Tumors of the Endocrine System Flashcards
(128 cards)
1
Q
The outcomes of SRT vs. fractionated RT in 44 dogs with pituitary masses were recently retrospectively evaluated. During the first 6mo after RT, ___-___% dogs were euthanized because of progressive neurologic signs. The OST was ____. ______ was significantly associated with survival but treatment type was NOT. MST for dogs txvwith fRT was ____ and MST for dogs tx with SRT was ____.
A
- 18-19%
- OST: 20mo
- younger age
- MST fRT: 25mo
- MST SRT: 17mo
2
Q
***CT/MRI should be considered at time of diagnosis of PDH in dogs. If NO mass is seen, recommend _________. If a mass is present but < _____ in diameter, recommend medical therapy and repeat imaging in 12-18 months. If a mass is present and > _____ in diameter, recommend RT.
A
- no mass: medical therapy alone
< 8mm: medical therapy and re-image
>8mm: RT
3
Q
______ is a somatostatin receptor analog that binds to receptors SST1, SST2, SS, and SST5.
A
Pasireotide
4
Q
What is a potential side effect of pasireotide and its frequency of occurrence?
A
diabetes mellitus - 15%
5
Q
_______ inhibits degradation of dopamine thereby potentially inhibiting ACTH secretion from the intermediate lobe of the pituitary gland.
A
Selegiline (Anipryl)
6
Q
______ is a dopamine D2 receptor agonist that has shown some efficacy in dogs with PDH.
A
cabergoline
7
Q
***Trilostane (Vetoryl) is a synthetic corticoid analog that competitively inhibits _______, which is essential for synthesis of cortisol.
A
3beta-hydroxysteroid dehydrogenase
8
Q
***Relative size of the pituitary gland is assessed by evaluating pituitary heigh:brain ratio. A P:B ratio > ____ is consistent with pituitary enlargement.
A
> 0.31
9
Q
***In the largest cohort to date of 306 dogs with PDH treated with transphenoid hypophysectomy, survival beyond 4 weeks post-op was seen in ____%. MST was ____ and DFI was ____. Recurrence occurred in ___% and recurrence of HAC occurred at median of ____ from surgery.
A
- 91%
- MST: 26mo
- DFI: 32mo
- recurrence: 27%
- recurrence of HAC: 19mo
10
Q
In a prospective study of 150 dogs with PDH treated with transsphenoidal hypophysectomy, 4-year survival was ___%, post-operative death occurred in ___%, remission occurred in ___%, and recurrence occurred in ___%. _____ occurred in 53% of dogs undergoing remission (complication). The overall success rate was deemed ___%.
A
- 4 year survival: 68%
- mortality: 8%
- remission: 85%
- recurrence: 21%
- diabetes insipidus
- success rate: 65%
11
Q
A study using high-definition video telescope for hypophysectomy of 26 dogs with PDH reported an overall mortality rate of ___%.
A
19%
12
Q
A study of 6 dogs with functional macrotumors treated with RT using 40Gy in 10 fractions reported a MST of ____. Neurologic signs resolved in ___% and ACTH levels remained high for ______ after treatment.
A
- MST: 24mo
- neuro signs resolved: 100%
- ACTH high for at least 1 year
13
Q
***A retrospective study of RT in dogs with pituitary macroadenomas demonstrated a significantly improved ST and control of neurologic signs in 19 dogs that received RT compared to 27 untreated dogs. The mean ST of treated dogs was ____ with a 1 year survival rate of ___% and 3 year survival rate of ___%. For untreated dogs, mean ST was ____ with a 1 year survival of ___% and 3 year survival of ___%. ____% of dogs with PDH showed resolution of clinical signs of HAC.
