Hemangiosarcoma of the third eyelid in a dog

Abstract A case of hemangiosarcoma of the third eyelid in a 7-year-old Caucasian Sheepdog is reported. A voluminous red mass protruding from the free edge of the third eyelid in the right eye was present. The mass and the free edge of the third eyelid were surgically excised. On histopathologic examination the tumor was seen to infiltrate the propria of the third eyelid and was composed of neoplastic mesenchymal cells forming irregular channels containing blood. These plump cells showed moderate anisocytosis and anisokaryosis with a low mitotic index. The surgical wound healed successfully and after 9 months there had been no recurrence. To the authors' knowledge, this is the first hemangiosarcoma of the third eyelid reported in the dog.     

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.     

Eosinophilic conjunctivitis, herpes virus and mast cell tumor of the third eyelid in a cat

A 3-year-old Himalayan cat was diagnosed with concurrent eosinophilic conjunctivitis, herpes virus, and a conjunctival mast cell tumor. Eosinophilic conjunctivitis was verified via cytology from a conjunctival scraping, which revealed 50% eosinophils and 50% neutrophils. Herpes virus was verified via a positive polymerase chain reaction (PCR). Conjunctival scrapings for chlamydia immmunofluorescent antibody (IFA) and herpes IFA were negative. A mycoplasma was detected by a general mycoplasma PCR but the organism did not grow on the available mycoplasma media. The mass was excised and microscopic evaluation revealed a histiocytic mast cell tumor. The mast cell did not recur following local excision (at 1 year follow-up). The eosinophilic conjunctivitis was treated with both topical steroids and systemic megesterol acetate (Ovaban). When topical steroids were used, the herpes virus flared up and resulted in dendritic and geographic corneal ulceration. Therefore, the cat was treated with megesterol acetate and the eosinophilic conjunctivitis was well controlled. Treatment of eosinophilic conjunctivitis in the cat with megesterol acetate may be the treatement of choice due to the possibility of herpes virus.     

Leiomyoma of the third eyelid in a dog

A 14‐year‐old neutered male Dachshund presented for the evaluation of oculus dexter (OD) third eyelid elevation ongoing for approximately 2 months. Complete ophthalmic examination revealed a large, nonpainful, well‐demarcated, soft mass at the base of the right third eyelid causing elevation and mild hyperemia. The mass was freely moveable with the third eyelid, and no right globe deviation was noted. No other abnormalities were noted on physical examination, routine blood chemistry, complete blood count, serum T4, urinalysis, or urine cortisol/creatinine ratio. Ocular B‐mode ultrasonography showed an anechoic, well‐demarcated, homogenous, soft tissue mass at the base of the third eyelid with no orbital extension. A leiomyoma was diagnosed after multiple punch biopsies were obtained from the palpebral surface of the mass. The right third eyelid was excised surgically. Histopathology confirmed a completely excised, nodular, unencapsulated, expansile mass within the third eyelid. Positive smooth muscle actin and negative S‐100 immunohistochemistry confirmed a leiomyoma. Bundles of normal smooth muscle were also present adjacent to the mass. The mass was compressing the adjacent lacrimal gland and associated with moderate dacryoadenitis. Twelve months postoperatively, the right globe position and motility remain normal with no evidence of mass regrowth. To the author's knowledge, this is the first reported case of a leiomyoma of the third eyelid in any species. In this case, the mass was completely excised and no regrowth has occurred twelve months after surgery. This case along with independently reviewed canine third eyelids clearly demonstrates the presence of smooth muscle within the canine third eyelid.     

Malignant melanoma of the third eyelid in a horse

An 8‐year‐old grey Quarter Horse gelding was referred for evaluation of a rapidly growing mass associated with the third eyelid of the left eye. A pigmented mass of approximately 2 cm in diameter was palpated and visualised associated with the conjunctival lining of the nictitans. It was not possible to palpate normal nictitans deep to the base of the mass. A full dermatological examination revealed no other melanomas in common sites. Based on the size and rapid growth of the mass, surgical excision and one application of local chemotherapy was performed under general anaesthesia. Histopathology confirmed the diagnosis of malignant melanoma and the presence of clean surgical margins. There was no recurrence at 5 weeks post surgery. To our knowledge, this is the first report of a primary malignant melanoma of the third eyelid in a horse.     

