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Module 17-Urinary, Endocrinology, Oncology > Approach to skin and soft tissue tumours > Flashcards

Approach to skin and soft tissue tumours Flashcards

(53 cards)

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1
Q

Diagnosis of skin tumours

A

Cystology for some tumour types
Histopathology for definitive diagnosis
(Excisional/Punch biopsy)

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2
Q

Where is the most common site of neoplasia for the dog and cat

A

Skin

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3
Q

What does TNM mean when staging skin tumours

A

T Primary lesion - size and extent

N Regional /Sentinel node - palpate, image, aspirate

M Distant metastases - Xray, AUS, bloods

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4
Q

Treatment for local skin tumours

A

Surgery

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5
Q

Treatment for local and region lymph nodes

A

Surgery +/or radiotherapy

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6
Q

Treatment for multifocal diffuses skin tumour

A

Chemotherapy

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7
Q

Suggest causes of multiple skin lesions

A

Primary Cutaneous lymphoma (T cell)
Disseminated mast cell tumours
Histiocytic skin conditions

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8
Q

Hystiocytic

A

A group of rare disorders in which too many histiocytes (a type of white blood cell) build up in certain tissues and organs, including the skin, bones, spleen, liver, lungs, and lymph nodes.

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9
Q

Differentiate between cutaneous and systemic REACTIVE histiocytosis

A

Cutaneous histiocytosis = skin only
Systemic histiocytosis = skin, lymph nodes & other organs

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10
Q

Give examples of neoplastic histiocytic skin conditions

A

Histiocytic sarcoma (Malignant histiocytosis)
Haemophagocytic histiocytic sarcoma

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11
Q

Treatment for Reactive histiocytosis

A

Some may respond to immunosuppressive drugs (high dose corticosteroids, cyclosporine, tetracycline/niacinamide)

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12
Q

Give examples of epidermal solitary skin tumours

A

Papilloma
Basal cell tumour (Trichoblastoma or solid-cystic ductular sweat gland adenoma)
Squamous cell carcinoma

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13
Q

Give examples of dermal solitary skin tumours

A

Sebaceous and sweat gland adenoma/ACA
Hair follicle tumours (pilomatricoma/trichoepithelioma/trichoblastoma)

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14
Q

Give examples of Mesenchymal / subcut connective tissue
solitary skin tumours

A

Fibrous tissue (fibroma/sarcoma)
Adipose tissue (lipoma/sarcoma)

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15
Q

Are basal cell tumors more common in cats or dogs

A

In cats

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16
Q

Cause of Squamous cell carcinoma

A

Chronic exposure to UV light in depigmented skin (white) areas

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17
Q

Squamous cell carcinoma treatment

A

Treatment wide local surgical resection

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18
Q

What is the most common skin tumour of old dogs

A

Sebaceous gland tumours (hyperplasia-warts, cysts, adenoma, epithelioma)

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19
Q

Canine cutaneous histiocytoma signalment

A

up to 10% of all skin tumours
Young dogs < 5 yrs,
50 % in dogs < 2 yrs

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20
Q

Are majority of melanocytic tumours slow growing and benign?

A

85% are slow growing and benign

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21
Q

Signalment for mast cell tumours

A

Middle aged - older dogs
No sex predisposition
Breeds:
Boxers, Staff BTs, Boston Terriers
Labradors,
Golden Retrievers*
Weimeraners
Pugs

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22
Q

What is the name of the two systems used to predict mass cell tumour

Study These Flashcards
A

Patnaik system (1984) - low, intermed, high grades
Kiupel system (2011)- low and high grade

23
Q

Name mass cell tumour proliferation markers

Study These Flashcards
A

Mitotic count (index)- no of mitoses/10 HPF
Ki67- nuclear stain for cells in cell cycle
AgNOR count- nuclear silver stain and PCNA (proliferating cell nuclear antigen)
cKI- Cell surface growth factor receptor with TK enzyme

24
Q

What is the number of Mitotic count (index)- no of mitoses/10 HPF for a bad prognosis

