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Flashcards in Tumors or GI tract Deck (56)
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1

What is the 4th most common site of D/C tumors

Oral tumors

2

Oral tumors occur more in what species and sex

Dog, Male

3

Oral tumor presenting complaint

middle aged -> older
visible mass: difficulty eating, oral bleeding, halitosis
Recent dental hx

4

Genetic predisposition to oral tumors

Boxers, GSD, Goldens, Cockers, Mini poodle, German SHP, Gordon Setter, Chows, Weimaraner

5

Oral tumor differential diagnosis - Dog

Melanoma. SCC. Fibrosarcoma.
OSA.
Odontogenic tumors (epulides)

6

Oral tumor differential diagnosis - Cat

SCC. Fibrosarcoma.

7

Oral tumor Work up & Staging

Cytology - ineffective
Biopsy
Radiographs - low yield
Lnn Staging w/ FNA
3 view thoracic met check (ALL)

8

Oral tumor biopsies

proliferative mass - shave biopsy
Non proliferative mass - incisional

9

Oral Malignant melanoma

Black or melanotic melanoma
80% mets (high malignancy - lungs/lnn)
thorough staging! Biopsy

10

Oral Malignant melanoma biggest failure

systemic mets

11

Oral SCC

locally invasive, low mets.
Cats: paraneoplastic hyperCa. Sublingual site preferred

12

Oral Fibrosarcoma

Young, large breeds
very invasive but looks benign - don't believe fibroma histopath.

13

Oral Fibrosarcoma biggest failure

recurrent disease: didn't resect it all

14

Odontogenic tumor origin

periodontal ligament

15

3 types of odontogenic tumors

Acanthomatous ameloblastoma
Peripheral odontogenic fibroma
Feline inductive odontogenic tumor

16

Acanthomatous ameloblastoma

locally invasive (bone) no mets
very aggressive sx required - 1 cm margins
Shetland and sheep dogs, rare in cats

17

Peripheral odontogenic fibroma

slow, benign - no bone involvement
common in dogs
cryotherapy

18

Feline Inductive odontogenic tumor

young cats (8-18m)
locally invasive

19

Treatment of oral tumors

Aggressive Sx excision - almost all have bone involvement
2cm margins for malignancies

20

Radiation and chemo or oral tumors

Adjunct RT - melanoma!, SCC, Acanthomatous ameloblastoma, FSA.
Chemo not commonly used

21

Oral positive prognostic indicators

Smaller tumor
Rostral location
Complete resection
No evidence of preop mets

22

Esophageal tumors

Rare.
Older animals
S. lupi - sarcomas
esophageal obstruction, stricture, 2˚ aspiration pneumonia

23

Differential diagnosis of esophageal tumors

SCC
Leiomyosarcoma

24

feline esophageal SCC tumor

females.
Middle 1/3rd, caudal to thoracic inlet

25

Esophageal work up and staging

Imagining - megaesophageus?
Esophagoscopy (GS)- biopsy
fecal

26

Esophageal tumor therapy

Surgery!
best for low grade leiomyosarcomas
RT - limited
Palliation - feeding tube

27

Esophageal tumor prognosis

Very poor
benign/low grade/LSA can be okay

28

Drug to resolve S. lupi infection

Dormectin

29

Gastric tumors

uncommon
males
chronic gastritis, helicobacter
Asymptomatic until blocking outflow - anorexia/hematemesis

30

Gastric tumor genetic predilection

Belgian shepherd, chows
Benign - beagles

31

Gastric Tumor dog differentials

Big 2
Adenocarcinoma (70-80%)
Leiomyosarcoma

32

Gastric tumor Cat differentials

Big 1
Lymphoma

33

Cat systemic status w/ gastric lymphoma

negative FeLV
possible concurrent LSA in small intestine

34

Gastric ademocarcinoma

predictable - pyloric antrum/lesser curvature
Scirrhous (leather)
High met rate (anywhere)
deeply ulcerative

35

Gastric work up and staging

Non specific lab
Abdominal US (decreased motility)
ENDOSCOPY - biopsy

36

Gastric leiomyomas

well circumscribed, submucosal mass
cardiac location - benign

37

Gastric tumor Treatment

Surgical excision
partial gastrectomy
gastroduodenostomy/jejunostomy (bilroth 1 or 2) - high morbidity

38

Gastric tumor prognosis

surgical excision, tumor type/grade, mets.

39

ACA Gastric tumor prognosis

poor - majority dead in 6m

40

LSA Gastric tumor prognosis

Doesn't respond to chemo,
resect and chemo might not be needed

41

Leiomyosarcoma Gastric tumor prognosis

12-21m
Cured with aggressive surgery

42

Intestinal tumors

older animals, same presentation as gastric tumors

43

Intestinal tumor Dog

uncommon
Large intestine!
Collie, GSD, male

44

Intestinal tumor cat

uncommon
Small intestine!

45

Intestinal tumor work up/staging

similar to gastric -
Goal: rule out LSA (no sx tx)
endoscopy (understand limits)
US guided FNA/cytology

46

Intestinal tumor differential diagnosis dog

Big 3
LSA > ACA > Leiomyosarcoma
GIST

47

Intestinal Tumor differential diagnosis cat

Big 3
LSA, ACA, MCT
no order

48

Intestinal tumor treatment

Exploratory laparotomy - R&A
except LSA
4-8cm margins
assess mesenteric and regional lnn

49

LSA intestinal tumor DOG

T cell, multifocal
not good remission or survival
Neg prog. factors: Failed to achieve remission

50

LSA intestinal Tumor CAT

responds well to chemo
prognostic factor: response to tx

51

ACA intestinal tumor dog

44% met rate - stage!
female neg prognosis?

52

ACA intestinal tumor cat

72% mets on dx
neg prognostic: histo subtype and mets

53

MCT intestinal tumor dog

100% mortality in 2m.
100% met rate.
BAD

54

MCT intestinal tumor cat

poor - euthanize/death
*solitary MCT w/o mets have good survival

55

Leiomyosarcoma intestinal tumor

old data.
8m MST dogs
cat - very uncommon

56

Gastrointestinal Stromal Tumor (GISTs)

IHC can differentiate from leiomyosarcoma
from cells of cajal (GI pacemaker)
express c-kit
predilection for cecum
die from septic peritonitis (ruptured mass)