Mandibular squamous cell carcinoma in a 5‐year‐old Tennessee Walking Horse

Squamous cell carcinoma (SCC) is the second most common neoplasm reported in the horse, but occurs rarely in the oral cavity. Clinical signs may be insidious in onset and mimic other non‐neoplastic processes, thus delaying appropriate treatment. Timely evaluation and advanced diagnostic imaging may offer the opportunity to initiate definitive treatment. This report describes a young gelding with mandibular SCC that was evaluated for mandibular swelling failing to respond to symptomatic therapy.     

Penile and preputial squamous cell carcinoma in the horse and proposal of a classification system

Squamous cell carcinoma (SCC) is the most common tumour of the penis and prepuce of the horse and is found mainly in older animals. Reports on breed predilection for penile tumour formation are equivocal but castration, coat colour, poor genital hygiene and various infectious agents have been suggested to predispose to the development of SCC. Careful assessment of the primary tumour is an important first step in the design of an optimal treatment protocol. Tumour size, invasiveness, differentiation grade and presence of metastases are relevant to the decision to pursue additional diagnostic procedures or specific treatment options. Complete elimination of the neoplasm and, therefore, risk of recurrence is highly dependent on the type of therapy chosen. However, the size and histopathological features of the primary tumour are also important factors with respect to prognosis. This review describes the clinical and pathological features of penile and preputial SCC in the horse and proposes a standard staging system.     

Multiple skeletal metastases from a penile squamous cell carcinoma in a horse

A 21‐year‐old gelding with ventral abdominal and preputial oedema was evaluated for right hindlimb lameness. Partial phallectomy had been performed 3 years prior for treatment of squamous cell carcinoma. Regional analgesia did not localise the source of lameness and nuclear scintigraphy was recommended. The results of the scan revealed severe increased radiopharmaceutical uptake in the proximal femur. Radiographic and ultrasound examinations were inconclusive. The horse was discharged with recommendations of stall confinement and a 2 week course of nonsteroidal anti‐inflammatory drugs. Four weeks later the horse presented for an inability to elevate his neck and persistent hindlimb lameness. The owner elected humane euthanasia. Post mortem examination revealed metastatic squamous cell carcinoma in the proximal femur and fifth cervical vertebrae consistent with metastasis from the penile squamous cell carcinoma. To the authors’ knowledge, multiple site bone metastasis of squamous cell carcinoma has not been reported previously in the horse.     

Pigmented squamous cell carcinoma of the conjunctiva of a horse

Abstract A heavily pigmented tumor was removed from the lateral, perilimbal, bulbar conjunctiva of a bay Thoroughbred horse. Excision was incomplete and the base of the tumor was lasered on the assumption that the tumor was a melanoma. No other ophthalmic lesions were seen. Histology showed the mass to be a pigmented squamous cell carcinoma (SCC). The prognosis and recommended treatment protocols are different for SCC and melanoma. This is, to the best of our knowledge, the first report of an ocular, pigmented SCC in the veterinary literature.     

Renal carcinoma as a cause of sudden death in an aged horse

This report describes rupture of a primary renal carcinoma as a cause of sudden death of an aged horse that presented with mild clinical signs of colic. The case is considered in the context of the few reported cases in the veterinary literature. The most striking feature of this case was the absence of prodromal signs prior to a catastrophic rupture of the tumour during a diagnostic work‐up.     

Oesophageal obstruction in an aged pony associated with squamous cell carcinoma

An aged miniature pony was referred for chronic recurrent oesophageal obstruction. Endoscopic examination demonstrated distal oesophageal constriction and radiography confirmed an irregular soft tissue mass in the region of the distal intrathoracic oesophagus. The pony was subjected to euthanasia and post mortem examination confirmed squamous cell carcinoma of the distal oesophagus and stomach. Oesophageal squamous cell carcinoma is a rare condition in horses, but should be considered as a differential diagnosis in cases of chronic recurrent obstruction, particularly in older horses.     

Renal cell carcinoma with bone metaplasia in a horse

A case of renal tubular carcinoma with bone metaplasia is reported in a 20-year-old male, mixed breed horse having a history of weight loss and hematuria. This report includes the clinical signs, macroscopic and microscopic lesions, and the immunohistochemical findings of this neoplasm.     

Skeletal metastasis from a squamous cell carcinoma of the nictitating membrane in a Haflinger horse

A 12-year-old Haflinger gelding with a history of a persistent cough was referred for evaluation of a severe lameness of the left forelimb. An excision of the right nictitans had been performed 2 years prior to presentation, and a squamous cell carcinoma (SCC) with embolic neoplastic cells in several blood vessels had been confirmed by histopathology. The origin of the lameness could not be localised with regional analgesia; therefore, a nuclear scintigraphic examination was performed. This revealed an area of marked increased radiopharmaceutical uptake at the level of the caudodorsal border of the left scapula. Further examination, including ultrasound-guided biopsy of the suspect region, confirmed the presence of SCC invading the scapula. Due to poor a prognosis, the horse was subjected to euthanasia. Prior to euthanasia, the gelding was tested homozygous for the missense variant in the damage-specific DNA-binding protein 2 (DDB2) gene, which is reported as a risk factor for the development of nictitans SCC in Haflinger horses. Post-mortem evaluation revealed multiple SCC metastasis, affecting the scapula, the liver and the lungs. To the authors' knowledge, this is the first reported case of bone metastasis following a primary periocular SCC in a horse.     