Study These Flashcards
A

> 5 mitoses/10HPF has worse prognosis

25
What is the percentage of Ki67 – nuclear stain for cells in cell cycle for a bad prognosis
1.8% of positive nuclei per total mast cells in field has a worse prognosis /decreased survival
26
What do granules in mast cell tumour contain
Histamine Heparin Vasoactive amines
27
What are the local effects of degranulation
Erythema Swelling Wheal formation- Raised, discolored blotch on the skin ‘Darier’s sign’- Urtication and erythematous halo that are produced in response to the rubbing or scratching of these lesions.
28
Systemic effects of hyperhistainaemia(paraneoplastic syndrome)
More likely with high grade tumour Acts on H2 receptors in gastric parietal cells,leading to - Increased acidity and motility - Vomiting, anorexia, melaena - Gastric ulceration
29
Treatment for Hyperhistaminaemia
Supportive therapy - fluids H2 antagonists- Cimetidine, ranitidine, famotidine Gastric protectants- Sucralfate (Antepsin) Proton pump inhibitor- Omeprazole Remove /treat mast cell tumour to remove source of histamine
30
Other biological effects of mass cell tumours
Hypotension Coagulation problems– Localised haemorrhage Delayed wound healing
31
Difference between low grade and high grade mast cell tumour 's effects of the body
Low grade - may have local effects High grade - more likely to have systemic effects High serum histamine reported with all grades
32
How do I diagnose a mass cell tumour
Do an FNA to confirm diagnosis (or biopsy) Evaluate/FNA sentinel LN – for clinical stage
33
Difference between treatment of clinical stage 1 and 2 mass cell tumours
If Clinical Stage I (solitary mass and no sentinel LN mets) - Surgical excision only – wide local excision or - Marginal excision and radiotherapy or - Radiotherapy alone if not amenable to surgery at all If Clinical Stage II (solitary mass plus LN mets) - As above and also LN excision / Radiotherapy - Metastasis to LN implies higher grade, so chemotherapy as well
34
Give examples of drugs used in mass cell tumour chemotherapy
12 week Vinblastine/Pred protocol Single agent Lomustine Single agent TK inhibitor
35
What is the most common skin tumour in cat
Mass cell tumour
36
Signalment of feline mass cell tumours
Older cats (mean age 11years) Siamese (Burmese, Russian Blue, Ragdoll) predisposed
37
List low grade sarcomas
peripheral nerve sheath tumor, haemangiopericytoma (cancer of capillary wall)
38
List medium grade sarcomas
Fibrosarcoma, myxosarcoma (neoplasm of connective tissue)
39
List high grade sarcomas
Haemangiosarcoma (neoplasm originating from the endothelial cells of the blood vessels) , Feline injection-site sarcomas, Histiocytic sarcoma
40
Outline sarcoma treatment
Chemotherapy as an adjunct to surgery for high grade tumours
41
Name drug name for sarcoma treatment
Doxorubicin based protocol for most sarcomas eg HSA (need care in cats eg FISS) Lomustine for histiocytic sarcomas
42
What kind of tumour grades are FISS (Feline injection site sarcoma)
High grade
43
Treatment for feline injection site sarcoma
Surgery +/- radiotherapy for primary tumour Chemotherapy for metastasis
44
Presentation of Haemangiosarcoma
1. Superficial /soft tissue mass or haematoma 2. Splenic Rupture- haemorrhage, collapse, abdominal distension, pale mmbs 3. Cardiac signs- Muffled heart sounds, arrhythmias, Right sided Heart Failure 4. Regenerative anaemia (blood loss, microangiopathic haemolysis), thrombocytopenia, neutrophilia, DIC
45
Treatment of Haemangiosarcoma
Primary tumour - Surgical excision of subcutaneous mass - Radical excision / amputation - Splenectomy - Pericardectomy Metastasis - Adjunctive chemotherapy - Doxorubicin - VAC -Metronomic therapy
46
What is median survival time of splenic haemangiosarcoma
Surgery alone 1-3 months Sx and Chemotherapy 5-7 months
47
What is median survival time of Intramuscular haemangiosarcoma
6-9 months with chemo
48
What is median survival time of skin haemangiosarcoma
Surgery alone Dermal: 26-33 months (UV induced, thin coated dogs eg whippets, Pit Bulls Subcutaneous: 7-10 months (39-40 mo in 1 study with adjuvant doxorubicin)
49
What is median survival time of cardiac haemangiosarcoma
3-4 months with Doxorubicin vs 12 days with no treatment
50
Outline the 'T' stage in TMN staging
Based off tumour diameter T1-T4 T1: <2cm T2: 2-5cm T3: >5cm T4: Invading muscle, bone etc
51
Outline the 'N' stage in TMN staging
N1,2: Ipsilateral or contralateral/bilateral LN N3: Fixed nodes
52
Outline the 'M' stage in TMN staging
M1-Distant metastasis
53
Outline the WHO criteria for MCT staging
0: Incompletely excised tumour from dermis with no LN involvement 1: Single tumour in dermis without LN involvement 2: Single tumour in dermis with LN involvement 3: Multiple dermal tumours/ Large infiltrating tumours ± LN involvement 4: Any tumour with distant metastasis, blood or BM involvement

Module 17-Urinary, Endocrinology, Oncology (28 decks)

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