Veterinary Cancer Diagnosis Quiz

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Questions and Answers

What is the reported success rate of ultrasound-guided aspirate for mass evaluation?

60-70%

80-90% (correct)

50-55%

95-100%

What is the main disadvantage of using a median sternotomy approach?

Higher risk of surgical site infection

Requires extensive cutting of intercostal muscles

Longer hospital stay

Poor access for inspecting lymph nodes (correct)

Which type of cancer has a better prognosis in dogs with solitary lesions?

Lymphoma

Melanoma

Sarcoma

SCC (correct)

What is a consideration when performing an ultrasound-guided aspirate?

Not recommended if abscess suspected Signup and view all the answers

What is one of the primary approaches used for accessing tumors of the lung?

Lateral thoracotomy Signup and view all the answers

What is the treatment of choice for superficial lesions associated with squamous cell carcinoma?

Nasal planectomy Signup and view all the answers

Which of the following conditions is commonly associated with paraneoplastic signs in respiratory tumors?

Hypertrophic osteopathy Signup and view all the answers

What is a key difference in prognosis between dogs and cats with respiratory neoplasia?

Cats typically have better long-term survival Signup and view all the answers

Which imaging technique is recommended for assessing thoracic conditions such as neoplasia?

Thoracic radiographs Signup and view all the answers

What typical symptom is most commonly observed in patients with lung neoplasia?

Cough Signup and view all the answers

Which cell type is most commonly associated with canine primary lung tumors?

Adenocarcinoma Signup and view all the answers

What is the median survival time for dogs with lung tumors that do not have lymph node metastasis?

12+ months Signup and view all the answers

Which histological type of lung tumors has the highest metastatic potential in cats?

Adenocarcinoma Signup and view all the answers

Which of the following is not a typical symptom reported in patients with lung neoplasia?

Increased appetite Signup and view all the answers

What is the common age range for dogs diagnosed with primary lung tumors?

5-12 years Signup and view all the answers

Study Notes

Neoplasia of the Respiratory System

Nick Bacon is an ACVS Founding Fellow, Surgical Oncology RCVS Specialist, Clinical Director, AURA Veterinary, and Professor, Surgical Oncology, University of Surrey
He has several professional qualifications: MA VetMB, CertVR, CertSAS, DiplECVS, DACVS, and FRCVS.
A conflict of interest is not relevant in the presentation.

Respiratory Tract

Structures include the nasal planum/nose, trachea, and lungs.

Squamous Cell Carcinoma

Biopsy often reveals inflammation, rather than the desired neoplasia.
Images show varying degrees of the condition in different animals.

Staging

Lymph node aspiration is important.
Pulmonary metastasis is rare.
Less aggressive than oral SCC in cats.
Just as aggressive as oral SCC in dogs.

Treatment

Available options for superficial lesions include: Strontium 90, cryosurgery, intralesional chemotherapy, and photodynamic therapy.

Treatment and Prognosis

Nasal planectomy is the treatment of choice.
Radiation therapy is an option.
Local control and cosmetics are usually poor outcomes with radiation.

Animals presented

Cats and dogs are included in the presentation.
Images show the progression of the condition in different animals.

Tracheal Mass

Causes can include neoplasia, parasitic infection, and granulomas.
Diagnosis may require radiography and tracheoscopy.
Images show cases of tracheal masses, along with procedures.

Tracheal Resection and Anastomosis

A diagrammatic representation of the procedure.

Tracheal Resection

Images of procedures, steps, and outcomes for the procedures for tracheal resection.

Lungs

Images display the layout of the lobes of the lungs.

Typical Patient

Common symptoms include coughing (52%), dyspnea (24%), lethargy (18%), weight loss (12%), tachypnea (5%), inappetence, increased respiratory effort and collapse.
25% of cases are asymptomatic at diagnosis.

Signalment

All breeds are affected frequently
Typically larger breeds, and urban areas are affected more frequently.
Some evidence suggesting passive smoking as a factor.
Average dog age is 9-11 years (5-12), and the average cat age is 11-13 years (2-18).

