Surgical excision of large melanocytic tumours in grey horses: 38 cases (2001–2013)

Melanocytic tumours are common in grey horses. Large tumours can obstruct the rectum, or prepuce, inhibit food intake and impinge upon the upper airway. Surgical excision is locally curative, but is controversial for large or confluent tumours. Limited information on outcome following surgical excision of large melanomas is available. The objective of this study was to report outcome following surgical excision of large (≥4 cm) melanocytic tumours in horses. Our hypothesis was that surgical excision of large (≥4 cm) single and coalescing melanomas would be locally curative. Medical records were reviewed and cases that underwent excision of a single or coalescing melanoma, with at least one lesion ≥4 cm in diameter, included. Follow‐up information was obtained a minimum of 12 months post‐surgery from owners and referring veterinarians via telephone interviews, questionnaire, or direct examination. A total of 48 cases were identified; 38 horses with follow‐up were included in the study. Tumours involved the parotid, perianal or mid‐cervical regions, ventral tail base, prepuce, penis, ear, or thoracic inlet. There were no cases of tumour regrowth following excision. Post‐operative complications occurred in five cases and were easily resolved in all but one. Continued or new growth of distant melanocytic tumours occurred in 50% of cases. Results suggest that excision of large melanocytic tumours in horses is a viable treatment option that is locally curative with minimal complications.     

Calcified tumours of the paranasal sinuses in three horses

Three horses, a 10-year-old Thoroughbred mare, a 9-year-old Thoroughbred gelding and a 6-year-old Arab gelding, with calcified tumours of the paranasal sinuses, are described. All horses presented with purulent nasal discharges and facial distortion. Exophthalmos, blepharospasm and ocular discharge were also a feature in individual horses. A presumptive diagnosis of a calcified tumour was made on the basis of clinical signs and radiographic and endoscopic findings. The tumours ranged from 15 to 25 cm in diameter. A large frontonasal bone flap was used to expose the tumours, which were cleaved into several pieces with an osteotome and removed. Histological examination of the masses identified cementomas in two cases and an osteoma in the third. Long term follow up from 18 months to 5 years after surgery indicated that there was no recurrence. This case series demonstrates that, although calcified tumours of the paranasal sinuses are rare in horses, they should be considered in the differential diagnosis of purulent nasal discharge, facial swelling and ocular distortion, and are amenable to surgical treatment.     

Penile and preputial tumours in the horse: a retrospective study of 114 affected horses

REASONS FOR PERFORMING STUDY: Preputial and penile tumours are more common in horses than in other domestic animals, but no large surveys of male horses with tumours of the external genitalia are available. OBJECTIVE: To present a retrospective analysis of male horses with neoplasms of the external genitalia. METHODS: The penile and preputial tumours of 114 horses were evaluated. Data recorded included age, gelding or stallion and breed; type and site of lesion; involvement of regional lymph nodes; histopathology (including grading of squamous cell carcinoma); and results of radiographic examination of the thorax. RESULTS: Mean age of horses was 19.5 years with no apparent breed predilection. Common presenting clinical signs were irregularities (e.g. the presence of a mass and/or ulceration) on the integument of the penis and prepuce, and purulent or sanguineous discharge from preputial orifice. Squamous cell carcinoma (SCC) was the most prevalent neoplasm followed by papillomas and melanomas. A basal cell carcinoma, neurofibrosarcoma, adenocarcinoma or fibrosarcoma were each found on single horses. Squamous cell carcinomas with poor differentiation had a higher tendency to metastasise than did more differentiated tumours. CONCLUSIONS: Squamous cell carcinoma is the most common urogenital tumour of the male horse and occurs primarily in old horses. Horses with poorly differentiated SCCs tend to have a higher incidence of regional metastases. Pathology of lymph nodes, even when not palpably enlarged, is a valuable diagnostic exercise. Radiology of the thorax to detect lung metastases is of little value.     

