Podcast
Questions and Answers
What is a common presenting symptom in cases of neoplasia of the chest?
What is a common presenting symptom in cases of neoplasia of the chest?
Which diagnostic technique is commonly used to differentiate between lymphoma and thymoma?
Which diagnostic technique is commonly used to differentiate between lymphoma and thymoma?
What is the median survival time for cats diagnosed with thymoma?
What is the median survival time for cats diagnosed with thymoma?
What is the typical prognosis after surgery for hemangiosarcoma?
What is the typical prognosis after surgery for hemangiosarcoma?
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Which of the following is a paraneoplastic sign associated with neoplasia of the chest?
Which of the following is a paraneoplastic sign associated with neoplasia of the chest?
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Which approach to the thorax is NOT mentioned as a surgical option for chest neoplasia?
Which approach to the thorax is NOT mentioned as a surgical option for chest neoplasia?
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Which imaging technique is NOT typically utilized to diagnose cardiac issues?
Which imaging technique is NOT typically utilized to diagnose cardiac issues?
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What is a common differential diagnosis for neoplastic hemorrhagic effusion?
What is a common differential diagnosis for neoplastic hemorrhagic effusion?
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What percentage of dogs diagnosed with thymoma underwent surgery?
What percentage of dogs diagnosed with thymoma underwent surgery?
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Which of the following is a surgical approach used for chest wall tumors?
Which of the following is a surgical approach used for chest wall tumors?
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Which of the following instruments is typically NOT used in thoracic surgery?
Which of the following instruments is typically NOT used in thoracic surgery?
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What is the recurrence rate for osteosarcoma after chemotherapy as reported?
What is the recurrence rate for osteosarcoma after chemotherapy as reported?
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Which breed is most commonly associated with thymoma?
Which breed is most commonly associated with thymoma?
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Study Notes
Neoplasia of the Chest
- Nick Bacon is a specialist in surgical oncology, clinical director at AURA Veterinary, and professor of surgical oncology at the University of Surrey.
- He has several veterinary certifications including MA VetMB, CertVR, CertSAS, DiplECVS, DACVS, and FRCVS.
- He is a founding fellow of the ACVS (American College of Veterinary Surgeons) and a RCVS specialist in surgical oncology.
Conflict of Interest
- The presenter has no relevant financial interests, arrangements, or affiliations with any organization or business entity that could be perceived as a conflict of interest or bias in the context of the presentation.
Plan
- The plan includes reviewing neoplastic conditions, diagnostic imaging, procedure details (requirements and risks), and prognosis.
Tissues Affected
- The affected tissues include the thymus, heart, lymph nodes, esophagus, trachea, and chest wall.
Typical Patient History
- Symptoms often include weight loss, cough, lethargy, tachypnea (rapid breathing), inappetence (loss of appetite), increased respiratory effort (sometimes), collapse, and chest wall mass.
Physical Examination
- Physical examination may reveal decreased lung sounds, muffled heart sounds, jugular venous distension, and head and neck distension.
Ascites and Pleural Effusion
- Ascites and pleural effusion are possible findings.
Paraneoplastic Signs
- Possible paraneoplastic signs include mega-esophagus, exfoliative dermatitis, and hypercalcaemia.
Cranial Mediastinal Mass Differential Diagnoses
- Potential diagnoses include thymoma, lymphoma, ectopic thyroid, rib mass extension, and branchial cyst.
Diagnosis
- Diagnosis often involves ultrasound-guided aspirate, flow cytometry, and/or ultrasound-guided Tru-cut biopsy.
Approaches to Thorax
- Surgical approaches include lateral/intercostal thoracotomy, median sternotomy, and thoracoscopy.
Instruments
- Instruments can include oscillating/sagittal saws, mini-drivers, and Finochietto rib retractors.
Malleable Retractors
- Malleable retractors are used to expose and manipulate tissues during surgery. The right auricular appendage is sometimes a visible landmark.
Satinsky Vascular Clamps
- Satinsky vascular clamps are used for blood vessel control.
Thymoma
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38% of cases are in Labradors or Golden Retrievers.
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17% have myasthenia gravis.
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34% have hypercalcaemia.
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27% have another tumour.
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72% undergo surgery.
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Median survival time for dogs with surgery is 635 days.
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Dogs without surgery have a median survival time of 76 days.
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In cats, Median survival with thymoma is 825 days and 1-year and 3-year survival rates are 89% and 74% respectively.
Pericardial Effusion
- Possible diagnoses include idiopathic hemorrhagic effusion and neoplastic hemorrhagic effusion.
- Investigation may include cardiac ultrasound and staging.
- Treatment often includes pericardectomy, and excision of the right auricle.
Haemangiosarcoma
- This is a condition.
Teflon Stents
- Teflon stents are used during procedures to treat issues like haemangiosarcoma.
OSA/Primary Rib Tumors
- Median survival times for dogs with OSA with 290 for 19/23 chemo and 119d for 13 cases.
- Recurrence rates are 12% with chemo and 0% without.
- Metastasis rates are 75% with chemo and 38% without.
- 34 OSA were treated and followed for a further period (DFI 225d (chemo) vs 60d (no chemo)).
Chest Wall Resections
- Steps involve cutting skin, resecting muscle and bone, further dissecting muscle to cover defects, closing skin, and inserting chest drains.
- Average recovery time is 2-5 days post-surgery.
Deep Pectoral Muscle
- The deep pectoral muscle is a type V muscle with a lateral thoracic blood vessel supply.
What We've Covered
- Key topics were reviewed, including types of diseases, successful imaging techniques, suitable instruments, surgical approaches, and the prognosis.
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Description
This quiz covers neoplastic conditions affecting the chest in veterinary patients, detailing diagnostic imaging, procedural requirements, and prognostic factors. Review typical patient histories and tissues involved, including the thymus and heart, guided by expert insights from Nick Bacon, a specialist in surgical oncology.