Management of rostral mandibular fractures in the young horse

Rostral mandibular fractures in the young horse can, in the majority of cases, be managed satisfactorily in the field. A technique for the field assessment and repair of such injuries is described here.     

Treatment of oral squamous cell carcinoma in a horse by surgical debulking followed by metronomic chemotherapy

A 19‐year‐old Quarter Horse gelding presented with a 6‐week history of hypersalivation, halitosis and dysmasesis. Oral examination revealed retention of food and saliva and the presence of a raised, nodular, 6 × 7 cm, ulcerated mass on the dorsal surface of the tongue base. The mass was confirmed histologically as squamous cell carcinoma. Complete resection of the mass was not possible and surgical laser debulking was followed 15 days later by chemotherapy with a combination of meloxicam and cyclophosphamide in metronomic regimen. After one week, there was a significant improvement in clinical signs and food consumption returned to normal. Therapy was well tolerated with no alteration in haematological or urinalysis parameters. After 5 months of excellent life quality, the horse showed progressive difficulties in mastication and swallowing. Endoscopic examination showed extension of the tumour to all the aboral aspect of the tongue and, with the owner's consent, the patient was subjected to euthanasia. This is believed to be the first report on the combined use of meloxicam and cyclophosphamide in a metronomic fashion for management of an oral squamous cell carcinoma in a horse. Since metronomic therapy is less expensive than conventional chemotherapy, easily administrable and well tolerated, it should be considered as a possible treatment option for nonresectable equine malignant tumours.     

Challenges in the treatment of equine periocular squamous cell carcinoma

Management of periocular squamous cell carcinoma is challenging because of the need for adjunctive therapy, the adverse effects of therapies and the frequent recurrence of SCC. Appropriate treatment of equine ocular SCC usually involves surgical excision combined with adjunctive therapy selected as appropriate for the anatomic site of the lesion. Metastasis of periocular SCC has been reported to occur in approximately 6–15% of cases. The horse owner should be carefully educated to understand that for best long‐term results from the treatment of periocular SCC, they must be diligent in observing signs of recurrence or metastasis and be willing to have the horse examined as soon as adverse signs are observed. Furthermore, external beam radiation may be effective in the treatment of metastatic SCC and further clinical studies of this treatment modality are needed.     

A review of equine mucocutaneous squamous cell carcinoma

Squamous cell carcinoma (SCC) accounts for approximately 20% of all equine mucocutaneous (MC) tumours and continues to present a therapeutic challenge to practitioners. Most MC‐SCC are locally invasive and slow to metastasise, but metastasis to local lymph nodes is not uncommon. The most common location for MC‐SCC is the periorbital region, with the eyelid most commonly affected. Although only 13% of MC‐SCC involves the external genitalia, MC‐SCC is the most common neoplasm of male genitalia. Equine caballus papillomavirus‐2 has recently been linked to MC‐SCC and may prove to be necessary for tumour development. Risk factors may include chronic exposure to ultraviolet light and chronic skin irritation. Horses developing genital MC‐SCC tend to be older compared to those with periorbital MC‐SCC. Histopathology is required for definitive diagnosis of MC‐SCC, although horse phenotype and lesion location may suggest MC‐SCC. Several treatment modalities have been successful in eliminating or managing MC‐SCC, with surgical excision and intratumoural chemotherapy yielding the best results. Other treatment options including cryotherapy, hyperthermia, radiotherapy and photodynamic therapy are often used as adjunctive therapies. Early recognition of tumours and prompt intervention are associated with a positive outcome.     

Resection cystoplasty of a squamous cell carcinoma in a mare

A 22‐year‐old Arabian mare was examined for evaluation of haematuria of 2 months' duration. Complete blood cell count and chemistry revealed anaemia of chronic disease (i.e. normocytic, normochromic) and hypoproteinaemia. Cystoscopy revealed a haemorrhagic mass protruding into the lumen of the urinary bladder in the apical region. The mass was surgically removed by partial cystectomy performed through a caudal ventral midline laparotomy. Histological examination of the mass confirmed the diagnosis of squamous cell carcinoma. Tumours of the equine urinary bladder are rare, and when a partial cystectomy is indicated, a caudal ventral midline laparotomy may provide adequate surgical exposure even in adult horses.     