Physical Examination

Possible findings include chest wall masses, decreased lung sounds, muffled heart sounds, jugular venous distension, and ascites.

Paraneoplastic Signs

Possible findings include hypertrophic osteopathy, hypercalcemia, and pyrexia.

Thoracic Radiographs

Three views are useful for diagnosis.
Potential causes of consolidated lung or lung mass include neoplasia, foreign bodies (FB), abscesses, fungal infections, and lung lobe torsion.

Visual Resolution

Visual resolution of 5-7mm soft tissue nodules.
Hilar mass of 5-10mm.
Solitary nodule, or multicentric pattern is prevalent.

Canine and feline primary lung tumours

Rare occurrences.
Incidence rate is 5.6 per 100.000 dogs and 2.2 per 100,000 cats.
Often malignant in both species.
Cats have a higher metastatic potential (75%).

Primary Lung Tumors

Carcinomas of various types.
Sarcomas of various types, and malignant histiocytosis are common.
The masses are generally well-demarcated, and generally found in the caudal lobes.

Classification

Origin based, alveolar/bronchogenic/bronchial gland/bronchoalveolar, and cellular morphology based classification.
Adenocarcinomas (70-85%) that can be differentiated or undifferentiated.
Squamous cell carcinoma.
Sarcomas (histiocytic, FSA, OSA).

Primary Lung Tumors-Differentiated vs Non-differentiated

Lymphatic and blood vessel invasion are common factors.
Median survival time for without LN mets >12+ months and with LN mets 2 months.
Poor prognostic indicators: location, grade, stage, clinical signs, and completeness of excision.

Lung Metastases to lung

X-rays show possible metastases to the lung.

Caudal

X-rays show location and possible mass condition.
Images show a mass in the caudal region of the lungs.

Solitary Mass

X-rays display a visible, solitary mass.
Region of interest is the costo-phrenic recess.

Primary Lung Tumors-Cats

Adenocarcinomas are most common presentations.
Presenting symptom can be multiple painful swollen digits caused by metastasis.
Chest radiographs are significant.
Cough is another possible symptom, but less frequent.
Poor prognosis with metastatic problems.

Ultrasound-Guided Aspirate?

Dependent on size and location of the mass, if suspect an abscess, and if adjacent to thoracic wall.
Reported success rate 80-90%.

Prognosis (dogs)

Solitary lesions <5cm have a 20v8-month prognosis.
Asymptomic lesions have an 18v8-month prognosis.
Negative lymph nodes have a 15v1-month prognosis.
No malignant effusion prognosis ranges form 16v8 months to 16v6 months.
Adenocarcinomas, SCCs, and Sarcomas have an 19v8 v 1-2-month prognosis.

Prognosis (cats)

Only histological grade is predictive.
Poorly differentiated MS is 2.5 months.
Moderate/well differentiated MS is 23 months.
Predisposition to SCC for finger metastasis.
Treatment is unrewarding.

Approaches to Thorax

Options include lateral/intercostal thoracotomy, median sternotomy, trans-diaphragmatic, and thoracoscopic.

Intercostal

Drawings/illustrations demonstrating anatomical locations of the muscles involved in the procedure.

Intercostal Thoracotomy

Surgical steps involved.
The procedures minimize impact on muscles and avoids bone cutting.
Recovery time is generally 1-3 days.

Median Sternotomy

Surgical steps involved. Minimally involves skin, pectorals,sternum osteotomy to approach tumours.
Repair of the sternum with suture or wire.
Chest drain required.
Recovery time is typically 3-4 days.

Advantages

Single incision for abdominal/thoracic procedures.
Avoids cutting intercostal muscles.

Disadvantages

Poorer lymph node inspection access.
Procedure is not as familiar as others.

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Description

Test your knowledge on the evaluation and treatment of cancer in dogs. This quiz covers specific techniques such as ultrasound-guided aspirates and surgical approaches like median sternotomy. Assess your understanding of tumor prognosis and considerations in veterinary oncology.