Veterinary Surgical Oncology

1 Cover

2 Title Page

3 Copyright Page

4 Dedication Page

5 List of Contributors

6 Preface

7 Foreword

8 About the Companion Website

9 1 Principles of Surgical Oncology Preoperative Considerations Surgical Planning Postoperative Considerations References

10 2 Multi‐modal Therapy Introduction Surgery Radiation Therapy Surgery and Radiation Chemotherapy Electrochemotherapy Molecular and Targeted Therapies Complications of Chemotherapy Complications of Radiation Therapy References

11 3 Interventional Oncology Imaging Instrumentation and Implants Approaches Nonvascular Interventional Oncology Techniques Vascular Interventional Oncology Techniques References

12 4 Skin and Subcutaneous Tumors Skin Tumors General Principles General Approach to the Diagnosis and Staging of Skin Tumors Treatment Options for Skin Tumors Mast Cell Tumors Mesenchymal Tumors and Melanoma References

13 5 Head and Neck Tumors Lymph Node Staging Nasal Planum Tumors Tumors of the Pinna Tumors of the External Ear Canal Tumors of the Middle Ear Salivary Gland Tumors Tumors of the Lip References

14 6 Oral Tumors Introduction Diagnosis and Clinical Staging General Surgical Considerations Surgical Approach to Tumors of the Mandible Surgical Approach to Tumors of the Maxilla Mandibular and Maxillary Tumors in Dogs Surgical Approach to Tumors of the Hard Palate Surgical Approach to Tumors of the Tongue Multimodal Management of Oral Tumors Prognosis References

15 7 Alimentary Tract Esophagus Stomach Liver and Gallbladder Pancreas Small Intestine Colorectal Tumors Perianal Tumors References

16 8 Respiratory Tract and Thorax Rhinotomy Laryngeal Tumors Thoracotomy Tracheal Tumors Lung Metastasectomy for Sarcomas Thoracic Wall Resection References

17 9 Cardiovascular System Heart and Heart‐Base Tumors Pericardial Tumors Carotid Body Tumors Vascular Oncologic Surgery – Tumor Thrombus Excision References

18 10 Reproductive System Female Reproductive System Histologic Tumor Types Prognosis Adjuvant Therapy Uterine Tumors Vaginal and Vulvar Tumors Histologic Tumor Types Prognosis Adjuvant Therapy Tumors of the Clitoris Canine Mammary Tumors Feline Mammary Tumors Male Reproductive System Testicular Tumors Prognosis Prostatic Tumors Surgical Techniques and Outcomes Radiation Therapy Histologic Tumor Types and Prognosis Penile Tumors Surgery References

19 11 Urinary Tract Biopsy Procedures for Urinary Tumors Laparoscopy FNA and Needle Core Biopsy Incisional Biopsy Imaging Techniques Kidney Bladder Palliative Procedures References

20 12 Eyelids, Eye, and Orbit Introduction Clinical Workup and Biopsy Principles Imaging Techniques Eyelid Neoplasia V‐plasty and Four‐sided Excision Advancement Flap Rotational Flap Semicircular Flap Mucocutaneous Subdermal Plexus Flaps (Lip‐to‐lid) Bucket Handle or Bridge Flap Conjunctival, Nictitans, and Scleral Neoplasia Eye Neoplasia Orbital Neoplasia References

21 13 Endocrine System Pituitary Tumors Adrenal Tumors Thyroid Tumors: Feline Hyperthyroidism Thyroid Glands: Canine Thyroid Tumors Parathyroid Tumors Cats Endocrine Pancreatic Tumors References

22 14 Hemolymphatic System Lymph Nodes Spleen Thymus Tonsils References

23 15 Nervous System Introduction Clinical Workup Preoperative Imaging Techniques Intracranial and Calvarial Tumors Vertebral and Spinal Cord Tumors Nerve Sheath Tumors References

24 16 Musculoskeletal Tumors Osteosarcoma Other Musculoskeletal Tumors Metastatic Tumors of Bone Primary BoneTumors of Cats Diagnostic Workup Surgical Principles Limb Amputation Hemipelvectomy Scapulectomy Ulnectomy Limb‐sparing Surgery Digit‐Metacarpus‐Metatarsus Amputation Vertebral Tumors Joint Tumors Muscle Tumors Adjunctive Therapies References

25 17 Ethics and Surgical Limits of Surgical Oncology Introduction Surgical Limits References

26 Index

27 End User License Agreement

1 Chapter 1 Table 1.1 Factors affecting the goal of surgery and consequently the dose o...

2 Chapter 2 Table 2.1 Epithelial. Table 2.2 Round cell. Table 2.3 Mesenchymal.

3 Chapter 4 Table 4.1 WHO TNM staging system for tumors in animals. Table 4.2 WHO Clinical staging system for canine mast cell tumors. Table 4.3 Common features of STS (as described by Liptak and Forrest 2013). Table 4.4 TNM staging and grading system for soft tissue sarcomas.