Extramedullary plasmacytoma of the third eyelid gland in a dog

A case of extramedullary plasmacytoma of the third eyelid gland in a 7-year-old American Cocker Spaniel is reported. An enlargement of the third eyelid gland, abundant mucopurulent discharge, mild hyperemia and corneal pigmentation in the OD was present. Excisional biopsy of the mass revealed the gland was infiltrated and partially destroyed by a uniform population of neoplastic plasma cells. The neoplastic cells were positive for CD138, Ki-67 and λ light chain. CD20, CD3, κ light chain and cytokeratin were negative. Twelve months following surgery, no recurrence was observed. To the authors' knowledge, this is the first extramedullary plasmacytoma of the third eyelid gland reported in dogs.     

Reconstruction of the lower eyelid by third eyelid lateral advancement and local transposition cutaneous flap after "en bloc" resection of squamous cell carcinoma in 5 cats

OBJECTIVE: To describe a novel technique for blepharoplasty to cover a tissue defect involving >/=50% of the lower eyelid. STUDY DESIGN: Prospective clinical study. ANIMALS: Five cats with lower eyelid squamous cell carcinoma (SCC). METHODS: En bloc resection of SCC by removing >/=50% of the lower lid with either the medial or lateral canthus was performed without other adjunctive treatment for SCC. The lid defect was reconstructed with a transposition skin flap derived from the frontal (medial defect) or temporal (lateral defect) region. The third eyelid was advanced laterally without dissection from its insertion; its outer conjunctival layer was removed, and the skin flap was sutured with single interrupted sutures dorsally over the nictitating membrane, ventrally to the cutaneous edge of the surgical wound and medially or laterally (depending on the canthus removed) to the skin of the remaining lower lid. RESULTS: Satisfactory cosmetic and functional results were achieved and the Schirmer tear tests were normal. In 2 cats, the skin flap needed monthly hair trimming to avoid corneal lesions. CONCLUSIONS: After en bloc resection of SCC involving >/=50% of the lower eyelid, reconstruction can be achieved by relocation of the third eyelid and use of a cutaneous transposition flap sutured to the scarified external surface of the third eyelid. Eyelid apposition and lacrimal function were preserved. CLINICAL RELEVANCE: Blepharoplasty using a cutaneous transposition flap sutured to the scarified surface of a relocated third eyelid should be considered for reconstruction of lower eyelid defects with >/=50% tissue loss of the lid margin.     

Management of eyelid neoplasms in the dog and cat

Eyelid neoplasms are common in the older dog and typically benign. Eyelid neoplasms in the cat are less common and more often malignant. Resection of eyelid masses may be curative; however, restoration of the eyelid structure after mass excision is essential for maintaining long-term ocular surface health. Surgical techniques and instrumentation for eyelid surgery are reviewed. Indications, benefits. and limitations of sharp excision, cryotherapy, and laser excision and ablation are discussed. Neoplasia of the third eyelid is also discussed.     

Primary lacrimal gland adenocarcinoma of the third eyelid in a horse

A 5-year-old Draft Horse gelding presented for evaluation of a large, fleshy, ulcerated third eyelid mass OD of 3 weeks duration. Complete ophthalmic examination, ocular ultrasound and skull radiographs revealed a large soft-tissue mass involving the entire third eyelid OD and extending into the ventral right orbit to the level of the globe equator. No other abnormalities were noted on physical or ophthalmic examination. Surgical removal via exenteration was performed 3 months after initial presentation. A lacrimal adenocarcinoma of the third eyelid was diagnosed based on histopathology. Concurrent asymptomatic intra-ductal and intra-acinar Demodex caballi parasites were found in the eyelid sebaceous glands, likely as an incidental finding. No tumor recurrence or metastasis has occurred 12 months after excision. To the author's knowledge, this case is the first reported primary lacrimal adenocarcinoma in a horse. Complete surgical excision was curative.     

