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Small Animal Medicine > Oncology - STS, HS, Mammary > Flashcards

Oncology - STS, HS, Mammary Flashcards

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1
Q

What are soft tissue sarcomas?

A

Mesenchymal tumors/spindle cell tumors - it is an umbrella term

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2
Q

What tumors are soft tissue sarcomas?

A

Fibrosarcoma, peripheral nerve sheath tumor, myxosarcoma, liposarcoma, rhabdomyosarcoma, synovial cell sarcoma, and lymphangiosarcomas

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3
Q

Soft tissue sarcomas are typically solitary/in multiples.

A

solitary

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4
Q

What age of dogs and cats typically get soft tissue sarcomas?

A

older dogs and cats

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5
Q

Where else, aside from the skin, can soft tissue sarcomas be seen?

A

GI tract, liver, and bladder possible

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6
Q

What is the behavior of STS?

A

slow growing/insidious onset

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7
Q

STS are __________.

a. not encapsulated
b. pseudoencapsulated
c. encapsulated

A

b. pseudoencapsulated

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8
Q

What grade of STS are more likely to recur and metastasize?

A

Grade III

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9
Q

What size STS generally have a poor response to chemo and/or radiation?

A

Bulky tumors - >5cm

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10
Q

Is an FNA or a biopsy preferred for STS diagnosis?

A

biopsy

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11
Q

What type of biopsy is preferred for STS diagnosis?

A

incisional - can be misleading

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12
Q

How do you need to position your biopsy for STS?

A

Position so that the biopsy tract is removed with surgery

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13
Q

What is staging for STS based on?

A

Minimum database, FNA local lymph node, 3 view chest rads and CT scan for surgical planning

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14
Q

What makes STS tumors especially difficult to excise?

A

They have spindles that can spread out from the tumor

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15
Q

What is grading of STS based on?

A

differentiation, mitosis, and necrosis

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16
Q

What treatment can be done for STS?

A

Wide surgery, +/- radiation therapy, +/- chemotherapy

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17
Q

What margins do you want for STS?

A

3cm lateral and 1 fascial plane

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18
Q

What may make it difficult to get complete excision for STS?

A

Less likely if >5 cm
Deep location
Invasive

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19
Q

Can STS recur after surgery?

A

Yes, the potential for recurrence is greater with a greater grade

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20
Q

If you chose not to do wide therapy for STS, what are the other options?

A

Amputation/hemipelvectomy or marginal excision with radiation therapy

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21
Q

When you take a STS out, what do you want to do before placing it into formalin?

A

pin it out and ink to help prevent shrinkage in formalin

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22
Q

What type of radiation do you want to use with STS if you got marginal excision?

A

Definitive radiation

Stereotactic doesn’t seem to work as well

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23
Q

What side effects are associated with definitive radiation for STS?

A

Acute skin effects and a long term potential for secondary tumors

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24
Q

What is the chemotherapy agent of choice for STS? When is it indicated?