A
Mean ST:
- Treated: 3.8 years
- Untreated: 18mo
1-year survival:
- Treated: 93%
- Untreated: 45%
3-year survival:
- Treated: 55%
- Untreated: 25%
- 35% resolved clinical signs of HAC
14
Q
Transphenoidal hypophysectomy for treatment of 7 cats with PDH reported a post-operative mortality rate within 2 weeks in ____%. The remaining cats experienced remission.
A
30%
15
Q
The prevalence of acromegaly in the average or typical diabetic cat is likely around ___-___% and the prevalence in cats that are difficult to regulate is likely ____%.
A
- 10-15%
- 30%
16
Q
What is the sensitivity and specificity of IGF-1 measurement for cats with acromegaly? IGF-1 levels in cats with acromegaly are usually at least ___________. In Europe, serum IGF-1 has a PPV of 95% if > __________.
A
- Se: 84%
- Sp: 92%
- at least 2x the URL
- > 1000ng/uL
17
Q
A study reported outcome of surgery in 21 diabetic cats with acromegaly. Post-operative deaths occurred in ___%, ____% experienced reduction in IGF-1 concentrations, and ___% underwent diabetic remission.
A
- mortality rate: 14%
- 100% reduction of IGF-1
- Diabetic remission: 78%
18
Q
***A recent study evaluated outcome of SRT delivered in 3 or 4 fractions for 53 cats with acromegaly. oMST was ____, acute effects occurred in ____%, hypothyroidism occurred in ___% months to years after treatment, reduction in insulin dose occurred in ____% and diabetic remission occurred in ____%. The median duration to the lowest insulin dose was ____.
A
- oMST: ~ 3 years
- acute effects: ~20%
- hypothyroidism: 14%
- reduction of insulin: 95%
- diabetic remission: 32%
- median duration: ~10mo
19
Q
What somatostatin analog has shown encouraging results in the medical management of cats with acromegaly? What is the most common side effect?
A
- pasireotide
- diarrhea
20
Q
What is the MST of cats with acromegaly treated with non-specific therapy?
A
- MST 21mo
21
Q
What is the sensitivity and specificity of detection of vascular invasion from adrenal tumors for both AUS and CT?
A
AUS:
- Se: 80-100%
- Sp: 90%
CT:
- Se: 92%
- Sp: 100%
22
Q
A size of _____ of an adrenal tumor is more likely to be malignant.
A
> 2cm
23
Q
***On histopathology, adrenal carcinoma is less likely to exhibit what characteristics?
A
- cytoplasmic vacuolization
- EMH
- Fibrin thrombi
24
Q
What is the vascular invasion rate and metastatic rate of adrenal carcinoma in dogs? Where are the most common sites of metastasis?
A
- vascular invasion: 20%
- metastasis: 50%
- liver and lungs
25
***For dogs undergoing adrenalectomy for an adrenocortical tumor, prognosis is excellent if they survive the _____ peri-operative period.
4-week
26
In a study of 144 dogs undergoing adrenalectomy for an adrenocortical tumor, mortality rate was ___% and average life-expectancy was _____. In general, MSTs for carcinoma is ____-_____ and for adenoma is _____.
- mortality rate: 26%
- average life expectancy: 3 years
- MST carcinoma: 8-26mo
- MST adenoma: 23mo
27
For 9 dogs with adrenocortical tumors with vascular invasion treated with SRT, MST was ____.
MST 2.8 years
28
In a series of 32 dogs with ADH treated with mitotane, MST was _____. Dogs without metastasis appeared to have better response. In two other studies comparing mitotane and trilostane, MST for mitotane ranged from ____ - ____ and MST for trilostane ranged from ____-____. STs were not statistically significant between the groups and were significantly shorter with metastatic disease.
1st study mitotane:
- MST: 16mo
MST:
- Mitotane: 3-16mo
- Trilostane: 8-14mo
29
What are 2 common biochemical abnormalities of aldosterone-secreting tumors?
hypokalemia and metabolic alkalosis
30
____% of functional adrenal tumors in cats are aldosterone-secreting.
84%
31
What medical management can be given for aldosterone-secreting adrenal tumors in cats?
