Exam 1 - Oral & GI Tumors Flashcards by Madeleine Swindell

what are the 3 most common oral tumors in dogs?

malignant melanoma
squamous cell carcinoma
fibrosarcoma

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what dog breeds are commonly affected by oral tumors?

cocker spaniel, GSD, GSP, weimaraner, goldens, gordon setters, mini poodles, chows, & boxers

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what are the most common oral tumors in cats?

squamous cell carcinomas
fibrosarcoma

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what should you look at during your physical exam for an animal with an oral mass? why do a sedated oral exam?

look at the tonsils, palpate lymph nodes, retropulse the eyes, check nasal airflow, & auscult the lungs

these tumors are painful - get an FNA or biopsy of the mass

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for animals with oral tumors, what does their labwork typically look like?

usually normal - may see increased BUN if they are swallowing blood

may see a left shift

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why should you do chest radiographs prior to sedating an animal with an oral tumor?

look for mets & avoid atelectasis

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why is it important to know what lymph nodes drain what structures for animals presenting with masses?

best diagnostic chance on getting a sample with definitive answers

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what is needed for diagnosing & staging oral tumors in small animals?

lymph node aspirates, CT scan

CBC/Chem/UA, chest rads, skull rads, & dental rads

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why is a biopsy for histopathology necessary for squamous cell carcinomas?

they are very inflammatory - an FNA won’t give a great sample

histopathology will

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what is the most common treatment option for oral tumors? what are the requirements of the procedure?

surgical removal - local tumor is removed & underlying bone is very commonly removed

2 cm margins are needed & any positive lymph nodes are removed

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what kind of tumor do you think this is?

malignant melanoma

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this dog had mandibular osteosarcoma & got a bilateral rostral mandibulectomy - why?

OSA very commonly crosses midline

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what complication is commonly seen after a partial maxillectomy? how is it avoided?

oronasal fistulas

close the hard palate to the skin & place a feeding tube after surgery to prevent chewing & damage during the healing process

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what is the biggest complication seen post-op for animals with oral tumors that were surgically removed?

incisional dehiscence!!!!

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what complications are commonly seen post-op for animals with oral tumors that were surgically removed?

incisional dehiscence, epistaxis, increased salivation, mandibular drift (may have to file down remaining canine teeth), malocclusion, & difficulty prehending food

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malignant melanoma is a disease of dogs with ______ _______ _________

pigmented oral cavities

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what breeds commonly are affected by malignant melanoma? what age?

cockers, poodles, chows, & goldens

older dogs - 10-12 years

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T/F: 33% of melanoma tumors are amelanotic

true

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T/F: malignant melanomas are aggressive both locally & systemically with a metastatic rate > 80%

true

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what history & clinical signs are associated with patients with malignant melanoma?

owner noticed a mass

facial deformity, halitosis, blood in saliva, difficulty eating, lymphadenopathy, & exophthalmus

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T/F: chemotherapy is effective for treating malignant melanoma

false - not very effective but may help to slow metastasis

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why is radiation therapy good for malignant melanoma therapy?

can be used in place of therapy for gross disease - can be used after surgery for incomplete margins

melanoma is very responsive to radiation - need high doses at a low frequency (looks like a palliative protocol but 6x6 protocol is seen as curative)

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T/F: there are acute & chronic side effects seen with radiation therapy for treating malignant melanoma

true - side effects will occur only in the radiation field

acute - inflammatory side effects, occur 2-3 weeks after RT, skin changes (sunburn), fatigue, decreased appetite

chronic - fibrosis/permanent, occur ~6 months post RT, fibrosis (scar tissue formation) and decreased ability to heal a wound or bone fracture

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what vaccine is available for malignant melanoma?

merial vaccine (conditional approval by the FDA) can use on stage 1-2 tumors that are small & haven’t metastasized

very expensive - based on human tyrosinase vaccine/DNA plasmid vaccine

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what are some poor prognostic factors for malignant melanoma in dogs?

tumors > 2cm tumors in the back of the mouth do worse evidence of metastasis recurrence of tumor