4 Chapter 6Table 6.1 Clinical staging (TNM) of oral tumors in dogs and cats.Table 6.2 Suggested analgesic options for oral surgery in cats and dogs.Table 6.3 Summary of common oral tumors in the dog and cat.

5 Chapter 7Table 7.1 Hepatic lesion characterization relative to normal liver using MR...Table 7.2 Relative weight of individual liver lobes in dogs.Table 7.3 Literature summary of the frequency of morphologic classification...Table 7.4 Differential diagnosis for hypoglycemia in dogs.Table 7.5 Reported survival times for dogs with insulinoma treated with sur...Table 7.6 Staging for insulinoma.

6 Chapter 8Table 8.1 Median Overall Survival (OS) and/or Progression‐Free Interval (PF...Table 8.2 Access to the main thoracic structures for tumor excision.Table 8.3 Percent functional volume of each lung lobe for dogs in the stand...Table 8.4 Clinical stages of primary lung tumors.Table 8.5 Clinical stages adapted from human staging system of primary lung...

7 Chapter 11Table 11.1 Reported survival times with total cystectomy.Table 11.2 Stent sizes available.

8 Chapter 12Table 12.1 Third eyelid glandular neoplasms in dogs and cats – data from a ...

9 Chapter 14Table 14.1 Tumors involving the canine spleen.Table 14.2 Disorders associated with thymomas in dogs and cats.Table 14.3 Clinical staging of thymoma.

10 Chapter 15Table 15.1 List of intra‐axial and extra‐axial nervous system tumors in dog...Table 15.2 Medications and dosing schemes commonly used for neuropathic pai...

11 Chapter 17Table 17.1 Anatomic structures or organs that can be sacrificed acutely in ...

1 Chapter 1 Figure 1.1 Diagram illustrating the different doses of surgery: marginal, wi... Figure 1.2 Diagram showing the extension of tumor into the grossly normal‐lo... Figure 1.3 (a) Automated needle core biopsy instrument. (b) The tip of the n... Figure 1.4 Punch biopsy instrument, 8 mm in diameter. Figure 1.5 (a) Jamshidi needle (left) with the two stylets (middle and right...

2 Chapter 2 Figure 2.1 (a) Standard or conventional linear accelerator. Most of the mach... Figure 2.2 (a) Conventional (i.e. standard) radiation plan for a nasal tumor... Figure 2.3 (a) Anal sac adenocarcinomas treated with adjuvant megavoltage ra... Figure 2.4 (a) focal necrosis on the antebrachium following extravasation of... Figure 2.5 Mix breed canine with an incompletely resected mast cell tumor on... Figure 2.6 Beagle canine with an incompletely resected soft tissue sarcoma o... Figure 2.7 American Staffordshire with an incompletely resected soft tissue ... Figure 2.8 Late radiation therapy side effects. Image (a) shows a dog with a...

3 Chapter 3 Figure 3.1 Interventional oncology instrumentation. From left to right: (a) ... Figure 3.2 Urethral stent placement (neoplastic obstruction). (a) An area of... Figure 3.3 Colorectal stent (neoplastic obstruction). In this dog, a stent w...

4 Chapter 4 Figure 4.1 (a, b) Noncontrast and contrast CT scan imaging of an interscapul... Figure 4.2 (a) Preoperative margins marked on skin with marking pen. (b) En ... Figure 4.3 Surgical en bloc resection of cutaneous tumor with planned recons... Figure 4.4 Range of cutaneous mast cell tumor appearances. (a) Ulcerated gra... Figure 4.5 Darier’s sign secondary to vasoactive substance release of an MCT... Figure 4.6 Cytological appearance of canine cutaneous MCT showing degranulat... Figure 4.7 Excision of STS at distal medial aspect of the metatarsus using a... Figure 4.8 (a) Wide excision of a feline injection‐site‐associated sarcoma. ... Figure 4.9 Radical excision of a feline injection‐site‐associated sarcoma. (...