- potassium supplementation
- Anti-hypertensives
- Spironolactone
32
Metastasis occurs in up to ___% of pheochromocytomas with up to ___% having vascular invasion.
- met: 40%
- invasion: 82%
33
Which IHC stain can distinguish a pheochromocytoma from an adrenocortical tumor?
chromogranin-A
34
***_________ appears to be the best way to differentiate between a pheochromocytoma and other adrenal disease pre-operatively.
Urine or plasma normetanephrine
35
The MST of pheochromocytoma after surgery in dogs is ____. Dogs without metastatic disease that survive the perioperative period appear to have a good prognosis.
MST 12mo
36
Perioperative mortality ranges from ___-____% for adrenalectomy.
15-37%
37
What are 5 prognostic factors for adrenal tumors?
1. Presence and size of tumor thrombus
2. Need for nephrectomy
3. Need for transfusion
4. Tumor type (pheo)
5. Tumor size (>5cm)
38
MSTs in cats undergoing adrenalectomy range from ____-____. A series of 10 cats undergoing unilateral adrenalectomy for aldosterone-secreting tumors reported a mortality rate of ___% and a MST of ____. Another study evaluated a laparoscopic approach with a ___% conversion rate, ___% mortality rate, and a MST of ____.
- MST: 1 - 3.5 yrs
Aldosterone-secreting tumors:
- Mortality: 20%
- MST: 3.5 years
Laparoscopic:
- 36% conversion rate
- 10% mortality
- MST: 27mo
39
***___% of dogs undergoing AUS found an incidental adrenal gland lesion and ___% of dogs undergoing CT found an incidental adrenal mass. Of the dogs who were diagnosed with adrenal lesion incidentally with AUS and underwent surgery/necropsy, ____% were malignant and all were > ___ cm in diamter.
US: 4%
CT: 9%
30% malignant
> 2cm
40
20 dogs with non-cortisol-secreting tumors that did not undergo surgery had a MST of _____, but not all of these tumors were found incidentally.
MST 18mo
41
***For incidental adrenal tumors, when is an adrenalectomy recommended and when is monitoring recommended?
Adrenalectomy:
1. Functional
2. Locally invasive
3. > 2.5cm
Monitor q3mo:
1. < 2cm
2. No evidence of hormonal activity
42
In a retrospective study evaluating the outcome of 32 dogs with invasive adrenal tumors that did not undergo adrenalectomy, the MST was ____, and the most common cause of death/euthanasia was ________.
- MST 50d (2mo)
- Hemoabdomen (25%)
43
***A recent retrospective study evaluating 59 dogs and 3 cats that underwent adrenalectomy following spontaneous adrenal tumor rupture reported a MST of _____ and ______ when short-term mortality was censored. Complication rate was ___% and mortality rate was ___%.
- oMST: 19mo
- MST exclude mortality: 30mo
- complication rate: 42%
- mortality rate: 21%
44
**What were the negative prognostic factors for short-term survival in a recent retrospective study evaluating 59 dogs and 3 cats that underwent adrenalectomy following spontaneous adrenal tumor rupture?
emergent surgery, intraoperative hypotension and performing additional sx procedures
45
A recent retrospective study evaluating laparoscopic adrenalectomy for resection of unilateral, non-invasive adrenal tumors in dogs found that ___________ increased the risk of tumor recurrence. The conversion rate was ___% and the discharge rate was ___%. Experienced surgeons did a better job.
- capsular penetration
- conversion rate: 9%
- discharge rate: 95%
46
***Risk factors influencing death prior to discharge in 302 dogs undergoing unilateral adrenalectomy for primary adrenal tumors was recently evaluated. _____ and ____ were significantly associated with peri-operative mortality and ______, _______, and _____ were significantly associated with decreased overall survival time. Did phenoxybenzamine pretreatment have effect on peri-operative mortality? TSS was _____ and ____% mortality rate reported in this study.