T/F: malignant melanoma carries a poor prognosis in dogs even if local control is achieved

true - MST is only 5-10 months

what is the most common malignant tumor in cats & second most common malignant tumor in dogs?

oral squamous cell carcinoma

what are some risk factors for oral SCC in cats?

flea collars, high intake of canned food (especially tuna), & exposure to cigarette smoke

T/F: the more rostral the oral SCC, the lower the metastatic rate

true

what oral SCC locations have a high metastatic rate in dogs?

tonsilar & tongue SCC in dogs, > 70%

T/F: oral SCC in cats are very locally invasive

true

when does metastatic disease occur in oral SCC?

late in the disease process - largely unknown in cats

what history & clinical signs are associated with patients with oral SCC?

owner notices mass in the mouth - halitosis weight loss, difficulty chewing, facial deformity, bloody saliva, epistaxis, & loss of teeth in the face of minimal dental disease

what is the treatment of choice for oral SCC in cats? what is required?

surgery!!! surgery may be curative if margins are achieved (2cm) techniques & complications are the same as malignant melanomas

cats don't tolerate oral surgery well for oral SCC, so what should you do?

feeding tube placed for all cats with oral surgery!!!!!

T/F: oral SCC in cats is responsive to radiation therapy

false

when is radiation therapy indicated for a cat with oral SCC?

primary treatment - palliative to alleviate bone pain adjunct therapy - incomplete surgical margins many fractions of small doses, place a feeding tube, & be aware of acute & chronic side effects

what chemotherapy is used for oral SCC in cats?

NSAIDS, carboplatin, mitoxanthrone - in combination with RT

what dogs have an excellent to good prognosis for oral SCC?

dogs with small rostral tumors

what are some poor prognostic factors of oral SCC in dogs?

dogs with large or caudally located tumors dogs with tonsillar or tongue SCC

what is the prognosis for cats with oral SCC?

poor prognosis in general - MST is 4-6 months for palliative care & may get up to 1 year with surgery/radiation

what may be the first sign seen in a dog with tonsillar SCC?

change in their bark

what dogs are commonly affected by oral fibrosarcomas?

large breeds - goldens & labs that are young to middle aged (6-7 years)

T/F: oral fibrosarcomas may appear very benign on histopathology but act very aggressively

true

what is the metastatic rate of oral fibrosarcoma?

~30%

what is the 2nd most common oral tumor in cats & 3rd most common in dogs?

oral fibrosarcoma

what history & clinical signs are associated with patients with oral FSA?

owner may notice a mass - often associated with the soft & hard palate same other signs as other oral tumors

T/F: metastatic lesions of oral FSA are usually seen in the lungs & lymph nodes first

false - yes to met lesions in lungs but lymph nodes are rarely affected

what is the median survival time for oral FSA in dogs?

surgery alone - ~1 year surgery + RT - ~ 18-24 months

what is the prognosis of oral FSA in cats?

unknown but likely poor because of their low tolerance for big oral surgeries

what is the overall prognosis for oral FSA in dogs & cats?

guarded

what is the therapy indicated for oral FSA?

aggressive surgery with margins of 3-5cm when possible - but even with good margins, they often reoccur - underlying bone MUST BE REMOVED radiation therapy - adjuvant therapy for incomplete margins but has severe side effects, can be palliative for gross disease

T/F: gastric cancer in dogs & cats is very rare

true

what animals are affected by gastric cancer?

male dogs - chows & belgian shepherds gastric carcinoma - 8 years old & leiomyosarcomas - ~15 years olf

what is the most common gastric tumor type in dogs? what is the metastatic rate?