Everted third eyelid cartilage in a cat: a case report and literature review

An 8-year-old neutered female British Blue cat was presented with a presumed diagnosis of a prolapsed nictitans gland and associated ocular irritation and epiphora. However, during surgery, the apparent nictitans gland protrusion was determined to be an everted cartilage of the nictitating membrane. The scrolled portion of the cartilage was removed through an incision through the conjunctiva on the bulbar aspect of the third eyelid, as previously described in the dog. This operation resolved the ocular irritation occurring, and the third eyelid returned to its anatomically correct position.     

Bilateral third eyelid ectopic cilia in an adult horse

A 15‐year‐old Cob mare presented with a 4‐month history of chronic epiphora and intermittent blepharospasm in the right eye. On ophthalmic examination, two translucent aberrant hairs were identified at the third eyelid margin corresponding to an area of corneal fibrosis and neovascularization. Partial excision of the third eyelid was performed, and histopathology confirmed ectopic hair follicles. Two weeks later, clinical signs recurred in the same eye. Examination revealed another pair of aberrant hairs on the bulbar surface of the third eyelid near its leading edge. This portion of the third eyelid was also excised, and histopathology confirmed two additional ectopic hair follicles. Eight months later, the horse developed similar clinical signs in the left eye. Ophthalmic examination showed a single aberrant translucent hair at the third eyelid margin associated with focal fibrosis and neovascularization of the ventromedial cornea. Partial excision of the third eyelid was performed, and histopathology confirmed an ectopic hair follicle within the third eyelid conjunctiva. Excision was curative at 4 years postoperatively with no further recurrence in either eye.     

Cutaneous Hemangiosarcoma in a Dog

A male golden retriever of unknown age presented with multiple cutaneous and subcutaneous masses from the left elbow to the digits. Histopathologically, multiple tumor foci had formed from the dermis to the subcutaneous tissue. Tumor foci consisted of a vascular structure, alveolar structure and solid proliferative area. The borders among these areas were not clear. Some neoplastic cells resembled a mature endothelium, while others were large pleomorphic cells. Immunohistochemically, the tumor cells were usually strongly positive for CD31 and often positive for PROX-1, the lymphatic endothelial cell marker. Based on these findings, the tumor was diagnosed as a hemangiosarcoma with lymphatic differentiation.     

Mucosa-associated lymphoid tissue lymphoma of the third eyelid conjunctiva in a dog

A 4-year-old, neutered female Cocker Spaniel was presented to the veterinary clinic for protrusion of the left third eyelid. When the third eyelids from both eyes were everted, lobulated masses were present on the bulbar surface. The left third eyelid had a larger protrusion. There was no apparent associated ocular or systemic involvement. The tumor of left third eyelid was removed and referred for histological examination. Histologically, there were proliferations of lymphoid follicles surrounded by lymphoid cells forming a marginal zone. Those lymphoid cells occasionally infiltrated into conjunctival epithelium. A few apoptotic bodies with karyopyknotic and karyorrhexic nuclei were observed in the germinal center of lymphoid follicles. Mitotic figures were rare. On immunohistochemistry, tumor cells expressed CD79a but not CD3. A diagnosis of extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue (MALT) of the third eyelid was established based on the histological and immunophenotypical features. At the 1-year follow-up, there was no evidence of recurrence of the mass at the area of excision of the left third eyelid and the remaining tumor of the right third eyelid was still a similar size. The dog still showed no significant findings, except those of the tumor, and no evidence of systemic involvement. To the authors' knowledge, this is the first reported case of MALT lymphoma of the third eyelid in a dog.     

