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58 Cards in this Set

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