"Nasal Adenocarcinoma" TUMOR TIDBITS Volume 2; Number 8; May 15, 2001 Editor: Kevin A. Hahn, DVM, PhD, Dipl - ACVIM (Oncology) & Overall Nice Guy! ADENOCARCINOMA, NASAL OVERVIEW Nasal adenocarcinoma causes slow, progressive, local invasion of neoplastic epithelial and glandular epithelial cells within the nasal and paranasal sinuses. SIGNS Intermittent and progressive history of unilateral to bilateral epistaxis. Sneezing. Halitosis. Anorexia. Seizures secondary to cranial invasion. Noninfectious nasal discharge. Facial deformity or exophthalmia. Pain with nasal or paranasal sinus examination. Obstructed nares (unilateral or bilateral). DIFFERENTIAL DIAGNOSIS Bacterial sinusitis (uncommon), Viral infection (cats), Aspergillosis, Cryptococcosis (cats), Foreign body, Trauma, Tooth root abscess, Oronasal fistula, Coagulopathy. DIAGNOSTIC FINDINGS Survey skull radiography shows typical pattern of asymmetrical destruction of turbinates with superimposition of a soft tissue mass. Fluid density in the frontal sinuses secondary to outflow obstruction is observed in some animals. Thoracic radiography--to evaluate for lung metastasis (uncommon). Computed tomography or magnetic resonance imaging--best method to observe integrity of cribiform plate or orbital invasion. Tissue biopsy necessary for definitive diagnosis. Bacterial culture often positive. TREATMENT Surgery alone is ineffective. Turbinectomy may be done before external (teletherapy) or internal (brachytherapy) irradiation but is generally unwarranted and may shorten overall survival time. Radiotherapy, with or without surgery, provides the best clinical control in dogs. Median disease-free intervals range from 8 to 25 months in dogs. Median disease-free intervals range from 136 months in cats. With radiotherapy, 38-57% of dogs and cats have 1-year survival rate, and 30-48% have 2-year survival rate. Chemotherapy is a good option in some animals. Median survival after cisplatin chemotherapy as the sole modality (60-70 mg/m2 IV once q3wk) in dogs is 22 weeks. Chemotherapuetic management in cats is unreported. FOLLOW-UP Physical examination with survey thoracic radiography at 1, 2, 3, 6, 9, 12, 15, 18, and 24 months after treatment. Survey skull radiography, computed tomography, magnetic resonance imaging when clinical signs recur. COMMENTS At Gulf Coast Veterinary Oncology we use a 3-times weekly external beam radiation protocol for 7 weeks, with or without concurrent platinum chemotherapy. We have be very satisfied with owner response to the pet's quality of life and observe a 50%+ 1 year and 40%+ 2 year survivor rates, regardless of tumor stage or facial deformity at presentation. Have More Questions? Don't hesitate to call or email us at Gulf Coast Veterinary Oncology! Kevin Kevin A. Hahn, DVM, PhD, Diplomate ACVIM (Oncology) & Overall Nice Guy Gulf Coast Veterinary Oncology 1111 West Loop South, Suite 150 Houston, TX 77027 www.gcvs.com drhahn@g... ////