Penile and preputial squamous cell carcinoma in the horse: a retrospective study of treatment of 77 affected horses

Reasons for performing study: The most common penile and preputial neoplasm in the horse is the squamous cell carcinoma (SCC), but no large surveys of treatment and effects of the grade of the tumour, based on the degree of differentiation, on outcome of affected horses are available. Objectives: Analysis of treatment of male horses affected with SCC of the external genitalia and long‐term results of treatment. Methods: Seventy‐seven cases of SCC were evaluated. Data recorded included treatment, outcome, post operative histopathology and retrospective tumour grading. Results: Treatments included: cryosurgery, excision, partial phallectomy, partial phallectomy and sheath ablation, and en bloc penile and preputial resection with penile retroversion and removal of inguinal lymph nodes. The incidence of recurrence after partial phallectomy was 25.6% (10/39) and following incomplete removal was 17.9% (7/39). The incidence of recurrence after en bloc resection with retroversion was 12.5% (1/8). In horses with confirmed inguinal lymph node metastasis, the incidence of recurrence was 25.0% (1/4). Poorly differentiated SCCs were more likely to metastasise than well differentiated SCCs, and there was a greater chance that the treatment would be unsuccessful. The success of treatment, complete removal and in preventing recurrence of the tumour, of male horses with SCC of the external genitalia was 55.7%. Conclusions: Horses that receive only partial phallectomy for treatment for SCC of the external genitalia have a high incidence of recurrence in contrast to horses that receive an en bloc resection. Tumour grading of SCC can help predict prognosis and guide selection of treatment.     

Parotid salivary gland carcinoma in a geriatric horse

This case report describes a geriatric gelding with a 2 month history of fast‐growing masses within the parotid and submandibular regions. The horse was dyspnoeic on presentation and upper airway endoscopy revealed partial airway obstruction at the level of the pharynx, secondary to a space‐occupying mass. Cytological evaluation of multiple fine‐needle aspirates obtained from the masses were suggestive of salivary gland neoplasia, therefore the horse was subjected to humane euthanasia. A computed tomographical scan was obtained post mortem and revealed a large multi‐lobulated mass involving both guttural pouches, resulting in 80% occlusion of the naso‐ and oropharynx. Histopathology confirmed a parotid salivary gland carcinoma (papillary‐cystic type). Salivary gland tumours are extremely rare in horses, with only a few cases reported in the literature. Treatment of these malignancies proves to be challenging, requiring complete parotidectomy or surgical debulkment, in combination with adjunctive therapy.     

Hemangiosarcoma and squamous cell carcinoma in the third eyelid of a horse

A 12-year-old Belgian draft horse presented for a right eye third eyelid mass and red-tinged ocular discharge of 3 months' duration. The third eyelid was excised and submitted for histopathology. On histopathologic examination, the mass was composed of both hemangiosarcoma and squamous cell carcinoma. The horse developed thickened eyelids and hemorrhagic ocular discharge from the right eye approximately 16 months following surgery, and was euthanized. Necropsy and histopathology confirmed local recurrence and regional metastasis of the hemangiosarcoma. This was an unusual case because there were two distinct neoplastic processes composing the same mass that could not be differentiated grossly.     

A tumour of vascular origin in a horse

Tumours of vascular origin are uncommon in horses. This report describes the surgical treatment of a large subcutaneous tumour in a Quarter Horse colt. The histopathological appearance of the mass was most consistent with a haemangioma. While these neoplasms of vascular origin are often difficult to characterise, it has been suggested that there is a continuum of types with some cases falling between the categories. Further classification of vascular tumours requires special stains and immunohistochemical techniques.     

Combined surgical and radiotherapy treatment of a mandibular ameloblastic carcinoma in a pony

A 9‐year‐old Welsh Section D gelding was referred to an equine hospital for evaluation and computed tomographic (CT) imaging of a left mandibular swelling. An expansile mass, found within the left mandible at the level of the caudal 2 cheek teeth, was surgically debulked and histology of the lesion identified it as an ameloblastic carcinoma. Radiotherapy using 4 fractions of 800 cGy, 7 days apart, was subsequently undertaken. The pony made excellent clinical progression following treatment. Repeat CT imaging at 7.5 and 19.5 months post surgery showed no apparent recurrence of the lesion and marked improvement in the remodelling of the mandible. In conclusion, radiotherapy in conjunction with surgical debulking appears to have been successful in treating an ameloblastic carcinoma in this pony and could be considered for similar tumours in other cases.     

Topical 5-fluorouracil as an adjunct treatment in equine corneolimbal squamous cell carcinoma

An 11-year-old crossbreed mare was presented with a nodular, pink mass at the temporal corneolimbal junction of the right eye. Histopathology confirmed the diagnosis of invasive squamous cell carcinoma. The mare underwent lamellar keratectomy and conjunctivectomy under general anaesthesia, followed by adjunctive topical chemotherapy with 1% 5-fluorouracil solution for 10 days post-operatively. Adverse effects included moderate conjunctival inflammation and exuberant granulation tissue formation at the surgical site, responding to surgical debulking and topical corticosteroid application. No mass regrowth was present at 12 months following discharge. This report describes the successful use of topical 1% 5-FU as an adjunctive treatment for equine ocular squamous cell carcinoma.