- increased surgical time & pre-surgical treatment other than phenoxybenzamine
- ureteronephrectomy, post-op pancreatitis, and post-op aspiration pneumonia
- No (85% vs. 82% survival)
- TSS: 3.96 years
- Mortality: 13%
47
In a recent prospective study of 70 dogs that underwent thyroidectomy and elective bilateral lymph node extirpation (MRP and deep cervical), ___% of lymph nodes were found to have metastasis. ___% of medullary tumors had LN metastasis. Was routine nodal IHC high yield for thyroid carcinoma?
- 19%
- >50%
- no
48
***Palladia was retrospectively evaluated in 42 dogs with thyroid carcinoma in the naive and prior therapy settings. ____% of naive dogs experienced clinical benefit while ___% of prior therapy dogs experienced clinical benefit. The PFI of naive dogs was _____ while the PFI in prior therapy dogs was _____. The MST of naive dogs was _____ while the MST of prior therapy dogs was _____.
Naive dogs:
- CB: 88%
- PFI: 7mo
- MST: 19mo
Prior therapy dogs:
- CB: 75%
- PFI: 34mo
- MST: 36mo
49
***What 3 dog breeds are predisposed to developing thyroid neoplasia?
Husky, Goldens, Beagle
50
In a study of dogs that had cervical CT scan for unrelated reasons, the incidence of thyroid masses was ____%.
0.76%
51
Lymphatic drainage of the thyroid grand is the _____ and _____ lymph nodes.
cranial and caudal deep cervical lymph nodes
52
List 2 complications of unilateral thyroidectomy. List an additional complication that may be seen with total thyroidectomy.
- hemorrhage and laryngeal paralysis
- hypocalcemia
53
***In a study of 15 dogs treated with total thyroidectomy, the parathyroid was preserved in some cases but majority of cases, it was completely removed. Post-operative hypocalcemia occurred in ____% and long-term management was required in ____%. MST was _____. In another study with intentional preservation in 6 dogs, MST was _____ and mean ST was _____ with no recurrence.
- 73%
- 63%
- MST 38mo
- MST not reached
- mean ST: 30mo
54
Hypofractionated RT in 13 dogs with thyroid tumors reported a MST of _____ and _______ at the time of diagnosis was NOT prognostic. In another study with definitive fractionated RT in 8 dogs with invasive tumors, MST was ______.
Hypofractionated:
- MST: 24mo
- pulmonary metastasis NOT prognostic
Definitive fractionated:
- MST 24mo
55
A study of 20 dogs treated with palliative RT for ADVANCED thyroid tumors, MST was ______. The only prognostic factors reported in this study were ____________.
- MST: 6mo
- achieving a CR or PR
56
In a study of 43 dogs with thyroid tumors treated with I-131 +/- surgery, MST with I-131 alone was ______ and MST with I-131 and surgery was ______. In another study of 39 dogs, I-131 was used as primary therapy (twice the dose as previous study). MST without metastasis was ____ and MST with metastasis was _____. Name a serious complication found in this study and the % frequency.
1st study I-131 +/- surgery:
- MST I-131 alone: 30mo
- MST I-131 + sx: 34mo
2nd study I-131 (double dose):
- MST with no met: 28mo
- MST with met: 12mo
- fatal bone marrow suppression in 8%
57
The prognosis for dogs with unilateral mobile thyroid carcinoma is excellent with surgery alone with MST of ____ and 2- year survival of ___%.
MST: 3 years
2-year: 70%
58
What are 3 factors associated with metastatic disease of thyroid carcinoma in dogs? What factor is associated with reduced DFS?
1. Tumor diameter
2. Tumor volume
3. Bilateral disease
4. Gross and histologic evidence of lymphatic invasion - reduced DFS
59
***In a phase 1 study evaluating the response of Palladia in dogs with thyroid carcinoma and metastatic disease, clinical benefit was seen in ____% with a PR rate of ___% and SD rate of ___%.