A

Doxorubicin

Indicated for grade III STS

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25
What is the average time to metastatic disease development from STS diagnosis?
1 year
26
What are the negative prognostic factors for recurrence of STS?
Large tumor size, incomplete excision, and high grade
27
What are the negative prognostic factors for metastatic disease of STS?
Grade, necrosis, mitotic index, and local regrowth
28
What is the MST for dogs with a grade I STS?
48 months
29
What is the MST for dogs with a grade II STS?
17 months
30
What is the MST for dogs with a grade III STS?
7.8 months
31
Can STS be cured?
Yes, with proper planning some can be cured
32
What type of neoplasia is a cutaneous histiocytoma?
A benign skin tumor that is a solitary lesion with rapid growth, but has spontaneous regression in 1-2 months
33
Where can histiocytic sarcomas (HS) be located?
They can be localized anywhere in the body or can be disseminated
34
What is the origin of hemophagocytic HS?
macrophage origin
35
What do hemophagocytic HS do?
Eat the RBCs
36
How are HS diagnosed?
Cytology or biopsy | Definitive diagnosis can be difficult
37
What may be needed for a definitive diagnosis for HS?
ICC/IHC | CD18 stain
38
What is needed for staging of HS?
minimum database, chest rads, abdominal ultrasound
39
How is the disseminated form for HS treated?
It is rapidly fatal and difficult to treat
40
How is localized HS treated?
Surgery if you can. radiation therapy, and chemotherapy
41
What is the treatment of choice for HS?
CCNU/lomustine
42
What are the most common tumors of intact female dogs?
mammary tumors
43
What percentage of canine mammary tumors are considered malignant? How many of them metastasize?
50% are malignant - 50% of those metastasize
44
What are the 3 major factors important in development of canine mammary tumors?
Age, hormonal exposure, and breed
45
What age is malignant canine mammary tumors associated with?
middle-older age
46
During what time in life is obesity especially an issue for canine mammary tumors?
9-12 months of life because adipose tissue produces estrogens and is inflammatory
47
What is field carcinogenesis?
when the entire mammary chain is exposed to estrogen
48
What mammary glands most commonly develop tumors first?
the caudal two glands
49
What is needed for diagnosis of canine mammary tumors?
Minimum database, FNA, chest x-rays, FNA to rule out other tumor types, and biopsy
50
What are the most common mammary tumors that we find?
carcinomas - malignant epithelial tumors
51
What are the types of malignant epithelial tumors that can be a canine mammary tumor?
In order from least to most aggressive - carcinoma in situ, complex carcinoma, simple tubulopapillary carcinoma, simple solid carcinoma, and simple anaplastic carcinoma
52
What is grading for canine mammary tumors based on?
tubule formation, nuclear pleomorphism, and mitotic index
53
What are some prognostic factors for canine mammary tumors?
Tumor size, differentiation, histologic classification, detection off lymphatic vessel invasion (BAD), and regional LN metastasis and distant metastasis
54
What are the treatment options for canine mammary tumors?
surgery, radiation therapy, and chemotherapy
55
What are the types of surgery that can be done for canine mammary tumors?
Simple lumpectomy, mastectomy, regional mastectomy, chain mastectomy, and bilateral mastectomies
56
What surgery should you start with first in dogs with canine mammary tumors?
conservative surgery
57
What surgery is recommended for dogs with one mammary tumor?
Surgery to completely remove the tumor
58
What surgery is recommended for dogs with multiple mammary tumors?
regional mastectomy or unilateral chain mastectomy
59
What surgery is recommended for intact dogs with multiple tumors?
unilateral or bilateral mastectomies
60
An OHE is recommended for intact females with mammary tumors. When should it be done?
It should be done before removal of the mammary glands
61
Why are inflammatory canine carcinomas in the mammary glands so bad?
They are highly metastatic and have local coagulopathies
62
When should radiation therapy be considered for canine mammary tumors?
if there are incompletely removed tumors
63
When is chemotherapy indicated for canine mammary tumors?
If the tumor is >3cm, if it has metastasized, or if it is inflammatory or an osteosarcoma
64
What chemotherapy agent is recommended for canine mammary tumors?
Doxorubicin or carboplatin
65
What is the prognosis for canine mammary tumors?
Overall great, but a worse prognosis is associated with high grade, inflammatory, or OSA
66
What are the three risk factors for feline mammary tumors?
Age, hormonal exposure, and breed
67
___% of cats have more than one mammary tumor.
60%
68
What age is associated with diagnosing mammary tumors in cats?
older cats
69
What is the malignancy percentage and metastasis percentage for feline mammary tumors?
85-95% are malignant and 90% are metastatic
70
What is needed for staging of feline mammary tumors?
minimum database, chest rads, AUS, and FNA of LN
71
What benign tumors can be feline mammary tumors?
Very rare - adenomas, ductal adenoma, and fibroadenoma
72
What malignant tumors can be feline mammary tumors?
simple carcinoma or other types of carcinoma
73
What are the prognostic factors for feline mammary tumors?
Grade, lymphovascular invasion, positive LN, +/- Siamese, size
74
What treatment can be done for feline mammary tumors?
surgery, radiation, and chemotherapy
75
What is the recommended surgical approach for feline mammary tumors?
Chain mastectomy - we need to be aggressive because they are aggressive
76
IF you do radiation therapy for feline mammary tumors, what type do you do?
palliative
77
What chemotherapy options are there for feline mammary tumors?
Doxorubicin, mitoxantrone, or carboplatin
78
When is chemotherapy indicated for feline mammary tumors?
High grade and vascular invasion, >3cm, or if there is LN involvement
79
Overall, what is the most common type of mammary tumor in dogs and cats?
carcinoma

Small Animal Medicine (100 decks)

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