Fibromatous epulis and peripheral odontogenic fibroma in horses

Fibromatous epulis is a rare tumour in horses which is analogous to the same condition in dogs and peripheral odontogenic fibromas in man. The nomenclature is varied throughout the veterinary literature, but these tumours are most correctly known as peripheral odontogenic fibromas. Although these lesions are benign, they have a high recurrence rate in other species, so wide local excision is important to give the best possible prognosis.     

Standing hand‐assisted laparoscopic removal of large granulosa cell tumours in horses using a specimen retrieval bag and morcellator

This report describes a method for removal of large granulosa cell tumours through small paralumbar incisions using laparoscopic dissection of the mesovarium and subsequent removal of the ovary in a sterile retrieval bag via morcellation. Morcellation allows division of the granulosa cell tumour and subsequent reduction of incision size required for removal. The use of a specimen retrieval bag prevented contamination of the abdomen and incision with tumour cells during activation of the morcellator.     

Melanoma in horses: Current perspectives

Debate surrounding the nature of equine melanoma has resulted in an underestimation of its life‐threatening potential. Contrary to popular dogma, the variable, often slow, rate of growth commonly associated with equine melanoma does not warrant benign classification. Equine melanoma is a malignant neoplasm with the capacity for local invasion and metastasis. A classification scheme was proposed in 1995, but this does not address the progressive nature of equine malignant melanoma (EMM). Additionally, frustration with conflicting therapeutic recommendations has led many practitioners to inappropriately advocate benign neglect. This article addresses the need for a clinically applicable, standardised classification system, provides a review of current therapies and recommendations for equine practitioners, and comments on the future directions of EMM research.     

Anaplastic malignant melanoma of the tail in non‐grey horses

Information regarding signalment, clinical findings, treatment and outcome of 5 previously reported cases of anaplastic malignant melanoma of the tail in non‐grey horses and of 5 additional cases are summarised. Age was recorded for 9 horses and mean age was 16 years, range 8–23 years. Gender was recorded for 8 horses and 6 of these 8 horses were male horses over 14 years of age. The most common coat colour was bay (6 horses). Other coat colours were palomino (one horse), chestnut (one horse) and black (one horse); coat colour of one non‐grey horse was not specified. Follow‐up information was available for 9 horses and only one horse, a palomino, survived more than 10 months following diagnosis and tail amputation. Surgical excision, including tail amputation and medical therapy with oral cimetidine, was not effective in non‐grey, non‐palomino horses. Tumour recurred on tail tissue remaining after amputation in 2 horses, widespread metastases were documented in 4 cases and metastasis was suspected at the time of death or euthanasia in 3 cases, including one case with amputation site regrowth. No subjective histopathological differences were detected in the palomino horse that survived as compared to horses of other coat colours. Findings suggest that anaplastic malignant melanoma of the tail in non‐grey horses is most often a very aggressive neoplasm, but that there are rare exceptions.     

Paravertebral malignant peripheral nerve sheath tumour (MPNST) in a horse

A 10‐year‐old Lipizzaner gelding was presented with intermittent ataxia and hindlimb weakness. Ultrasonographic examination identified a mass cranial to the tuber sacrale. A provisional diagnosis of a soft tissue sarcoma was made based on a biopsy specimen. Owing to the extensive nature of the tumour and the associated poor prognosis, the horse was subjected to euthanasia on humane grounds. A post mortem examination revealed a locally infiltrative soft mass within the left lumbosacral epaxial musculature. Histologically, an infiltrative neoplasm predominantly composed of pleomorphic spindle or stellate‐shaped cells was identified. Neoplastic cells exhibited strong S‐100 protein and GFAP expression and variable vimentin, NSE, NGFR and myoglobin expression. They were uniformly negative for pan‐cytokeratin, melan A, laminin and desmin. The ultrastructural examination revealed pleomorphic cells with long cytoplasmic processes and an absence of melanosomes. Based on these results, a diagnosis of malignant peripheral nerve sheath tumour was made. This report contributes further information to assist in the diagnosis of these poorly defined neoplasms in animals, especially when they occur in uncommon locations.     