- CB: 80%
- PR: 27%
- SD: 53%
60
Malignant thyroid carcinoma in cats is the least common cause of hyperthyroidism at ___-___%.
1-3%
61
The metastatic rate of thyroid carcinoma in cats is up to ___%.
70%
62
Approximately ___% of hyperthyroid cats have a NORMAL total T4. You can consider free T4 ONLY if cats have clinical signs of HT and the total T4 is _______. Free T4 should NEVER be used as screening test.
- 10%
- high normal range
63
Methimazole may cause blood dyscrasia, which is most likely to occur within __________.
first 3 months of treatment
64
***What are potential complications associated with thyroidectomy in cats?
- cardiac dysrhythmias (most significant intra-operative complication)
- hypocalcemia - 10-15%
- hypothyroidism
- Horner's syndrome
- laryngeal paralysis
65
***The reported doses of I-131 for the treatment of benign thyroid disease in cats is ____-____. For thyroid carcinoma, a higher ablative dose is needed at ___-____.
- benign: 2-6mCi
- carcinoma: 20-30mCi
66
***What is the response rate to I-131 for benign hyperthyroidism in cats?
95%
67
In a large study of hyperthyroid cats treated with I-131, MST was _____ and the most common cause of death was _____ and _____. In another study comparing I-131 to medical management, MST with I-131 was ____ compared to _____ with methimazole.
- MST: 2 years
- cancer or renal disease
- MST I-131: 4 years
- MST methimazole: 2 years
68
A decline in renal function is a risk of all effective treatments of hyperthyroidism and usually occurs within _______ of treatment.
1 month
69
______ is the most common cause of primary hyperparathyroidism.
Adenomas
70
***What breed has an autosomal dominant mode of inheritance for primary parathyroidism?
keeshonds
71
***What may you see on bloodwork with primary hyperparathyroidism? Vitamin D toxicosis and renal failure should cause what changes on bloodwork? What is diagnostic for primary hyperparathyroidism?
BW:
- Primary parathyroidism: hypercalcemia in face of low normal or hypophophatemia
- Vitamin D toxicosis and renal failure: hypercalcemia AND hyperphosphatemia
- diagnostic: normal or high PTH in face of hypercalcemia
72
***Up to _______ parathyroid glands can be removed without risk of permanent hypoparathyroidism.
3 out of 4
73
Serum ionized calcium should be monitored _____ a day for ____ - ____ days post-operatively after parathyroidectomy or ablative procedures.
twice daily for 5-7 days
74
When should hypocalcemia be treated?
1. iCa falls below 0.8-0.9mmol/L
2. Total calcium is less than 8-9mg/dL
3. Signs of tetany
75
_______ is recommended for Vitamin D supplementation with hypoparathyroidism as oral calcium alone is NOT sufficient.
calcitriol
76
A direct comparison of surgery, RFA, and ethanol ablation for primary hyperparathyroidism reported a control of hypercalcemia for ___% treated with surgery, ___% treated with ethanol ablation, and ___% treated with RFA.
- Surgery: 94%
- Ethanol ablation: 72%
- RFA: 90%
77
Recurrence following treatment of primary hyperparathyroidism is reported to be ____%. A second surgery or ablative procedure should be performed.
10%
78
Clinical signs, neurologic examinations, and survival in 116 dogs with insulinoma was evaluated. The MST for dogs undergoing surgery (________) was significantly longer than dogs undergoing medical management (_________).
- 20 months (surgery MST)
- 8 months (medical MST)
79
Outcomes after surgery for 49 dogs with insulinoma was evaluated. ___% had immediate resolution of hypoglycemia. The oMST was _______. The MST for dogs with resolution of hypoglycemia was _______ and the median euglycemic time was _____.
