Neoplasia of the Chest in Veterinary Oncology

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

• 38% of cases are in Labradors or Golden Retrievers.

• 17% have myasthenia gravis.

• 34% have hypercalcaemia.

• 27% have another tumour.

• 72% undergo surgery.

• Median survival time for dogs with surgery is 635 days.

• Dogs without surgery have a median survival time of 76 days.

• 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.