
- Effective, but commonly used as a rescue or to un-obstruct
56
Which thoracic structures can give rise to a tumor?
- Heart and greater vessels
- Trachea and lungs
- Esophagus
- Lymph nodes
- Mesothelium
- Thymus
57
Most like history for tumors in the thorax
- Labored breathing or cough/dyspnea, tachypnea
- Difficulty swallowing/regurgitation
- Poor blood circulation (low BP, sudden collapse)
- Paraneoplastic association of hypertrophic osteopathy
58
Signalment for tumors in the thorax
- various, usually older animal
| - May be from a smoking household
59
Diagnosis and staging of tumors in the thorax
- Most thoracic problems would be difficult without at least a thoracic radiograph
- Thoracic CT, or cardiac ultrasound, or trans-esophageal ultrasound often needed as well
- Biopsy can be difficult without surgical approach
- Needle aspirates as well can be difficult and ill-advised
60
Staging for primary lung tumors
- Thoracic rads
| - Thoracic CT is very helpful to identify presence of metastasis to other lung lobes or LN
61
Treatment of primary lung tumors
- Depends on size, type of tumor, and presence or absence of metastasis
- Surgery is usually treatment
- Chemo is minimally effective but Vinorelbine may be better than most drugs
62
Good prognostic indicators for primary lung tumors
- Adenocarcinoma or papillary carcinoma, low grade tumors
- <5 cm diameter
- Peripheral location
- Negative node, no clinical signs
- Survival ~1-2 years
63
Bad prognostic indicators for primary lung tumors
- SCC, poorly differentiated tumors, high grade tumors
- >5cm diameter
- Pleural effusion
- Presence of clinical signs
- Positive nodes
- Evidence of metastasis