- 80%
- 19 months
- 24 months
- 14mo
80
***A retrospective study of 20 cats treated with surgery for insulinoma was performed. The oMST was ________ with 1-, 2-, and 3-year survival rates of ______%, ____%, and ___%.
- 29 months
- 1-year: 75%
- 2-year: 51%
- 3-year: 10%
81
Metastasis occurs in ___% of insulinomas in dogs. The most common locations are the ____ and ____.
50%
liver and regional lymph nodes
82
***Define the WHO staging scheme for insulinoma in dogs.
- Stage 1: confined to pancreas
- Stage 2: regional lymph node involvement
- Stage 3: distant metastasis
83
List 6 prognostic biomarkers for dogs with insulinoma.
1. Tumor stage
2. Tumor size
3. Ki67 index
4. Presence of necrosis
5. Stromal fibrosis
6. Nuclear atypia
84
What breeds are predisposed to insulinoma?
- Westie, GSD, GSP, Boxers, Labs, Goldens, Irish Setters, MBD
85
Abdominal ultrasound has low sensitivity and specificity for detecting metastatic lesions of insulinoma and identification and localization of a pancreatic mass occurs in ___% of patients.
<50%
86
____ is the most sensitive technique to identify insulinomas with a ___% rate reported in one study.
- CT
- 71%
87
***A starting dose of ______ is recommended for prednisone in dogs with insulinomas with gradual dose increases as needed to control glucose levels.
0.25mg/kg BID
88
_____ is a non-diuretic benzothiadiazine that suppresses insulin release fro beta cells, stimulates hepatic gluconeogenesis and glycogenolysis and inhibits cellular uptake of glucose.
diazoxide
89
What is the response rate of diazoxide for canine insulinoma?
70%
90
______ is a somatostatin receptor ligand that inhibits synthesis and secretion of insulin by beta cells.
octreotide
91
What is the response rate of octreotide in canine insulinoma?
50%
92
***The MST following surgery dogs with insulinoma is reported to be ___-___. Clinical stage of disease is a prognostic factor. Stage I dogs have a median duration of control of _____ after surgery. ___% of dogs with stage 2 or 3 are free of hypoglycemia by 14 months. Dogs with metastasis have a MST of _____ following surgery. A more recent retrospective study showed an improved ST in dogs undergoing surgery. DFI was ____ and oMST was ____. 47% of dogs treated with surgery and post-operative prednisolone had a MST of _____. Dogs treated with medical therapy alone had a MST of ____. When evaluating stage and outcome, this paper reported a MST of ____ for stage I, ____ for stage II, and ____ for stage III.
- MST: 12-14mo
- Stage 1: median duration of control 14mo
- Stage 2 and 3: <20% by 14mo
- MST metastasis: 6mo
- DFI: 17mo
- MST: 26mo
- MST subset (47%): 3.6 years
- MST med alone: 6mo
- MST stage I: 26mo
- MST stage II: 18mo
- MST stage III: 7mo
93
_________ is a triad of a non-beta cell neuroendocrine tumor in the pancreas, hypergastrinemia, and GI ulceration.
Zollinger-Ellison syndrome
94
Gastrinoma metastatic rate is ____% at diagnosis.
85%
95
***How to diagnose gastrinoma?
Measure basal serum gastrin levels
96
________ is recommended for patients with suspected gastrinoma. Long-term medical management consists of _____, _____, and _____.
- exploratory laparotomy
- PPIs, H2-antihistamines, and sucralfate
97
Survival times of gastrinoma range from ____ - ____.
1 week to 26 months
98
What skin condition is associated with glucagonoma?
Necrolytic migratory erythema
99
Glucagonoma arises from ____ cells in the pancreas.
alpha
100
________ is the treatment of choice for glucagonoma.
Surgical resection or debulking
101
___% of cats with acromegaly treated with hypofractionated RT had improved diabetic control for up to _____ months.
- 92%
- 60mo
102
What is the complication rate of US-guided FNA of adrenal lesions?
