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58 Cards in this Set
- Front
- Back
What local treatments are available for treatment of tumors of the nasal tract?
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surgery and radiation therapy
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What systemic treatments are available for tumors of the nasal tract?
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chemotherapy
immunotherapy targeted therapy |
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What is the most common tumor of the respiratory tract and comprises 60-80% of tumors?
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Sino-nasal tumors
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What type of dogs and cats do you usually see sino-nasal tumors in?
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older medium to large breed dogs
DSH dolicocephalic breeds may be predisposed |
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Is FeLV a risk factor for nasal tumors?
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No
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What accounts for most of the tumors seen in dogs?
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Carcinoma (epithelial) accounts for 2/3 followed by sarcoma (mesenchymal)...lymphoma accounts for very little
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What accounts for the most common tumor seen in cats?
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Cats you most often see lymphoma. Lymphomas are seen a lot more than either carcinomas or sarcomas
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What is the biological behavior like of these tumors?
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they are locally invasive and don't commonly metastisize
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If these tumors do metastasize where do they end up going?
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regional LN
lungs |
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What are some of the clinical signs that animals with nasal tumors may have?
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are referable to the nasal cavity
-decreased nasal airflow -nasal discharge -epistaxis -sneezing -congestion/stertor -facial deformity -inappetance (cats) -ocular discharge -seizures or obtunded (rare) |
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What is the goal of your diagnostic approach if you suspect nasal neoplasia?
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you are going to rule out systemic disease
you will look at the nose and face and assess the appearance and the airflow -you also want to look at lymph nodes |
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What is your diagnostic approach like?
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CBC, chemistry, UA
T4, FeLV/FIV If epistaxis -BMBT -blood pressure -ACT, PT, PTT? -Cross match and typing potentially ---> also want to rule out infectious causes |
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What is baseline staging?
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cytology of regional lymph node
thoracic radiographs (3 views) |
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What do you want to do in baseline staging with a feline lymphoma?
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abdominal US and bone marrow aspirate
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What do nasal radiographs assess?
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symmetry
bone or turbinate destruction masses or variations in opacity soft tissue changes |
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Is nasal CT necessary for staging and radiation planning?
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yes
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What does Nasal CT assess?
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location
presence/absence of mass osseous involvement disease extent invasion into adjacent structures |
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What are your methods for getting a tissue biopsy?
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-vigorous nasal flushing
-blind nasal biopsy -visual guidance -trephination or sx biopsy |
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What should you be prepared for when doing a nasal biopsy?
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hemorrhage
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What type of treatment is the standard of care for nasal tumor?
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radiation therapy
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What is the median survival with RT?
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greater than 1 year
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is surgery a good option?
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no
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What are some other treatments?
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NSAIDS
chemotherapeutics Toceranib maybe |
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What type of radiation therapy are we going to use?
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external beam radiation sources
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What is a post radiation toxicities that you can have late?
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alopecia
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What is the prognosis for dogs?
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13-18 months MST
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What is the prognosis for cats with lymphoma?carcinoma?
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lymphoma > 18 months median survival time
carcinoma approximately 12 months median survival time |
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Are you more likely to see primary lung tumors or metastatic lung tumors?
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METASTATIC
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When are you more likely to see primary lung tumors?
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in dogs
older animals brachycephalic dogs |
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When do you see a higher metastatic rate (dogs vs. cats)?
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cats
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What is the makeup of epithelial tumors?
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70% adenocarcinoma
20% carcinoma poorly differentiated carcinoma |
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What are metastatic sites?
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regional Ln
lungs extrathoracic sites especially in cats! |
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What are some clinical signs you see with lung tumors?
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incidental finding
-may have chronic cough or hemoptysis -lethargy -tachypnea/dyspnea -lameness |
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What is a reason that dogs may present with lameness with a lung tumor?
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hypertrophic osteopathy
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What is something you want to do when you see lysis of P3 in a cat?
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take rads you will probably see a lung tumor (i.e. lung digit syndrome)
it is likely a squamous cell carcinoma that has metastasized in this case |
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Are masses usually solitary in dogs?
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yes
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What part of the lung lobes more often have tumors?
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caudal lung lobes simply because there is more lung tissue
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What can thoracic Ct identify much better than chest films?
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lymph nodes
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What are some negative prognostic indicators in dogs?
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-presence of metastasis
-pleural effusion -tumors greater than 5cm -presence of clinical signs -squamous cell carcinoma -poorly differentiated tumors |
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What are some negative prognostic indicators for cats?
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-poorly differentiated tumors
-metastasis to the digits -probably presence of metastasis to lyph nodes |
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What is the long term survival possible for dogs with a solitary, small, and well differentiated lung tumor?
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survival time is typically greater than 1-2 years
If SCC or LN metastasis, we hope for 3-6 months |
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When can chemotherapy be used?
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if negative prognostics exist. Optimal protocols are not known.
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o cats tend to do as well as dogs?
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NO
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digital metastasis median suvival?
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1 month
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Poorly differentiated tumors in cats median survival?
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2-3 months
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What are some things we can do in cats?
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chemo
palladia (toceranib) nsaids analgesics (buprenorphine) |
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What are some reasons that the lungs are frequent sites of metastasis for both carcinomas and sarcomas?
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pulmonary capillary bed
-growth factors, oxygen, etc. that facilitate growth |
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Are metastatic tumors more common than primary in the lung?
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yes
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What are the clinical signs like in metastatic lung disease?
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-usually reflect the primary tumor
-respiratory signs often absent -often nonspecific |
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What are the chest x-rays usually like in metastatic lung disease?
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they are variable
-well defined interstitial nodules -ill defined alveolar pattern -alveolar pattern |
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If a primary tumor is identified is metastatic lung disease often presumptive?
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yes
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What are your differentials for metastatic lung disease?
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-systemic fungal disease
-mycobacterial -eosinophilic granuloma |
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What is the prognosis like for metastatic lung disease?
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poor prognosis
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What is the treatment for metastatic lung disease?
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-usually palliative measures
chemotherapy biphosphonates NSAIDS |
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Is metastatectomy a good option for metastatic lung disease?
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It is rarely a good option
it will allow control f the primary tumor for greater than 300-360 days -it is good if you have less than 3 metastatic lesions -radiographically determine the doubling time greater than 40 days |
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Is pleural neoplasia rare?
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yes
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Is primary pleural neoplasia reported in dogs and cats?
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yes
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Is pleural neoplasia often a primary extension from other sites? where?
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yes ;
rib or body wall sarcoma (chondrosarcoma, osteosarcoma) pulmonary carcinoma |