IgA and secretory component (SC) in the third eyelid of domestic animals: a comparative study

Objective The third eyelid of domestic animals is important for the production and distribution of tears, in removing ocular debris and in protection of the globe, and has significant immunologic functions. Although it is known that tears contain antibodies of the immunoglobulin A (IgA) isotype which are produced mainly by plasma cells of the lacrimal gland, very little is known about the antibody repertoires in the third eyelid of domestic animals. To assess whether IgA is derived from local synthesis, we analyzed the location of IgA‐producing cells and the cellular distribution of secretory component (SC) in the third eyelid of domestic animals in a comparative study. Animal studied A total of 83 third eyelids of dogs, cats, pigs, cows, sheep, goats and horses were investigated in the course of this study. Procedures Third eyelids were obtained immediately after death, cut length‐wise, fixed overnight and processed for immunohistochemical detection of IgA and SC by the ABC technique. Results The results show that IgA‐producing plasma cells are densely populated in subepithelial spaces of the surface epithelium as well as in the nictitating gland in a species‐specific manner. In contrast, the SC could be demonstrated exclusively in glandular acinar and ductal epithelial cells and in different cell types of the surface epithelium, preferentially located on the bulbar side of the nictitating membrane. Conclusion It is suggested that most of the SC is locally produced by resident plasma cells and subsequently transferred through the surface epithelium and glandular duct cells by transcytosis. This indicates that the third eyelid is an important member of the secretory immune system in domestic animals.     

Morphologic changes of the anterior corneal epithelium caused by third eyelid removal in dogs

Morphologic changes of corneal epithelium after third eyelid removal were observed in six normal Beagle dogs. The observation was conducted on the 17th, 35th and 72nd week after the removal. Morphologic changes were observed on corneal epithelium layers at 17 and 35 weeks post excision of the third eyelid but they were limited to minor changes including abnormal intercellular adhesion and further exfoliation of superficial cells at 72 weeks. The reduced BUT and evidence of vital positive staining correspond with these morphologic changes. Therefore, these changes are thought to be important findings from a morphologic view point in identifying pathologic symptoms of the cornea using clinical evaluation methods such as BUT and vital staining method. Grossly, no clinical indication of ocular disease was indicated by slit-lamp biomicroscopic observation; however, the BUT shortage and positive finding of vital staining indicated that the corneal epithelium layers after third eyelid removal lacked the essential barrier function. Thus, it would seem appropriate to consider that such a condition of the ocular surface would worsen with excessive exposure of the ocular surface, palpebration disorders and other exogenous factors.     

Corneal hemangiosarcoma in a cat

A 10 year-old castrated male Domestic Short-hair cat with a history of chronic bilateral keratitis was referred for assessment of a red, elevated mass involving the left cornea. The rapid growth of the mass, over a month period in combination with pronounced vascularization and invasion of the corneal surface suggested an aggressive inflammatory or neoplastic process. Following keratectomy, the lesion was diagnosed histopathologically as a hemangiosarcoma. The tumor recurred locally within 3 weeks and enucleation was performed. Histopathologic examination of the globe confirmed the diagnosis and did not reveal infiltration of the limbus and conjunctiva. No signs of local recurrence or metastatic disease have been observed 18 months following enucleation. To the authors' knowledge this is the first case of primary corneal hemangiosarcoma described in the feline species.     

Oral doxycycline, niacinamide and prednisolone used to treat bilateral nodular granulomatous conjunctivitis of the third eyelid in an Australian Kelpie dog

A 5-year-old, female neutered, Australian Kelpie presented with a 2-month history of dramatic bilateral erythematous thickening of the third eyelids. Ophthalmic examination demonstrated raised, pink to red, irregular thickening of the entire palpebral surface of both third eyelids. There were no other ocular abnormalities. A surgical biopsy was taken from each third eyelid. Histopathologic examination revealed sheets of macrophages, plasma cells, lymphocytes, and occasional fibroblasts and neutrophils infiltrating the third eyelid stroma. A diagnosis of chronic granulomatous conjunctivitis was made. Grossly and histopathologically this case closely resembles previously described cases of nodular granulomatous conjunctivitis involving the third eyelids of Collie dogs. This report describes an unusual case of nodular granulomatous conjunctivitis isolated to the third eyelids in an Australian Kelpie. Resolution of the condition was achieved with a combination of oral doxycycline, niacinamide and prednisolone.     

Correction of eyelid coloboma in four cats using subdermal collagen and a modified Stades technique

Four feline cases of bilateral eyelid coloboma were treated with injectable subdermal collagen and a modified Stades technique. This new technique was found to be easy to perform and the long-term results appear to be similar to other published reports.