- 5-8%
- older paper: 5%
- newer paper (Pey 2020): 8%
103
The outcome of 9 dogs undergoing bilateral adrenalectomy reported a MST of ____ for those that survived to discharge. ___% died due to perioperative complications.
- MST: 18mo
- 11%
104
Phenoxybenzamine has been suggested to decrease the postoperative mortality rate of dogs undergoing adrenalectomy for pheochromocytoma. According to the study by Herrera et al, the preoperative administration of phenoxybenzamine for a median duration of 20 days decreased mortality rate from _____ to ______?
48% to 13%
105
What is the reported median time to develop hypothyroidism after radiation therapy in dogs with thyroid carcinomas? ____% developed hypothyroidism after various RT protocols.
6 months
48%
106
***Which type of multiple endocrine neoplasia syndromes has loss of function of germline tumor suppressor genes and which type has gain of function of protooncogene, RET?
- MEN1: loss of function of TSG
- MEN2: Gain of function oncogene (RET)
107
What types of tumors make up MEN1, MEN2, and MEN3 (formally known as MEN2b)?
MEN1:
- Parathyroid tumor
- Pituitary tumor
- Pancreatic islet cell tumors
MEN2:
- Parathyroid tumor
- Pheochromocytoma
- Medullary thyroid tumor
MEN3:
- Mucosal neuroma
- Pheochromocytoma
- Medullary thyroid tumor
108
The most common multiple endocrine neoplasia in the dogs occurs in what organ? Cat?
- dog: adrenal
- cat: thyroid
109
What is the optimum cutoff size of parathyroid gland for differentiating hyperplastic and neoplastic parathyroid glands with ultrasound in dogs
3mm (size does not correlate with histopath so use caution)
110
What percentage of dogs receiving parathyroidectomy for parathyroid carcinoma have hypocalcemia post-operatively? Estimated 1 year survival was ___%, 2-year was ___%, and 3-year was ___%. For adenomas, 39% are hypercalcemic but only ___% become clinical.
- 34% (newer) - 47% (older paper)
- 1 year: 72%
- 2 year: 37%
- 3 year: 30%
- 10%
111
What IHC marker is used for definitive diagnosis of gastrinoma in dogs?
gastrin
112
SRT (15GY x 1 or 8Gy x 3) was evaluated in 45 dogs with pituitary tumors. MST was ____ and clinical improvement was seen in ___%. Shorter outcomes were seen in this study compared to dogs treated with fractionated RT in prior studies.
- MST: 10mo
- improvement: 82%
113
A recent paper evaluated outcome in 14 cats with insulin resistance and acromegaly treated with stereotactic radioSURGERY (SRS - 17Gy). Insulin dose was decreased in ___% of cats and median time to lowest insulin dose was _____. ___% of cats entered diabetic remission and MST was ___.
- dose decrease: 71%
- median time to lowest dose: 13mo
- remission: 21%
- MST: 24mo
114
What is the sensitivity and specificity for plasma normetanephrine and metanephrine in diagnosis of pheochromocytoma in dogs?
Plasma normetanephrine:
- Se 100%
- Sp: 94-98%
Plasma metanephrine:
- Se: 63-73%
- Sp: 94-97%
115
What is the half-life of GH and IGF-1?
- GH: 10-30min
- IGF-1: 12-15h
116
What is the clinical benefit rate for dogs with inoperable or metastatic pheochromocytoma? PR and SD?
- CB: 100%
- PR: 20%
- SD: 80%
117
SBRT in 8 dogs with pheochromocytoma was recently evaluated. ____% experienced complete resolution of clinical signs and reduced urine normetanephrine:creatinine ratio and/or tumor size. ___% were alive at 26 months.
