Urinary Tract and Mammary Gland Tumors

Question 1

What are the 4 types of Renal tumors?

Answer 1

1. Renal Cell Carcinoma
2. TCC
3. Nephroblastoma
4. Lymphoma

Question 2

What causes Cystadenocarcinoma in German Shepherd Dogs ?

Answer 2

Mutation in the BHD gene - folliculin

Question 3

Where are the two types of neoplasia that occurs in the bladder?

Answer 3

Transitional Cell Carcinoma

Rhabdomyosarcoma

Question 4

What are the two types of neoplasia that occurs in the Urethra?

Answer 4

TCC

Granulomatous urethritis

Question 5

What is a type of neoplasia that can occur in BOTH urethra and bladder ?

Answer 5

TCC

Question 6

A FEMALE, OBESE Westhighland Terrier (Small Breed Dog) presents with hematuria, dys/polla/strang-uria. What are the top two differentials for this case? How would you differentiate them?

Answer 6

TCC or UTI.

For TCC, animal’s signs will resolve with Abs but once the course is over, the signs will recur again.

TCC will also have mass in bladder

Other ddx to rule out include : Diabetes, Cushings and Uroliths

Question 7

If you suspect TCC in the patient, would you perform FNA/cystocentesis ?

Answer 7

NO !! Tumor seeding may occur.

Question 8

How would you treat TCC?

Answer 8

Sx: Apically located tumors –> cystectomy
with Chemo (Mitoxantrone and Piroxicam).
IMPORTANT : Give them, NSAIDs - Piroxicam, Deracoxib and Firocoxib !!

Question 9

An OLDER, NEUTERED male dog presents with HEMATURIA, STRANGURIA, POLLAKIURIA and POOR URINE STREAM. Upon transrectal examination, the prostate feels enlarged. What is the most likely dx?

Answer 9

CANINE PROSTATIC NEOPLASIA

Question 10

Which organs does CANINE PROSTATIC NEOPLASIA typically metastasize to?

Answer 10

Lung or Bone

Question 11

How would Canine Prostatic Neoplasia present itself in the following modalities ?

Answer 11

Abd rads : prostatomegaly, mineralization or Bone metastasis
Chest rads or CT: mets –> lung or bone
Ultrasound - capsule disruption and mineralization

Question 12

Is Canine Prostatic Neoplasia ANDROGEN dependent ?

Answer 12

NOPE

Origin: ductal epithelium

Question 13

What is the treatment for Canine Prostatic Neoplasia ?

Answer 13

NSAIDS : Piroxicam
Radiation Therapy : Palliative
Definitive Radiation Therapy and Chemotherapy

Question 14

What is the prognosis for Canine Prostatic Neoplasia ?

Answer 14

POOR

Question 15

A 11 year old, intact obese female dog presents with mammary gland enlargement, what is your most likely dx?

Answer 15

Canine Mammary Tumor

Question 16

What are the % of malignancy in for canine mammary tumors?

Answer 16

50% Malignant and %50% will metastasize

50% : Benign

Question 17

What are the clinical signs of malignancy for canine mammary tumors?

Answer 17

Rapid growth
Ulceration
Inflammation
Poorly circumscribed 
Fixed to muscle or skin

Question 18

Describe a Stage 1 Mammary Gland Tumor for canines

Question 19

Describe a Stage 2 Mammary Gland Tumor for canines

Answer 19

3-5cm - no node involvement

Question 20

Describe a Stage 3 MGT for canines

Answer 20

> 5cm - no node involvement

Question 21

Describe a Stage 4 MGT for canines

Answer 21

0: no node involvement
I: local node metastasis
II: bilateral node involvement

Question 22

Describe a Stage 5 MGT for canines

Answer 22

0: no mets
I: Distant metastasis to liver and bone

Question 23

How would you treat Mammary Gland Tumors for canines ?

Answer 23

SURGERY - LUMPECTOMY, MAMMECTOMY and REGIONAL MASTECTOMY! Ovariohysterectomy is recommended.

Question 24

When is a lumpectomy for MGT indicated ?

Question 25

When is a mammectomy for MGT indicated ?

Answer 25

>1 cm or fixed - remove fascia underneath

Question 26

When is a regional mastectomy indicated?

Answer 26

When you have multiple large tumors. - Glands 1,2 or 3 --> axillary LNs - Glands 4,5 - inguinal LNs

Question 27

If there are negative prognostic factors for the Mammary Gland Tumor, what medical therapy is indicated?

Answer 27

Carboplatin and NSAID

Question 28

What is the Mean Survival Time for a primary mammary gland tumor that is less than 3 cm with no metastasis

Answer 28

2 years with surgery

Question 29

What is the Mean Survival Time for a primary mammary gland tumor that is more than 5 cm ?

Answer 29

10 months with surgery If there are nodal metastasis --> 2-5 months

Question 30

What are the 6 factors that are NOT prognostic for mammary gland tumors ?

Answer 30

``` # of tumors Glands involved Type of Sx Age Breed Weight ```

Question 31

Almost all tumors

Answer 31

1cm. REMOVE when they are still small !

Question 32

Tumors > than ___ months have a higher risk of metastasis

Answer 32

6 months

Question 33

A 12 year old, intact, Siamese cat presents with fixed, inflammed and ulcerated mammary tumors. If this tumors are malignant, which two organs is it most likely to metastasize to ?

Answer 33

Lymph nodes and Lungs

Question 34

Describe the Modified Staging Scheme for Mammary Gland Tumor for cats

Answer 34

Stage 1 : 3 cm, no nodal metastasis Stage 4: >3 cm : 1: nodal metasis Stage 5 (0) : absent

Question 35

How would you treat mammary tumors in cats ?

Answer 35

COMPLETE RADICAL MASTECTOMY - removal of entire chain and inguinal node +/- fascia --> if bilateral , remove one chain followed by the other OHE is recommended but there is no proven benefit Chemotherapy with either Carboplatin and Piroxicam or Doxorubicin

Question 36

A young cat, less than 2 years old presents with massive swelling, ulceration and edema of the mammary glands . What is the most liely dx for this cat?

Answer 36

Fibroepithelial Hyperplasia.

Question 37

What is the CAUSE of FIBROEPITHELIAL HYPERPLASIA ?

Answer 37

Pregnancy or progestins

Question 38

What is the treatment of FIBROEPITHELIAL HYPERPLASIA ?

Answer 38

OHE : Flank incision