The clinical presentation of a mid‐tail melanocytoma with sudden malignant transformation in a bay Irish Draught gelding

Equine melanocytic tumours may be either a benign or malignant skin disease. They commonly involve the skin of grey horses. There are no reports of mid‐tail melanocytoma with sudden malignant transformation. Partial tail amputation was used to resect a melanocytic tumour mass from the mid‐tail of a 16‐year‐old bay Irish Draught (ID) horse. There was no evidence of significant re‐growth or complications at a 6‐month post operative examination.     

Computed tomography in the diagnosis of malignant sinonasal tumours in three horses

Malignant tumours are uncommon in horses, but when they do occur, they are most frequently found in the head. Clinical findings, such as facial swelling and nasal discharge, are frequently encountered but are nonspecific. To highlight the usefulness of a computed tomography (CT) examination in malignancy in the equine head, this Case Report describes the CT features of a leiomyosarcoma, an osteosarcoma and a sarcoma in 3 horses. CT of the equine head was able to provide more information about the extent and severity of lesions than conventional radiography in these cases.     

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.     

Use of intralesional cisplatin to successfully treat distal limb haemangiosarcoma in a foal

A 4-month old, 200 kg, grey warmblood colt presented for a firm, non painful mass on the distal medial aspect of the left third metatarsus. Excisional biopsy revealed a diagnosis of haemangiosarcoma. Equine haemangiosarcoma is uncommon and only limited reports of successful treatment are available. The prognosis for survival is therefore considered to be poor. After two separate incidences of recurrence with incomplete excision of the tumour, intralesional treatment with cisplatin without excision or debulking was performed on three separate occasions. Intralesional cisplatin injection was performed at monthly intervals for three treatments. Four years post treatment with cisplatin, the horse remained in remission. This case report describes the diagnostic and treatment challenges for successful treatment of a primary haemangiosarcoma on the distal limb of a warmblood foal using intralesional cisplatin chemotherapy.     

Paraneoplastic manifestations of cancer in horses

Paraneoplastic manifestations of cancer, probably under‐recognised in equine clinical practice, are often observed before the underlying primary disease is identified. This review provides a summary of paraneoplastic phenomena that have been reported in horses. The inclusion of paraneoplastic explanations in the differential diagnosis of common and challenging clinical problems should lead to earlier diagnosis and greater chance for successful therapeutic outcomes. In some cases, alterations in the clinical severity of paraneoplastic signs can be used as indicators of disease progression or response to treatment.     

Penile and preputial tumours in the horse: literature review and proposal of a standardised approach

Penile and preputial tumours are not uncommon in the horse, but can cause discomfort and lead to serious complications. Several types of tumour of the male external genitalia have been described. The most common type is the squamous cell carcinoma (SCC), which is found mainly in older horses. Reports of a breed predilection for penile tumour formation are equivocal, but castration, coat colour, poor hygiene and various infectious agents have all been suggested to predispose to the development of some types of tumour (e.g. SCC, papilloma and melanoma). Careful assessment of the primary tumour is an important first step in the design of an optimal treatment protocol. Invasiveness, differentiation grade, tumour size and presence of metastases are all relevant to the decision to pursue additional diagnostic procedures or specific treatment options. To date, no standard protocol has been reported for the approach to penile tumours in the horse and treatments range from minimally invasive therapies (e.g. topical use of 5-fluorouracil) to radical surgical interventions (e.g. en bloc penile and preputial resection with penile retroversion). Completeness of removal 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 the likelihood of recurrence. This review describes the most common penile and preputial neoplasms in the horse, and outlines a standard protocol aimed at arriving at a specific diagnosis and tailoring the therapeutic approach accordingly.