Oral tumours

image of Oral tumours
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Oral tumours are common in both cats and dogs, with cancers of the oral cavity accounting for 3–12% and 6% of all tumours in these species, respectively. This chapter looks at tumour types and behaviour; presentation and clinical signs; clinical approach; management; prognosis.

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15.2 Oral tumours cannot be distinguished from each other based on appearance alone: squamous cell carcinoma; melanoma; fibrosarcoma; mast cell tumour.
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15.4 In oral surgery, dehiscence is an expected complication, especially in larger resections. The incidence of dehiscence can be decreased by using holes drilled in bony edges through which to secure sutures. Closure of the defect has been completed using a two-layer closure. Polydioxanone has been used to close the oral layers; although this is stiffer than polyglactin 910, and potentially more irritating, its more gradual loss of tensile strength results in a longer-lasting suture and decreased dehiscence.
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15.5 The 24-hour postoperative appearance of the dog undergoing surgery in Figure 15.4 . The reconstruction has resulted in a medial ‘puckering’ of the lip. This will relax to a certain extent, and is less apparent as hair grows back. In this German Shepherd Dog medial deviation of the caudal lip occurred due to reconstruction of a large defect created following a caudal maxillectomy for OSA performed using a combined approach.
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15.6 Complete excision of a relatively small, low-grade FSA using full thickness resection of the caudal hard palate. Reconstruction was performed using a labial mucosal flap, and the closure of this defect resulted in ‘dimpling’ of the lateral face. Head and neck surgery readily results in swelling.
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15.7 Postoperative appearance can be dramatically altered following radical oral surgery, such as in this dog with a bilateral rostral mandibulectomy to the level of the 3rd premolar. However, function in this dog was excellent. During surgery, care was taken to avoid the hypoglossal nerve to avoid any functional compromise of the tongue.
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15.8 This dog underwent resection of the zygomatic arch, vertical ramus and caudal maxilla and a partial orbitectomy (including orbital contents) for a low-grade multilobular osteochondrosarcoma. Due to the extent of surgery and some postoperative bleeding, the immediate postoperative appearance of the dog is startling. Note the analgesic catheter on the lateral aspect of the neck of the dog – a technique that ensures the dog is kept maximally comfortable postoperatively. Owners should be over-warned about the postoperative alteration of their pet’s features. After several weeks, however, the appearance of the dog is very reasonable. Part of the pigmented tissue around the eyelid had been left in place as this was considered cosmetically more acceptable to the owner, and did not compromise the resection.
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15.9 Dehiscence can occur following oral surgery. It is minimized by adhering to appropriate surgical principles and by minimizing tension. Pre- or postoperative radiation therapy increases the chance of dehiscence occurring, as in the patient shown here. In this case, multiple surgical attempts to close the small oronasal fistula were unsuccessful, and so a ‘nasal septal button’ was placed to ‘plug’ the fistula. This was a permanent placement, and the dog died several years later of disease unrelated to the oral tumour.
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15.10 Although dogs generally function extremely well after radical resections, cats tend not to function as well, and feeding tubes should always be placed after radical oral surgery. Owners should be warned that cats may not learn to eat on their own, and may require their owners to groom them.
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15.11 Radiation of oral tumours can result in side effects. These two dogs show permanent alopecia in the radiation field.
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15.13 Subtotal glossectomy performed for a malignant melanoma of the tongue. Histologically, complete resection was achieved and the dog learned to ‘suck’ up food of a slurry consistency. A surgically placed gastrostomy tube was placed at the time of surgery and used over a 1-month period while the dog learned to suck up food.
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