70-80% are carcinomas high metastatic rate of 70-80%

what is the most common gastric tumor type in cats?

lymphoma is most common with small intestinal involvement

what clinical signs are associated with gastric tumors in dogs & cats?

vomiting, hematemesis, weight loss, & anorexia

what diagnostics are needed for working up a gastric tumor case?

good physical exam with thorough abdominal palpation CBC, chem, UA - hypoglycemia (intestinal leiomyosarcoma), increased BUN, anemia chest rads - look for mets contrast gastrogram abdominal ultrasound endoscopy for biopsy in dogs - need to do surgery for leiomyosarcomas & cats to get biopsies

what dog breed is commonly affected by gastric lymphoma?

boxers

what is the medical treatment that can be used for gastric lymphoma in boxers?

chemotherapy

how is surgery used for treating gastric tumors?

tumor is often on the lesser curvature of the stomach, need to look at the vascular supply, do surgery in debilitated patients, & if leiomyosarcoma, you can shell it out

what gastric cancer type in cats has a good prognosis?

small cell lymphoma

what is the prognosis for malignant gastric tumors?

poor - MST <6 months large cell lymphoma, early metastasis of carcinomas, & know that gastric mast cell tumors met early!!!

what is the most common intestinal tumor in dogs? what about cats?

dogs - adenocarcinoma/lymphoma affecting older male large breed dogs cats - mostly lymphoma, older males/siamese breeds, no retroviral association

what intestinal tumor type is most common in the colon? what about the small intestines? what about the cecum?

colon - adenocarcinoma small intestines - lymphoma cecum - leiomyosarcoma or GIST

what locations are adenomatous polyps commonly seen in dogs & cats?

colon of dogs small intestines of cats

what clinical signs are associated with intestinal tumors?

weight loss, diarrhea, vomiting, anorexia, melena, anemia, & hypoglycemia

what is seen on CBC/chem/UA for an animal with an intestinal tumor?

cbc - anemia, leukocytosis chem - hypoproteinemia, increased BUN, increased liver values, hyperglycemia, & hypoglycemia

what is required in your physical exam for diagnosing a dog with an intestinal tumor?

thorough abdominal palpation feeling for a mass rectal exam feel for thickened intestines

what diagnostic imaging is indicated for diagnosing & staging an intestinal tumor?

chest rads - look at lungs for mets, evaluate lymph nodes, & look for malignant effusion abdominal rads - plain & contrast abdominal ultrasound endoscopy/laparoscopy/exploratory - get a biopsy

how is surgery used to treat intestinal tumors?

used to alleviate many symptoms but 30-50% do metastasize need to remove any suspicious lymph nodes or metastatic lesions remove 5-10cm on either side of the lesion to decrease the chances of dehiscence - MCT need largest margins!!!! or endoscopic removal of polyps

when is chemotherapy appropriate for treating intestinal tumors? what is the protocol?

appropriate for lymphoma small cell lymphoma - chlorambucil large cell lymphoma - CHOP adjuvant after surgery for MCT (VBL & pred), carboplatin/doxorubicin or 5-FU for carcinomas in dogs only, & piroxicam for rectal polyps in dogs

T/F: with leiomyosarcomas, perforation is not a negative prognostic factor

true

for non-lymphoid intestinal tumors, what is a poor prognostic factor?

metastasis at diagnosis of tumor

what is the best predictive prognostic factor for cats with lymphoid intestinal tumors?

response to treatment!!

T/F: immunophenotype of lymphoid tumors in dogs & cats doesn't play a role in prognosis

true

what is the MST of small intestinal adenocarcinomas?

with no surgery - MST is 2 weeks with surgery - 115 days before recurrence or mets

what is the MST of large intestinal adenocarcinoma?

with surgery, MST 20 months

what are some poor prognostic factors of intestinal tumors?

extensive lesions with many adhesions metastasis at diagnosis carcinamatosis

what is the prognosis/MST of a cat with solid small intestinal tumors?

15 months after surgery if they survive - immediate perioperative risk

what is the prognosis/MST of a cat with solid tumors in the large intestine?

3-6 months with surgery

what is the prognosis/MST of a cat with large cell gi lymphoma?

4-6 months with therapy

what is the prognosis/MST of a cat with small cell gi lymphoma?

18-24 months with therapy

Exam 1 - Oral & GI Tumors Flashcards

(83 cards)