- 100%
- >50%
118
Outcome in 51 dogs undergoing adrenalectomy for small (
- mortality: <10%
- major comp: 12%
- 1 year DSS: 83%
119
Perioperative morbidity and mortality in 45 dogs with invasive adrenal neoplasms treated by adrenalectomy and cavotomy was recently assessed. Mortality rate was ___% and oMST was ____. _____ was associated with increased risk of death.
- mortality rate: 24%
- oMST: 18mo
- post-diaphragmatic thrombus
120
A recent retrospective study evaluated the short and long-term survival after adrenalectomy in 53 dogs with pheochromocytomas with or without alpha-blocker therapy. MST for those who survived to discharge was ____, metastatic rate was ___%, and LR was ___%. Pre-operative alpha blocker was NOT associated with increased survival. The mortality rate was ___% in this study.
- MST: 3.2 years
- met: 15%
- LR: 5%
- Mortality: 17%
121
A recent group evaluated 9 dogs with thyroid carcinoma to determine to safety and efficacy of ultrasound-guided core needle biopsy. ___% had minor localized hemorrhage and biopsy was diagnostic in ___% of cases. The authors concluded UGCNBs can be safely obtained in suspected canine thyroid carcinomas and enable a reliable diagnosis.
- minor hemorrhage: 77%
- diagnostic: 88%
122
Two recent papers evaluated the outcomes in dogs with functional thyroid tumors. In the first paper, _____ and ______ breeds were commonly presented, the MST was _____ after surgery alone, and ______ and ______ were the most common clinical signs. In the second paper with a larger group of dogs (n=70), oMST was ___, MST with surgery was ____ and MST without surgery was _____. ____% of dogs developed hypothyroidism following surgery.
1st paper:
- Goldens and Labs
- MST: 2.9 years
- PU/PD and weight loss
2nd paper:
- oMST: 35mo
- MST sx: 72mo
- MST no sx: 16mo
- 64% hypothyroidism
123
Outcome and posteroperative complications in 73 dogs with thyroid carcinoma with gross vascular invasion managed with thyroidectomy was recently evaluated. The complication rate was ___%, LR occurred in ___% at a median of ____, distant metastasis occurred in ___% at a median of ____. MST was ____, DSS was ____ and 1-year survival was ___%.
- complication: 23%
- LR: 10% at median 8mo
- distant met: 12% at median 12mo
- MST: 21mo
- DSS: Not reached
- 1 year survival: 83%.
124
***A recent retrospective study evaluated outcome of 156 dogs with thyroid tumors undergoing unilateral thyroidectomy. MST was ____, ___% survived to discharge, complication rate was ___%, _____ was the most common intra-operative complication and _____ was the most common post-operative complication.
- MST: 30mo
- 98% survived to dischage
- complication: 20%
- hemorrhage
- aspiration pneumonia
125
The safety and efficacy of SBRT (15 to 40Gy in 1-5 fractions) was recently retrospectively assessed in 23 dogs with thyroid carcinoma. The ORR was ___% with a CR of ___% and PR of ___%. ___% achieved improvement in clinical signs at median of _____. PFS was _____ and MST was _____. Pulmonary metastasis did NOT affect survival with a MST of ______.
- ORR: 70%
- CR: 17%
- PR: 43%
- Improvement: 81%
- PFS: 11mo
- MST: 12mo
- MST lung met: 12mo
126
Familial follicular cell thyroid carcinomas has been identified in what Dutch breed?
German longhaired pointers
127
A recent retrospective study evaluated response of canine thyroid carcinoma to radioiodine in 66 dogs. The ORR was ____% with improvement of clinical signs seen in ___%. PFS was ____ and OST was ____.
- ORR: 35%
- Improvement: 76%
- PFS: 10mo
- OST: 19mo
128
A retrospective study of 15 dogs treated with transsphenoidal hypophysectomy for nonfunctional sellar masses reported a perioperative mortality rate of ____%, oMST of ____, and MST of _____ when excluding dogs that had died before discharge.
- mortality: 33%
- oMST: 8mo
- MST excluding dead: 24mo
