Tumors of the Respiratory System (not done)

What is the signalment for sinonasal tumors?

<1% of all canine tumors but average age is 10 years old

Commonly medium to large breeds especially dolichocephalics

Why are dolichocephalics more likely to get sinonasal tumors?

Increased filtering of environmental pollutants

What is the most common C/S of sinonasal tumors?

UNILATERAL EPISTAXIS

What are the C/S of sinonasal tumors?

Unilateral epistaxis and mucopurulent discharge, facial deformity, unwillingness to open mouth, sneezing, dyspnea or stertorous breathing, exophthalmos, ocular discahrge

How long have C/S of sinonasal tumors started before presentation in a clinic?

2-3 months

What are your local ddx for sinonasal tumors?

Fungal disease, trauma, L-P rhinitis, severe infectious rhinitis, severe dental disease, FB, oronasal fistula, angiomatous proliferation

What fungus causes nasal disease in dogs?

Asperigillosis

What fungus causes nasal disease in cats?

Cryptococcosis

What are some systemic ddx for sinonasal tumors?

Coag problems like rodenticide toxicity, thrombocytopenia, hypertension, immune-mediated vasculitis, DIC, systemic multiple myeloma (will be bilateral epistaxis)

How do you dx sinonasal tumors?

Tissue biopsy required

CT scans can help and assess the full nasal cavity

Need to rule out coag disorders

Rads have very poor sensitivity

How do you stage sinonasal tumors?

Thoracic rads

Lymph node aspirates

How do you get a tissue biopsy of a sinonasal tumor?

Rhinoscopy at the cribriform plate

Histo then gives you a dx

What do you do to prevent hemorrhage during a sinonasal tumor?

Pack off with ice packs, pressure, or epi, b/c blood can be aspirated

Also provide analgesia

What is the most common nasal tumors in a dog?

Carcinomas (2/3), adenocarcinoma most common

Also sarcomas and round cell tumors

What is the most common nasal tumor in cats?

Lymphoma

Also carcinoma and sarcoma

What is the treatment of choice of tx for nasal carcinomas and lymphomas?

Radiation

Why is sx not a very good tx for most sinonasal tumors?

Complete removal of tumor is not possible. Sarcomas can be tx this way though

How do you add chemo to tx sinonasal carcinomas?

NSAIDs and toceranib phosphate

How do you add chemo to a sinonasal lymphoma?

CHOP

What are some negative prognostic factors?

>10 years

C/S: longer duration of C/S, epistaxis, no resolution of C/S

Stage 4 or metastasis

Histo: anaplastic carcinoma, SCC, undifferentiated carcinoma

What has the longest survival time for canine nasal adenocarcionmas?

Radiation and palladia (toceranib) can get you 20 months

Radiation or palladia alone can get you 10 months

No tx is 3 months

How does choosing CHOP, CHOP + RT, and RT alone change prognosis for feline nasal lymphoma?

Does not get better

What is the signalment for tumors of nasal planum (extranasal)?

Cats more than dogs due to UV light exposure on non-pigmented skin

What is on histo of a tumor on nasal planum?

SCC more common

Dogs also get MCT, FSA, melanoma, OSA, lymphoma, eosinophilic disease

What is on history of SCC of nasal planum?

Long duration of months to years of

• Crusting and erythema

• Superficial erosions and ulceration

• Carcinoma in situ

• Superficial SCC

• Infiltrative SCC

What are some additional locations of SCC of nasal planum (especially in cats)

Pinna, periocular head and neck

What is not useful for nasal planum tumors?

Scraping and impression smears and FNA b/c usually just inflammatory cells

What is the best way to dx nasal planum diagnostics?

Biopsy with a regional LN aspirate and thoracic rads

What is needed for surgical planning of a nasal planum tumor?

CT scan

How do you tx nasal planum tumors in dogs?

Sx for carcinomas (nasal planectomy)

Radiation or chemo if lymphoma (usually a T cell lymphoma)