The epidemiology of squamous cell carcinoma of the perineal region of sheep: Abattoir and flock studies

The roles of age, tail length and the Mules operation in the epidemiology of squamous cell carcinoma in ewes were studied. The prevalence of the disease in adult sheep slaughtered at 2 abattoirs was 0.08%. No cases occurred in lambs. Of all adult sheep condemnations before slaughter, 38.5% were due to squamous cell carcinoma. Of these sheep, 73.3% had a single lesion of the vulva (62.9%), tail (6.6%), or anus (3.8%), while 26.7% had lesions at more than one site. The number of lesions was significantly greater (p < 0.01) in sheep with a radical Mules operation than in those with a modified Mules operation or not mulesed. Tails were significantly shorter (p < 0.01) in affected than unaffected sheep. Small keratinised outgrowths on the skin of the tail and perineum were considered on histological grounds to be precursors of squamous cell carcinomas. On one affected farm 4% of ewes were culled in one year for gross lesions of squamous cell carcinomas. A further 3.5% of sheep with gross lesions and 25.3% with precursor lesions remained in the flock, undetected by the farmer. Gross lesions were not observed in ewes under 3 years of age, whereas precursors occurred in all age groups, including one-year-old ewes. The prevalence of lesions increased with age, from 0.43% in 5-year-old ewes to 5.14% in 6-year-old and 41% in 7-year-old ewes. Discriminant analysis indicated that age of ewe, tail length and the width of the healed Mules operation were important determinants of squamous cell carcinoma. In all the sheep studied the style of mulesing was consistently radical, with a mean healed width of 12.3 ± 2.6 cm. Tails were amputated much shorter than the traditionally recommended length of level with the tip of the vulva. The presence of gross and precursor lesions was associated with shorter tails and a radical Mules operation. It is suggested that the prevalence of the disease may be reduced by the adoption of a less severe mulesing technique and leaving tails longer.     

Factors influencing morbidity and outcome of equine ocular squamous cell carcinoma

A retrospective review of 41 cases of equine ocular squamous cell carcinoma with follow up information for 33 horses is presented. An apparent prevalence in heavy horse breeds was identified. Age and sex distribution were similar to those previously reported. High recurrence (42.4 per cent) and low metastasis (6 per cent) rates were seen. Initial tumour location, primary treatment used, or patient case history had no apparent influence on final outcome. The willingness of owners to pursue with continuous treatment correlated with a high degree of success.     

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.     

Toxicity and outcome in cats with oral squamous cell carcinoma after accelerated hypofractionated radiotherapy and concurrent systemic treatment

Recently, a multimodal approach to oral squamous cell carcinoma (SCC) in cats, combining medical treatment and accelerated radiation therapy, showed a substantial outcome improvement in a small pilot study. Herein we retrospectively review 51 cats with unresectable, histologically confirmed oral SCC and a complete initial staging work‐up: cats in group A (n = 24) received medical anti‐angiogenic treatment consisting of bleomycin, piroxicam and thalidomide, cats in group B (n = 27) received the anti‐angiogenic treatment and concurrent accelerated hypofractionated radiation therapy with 48Gy delivered in 10 fractions. Overall median progression‐free interval (PFI) was poor with 70 days (95% CI: 48;93). In the irradiated cats (group B), however, PFI was significantly longer with 179 days (95% CI: 58;301) days, vs 30 days (95% CI: 23;38) in medically only treated cats (P < .001). Overall median overall survival (OS) was 89 days (95% CI: 55;124), again significantly longer in the irradiated cats (group B) with 136 (95% CI: 40;233) vs 38 days (95% CI: 23;54) (P < .001). In 8 of the 27 (29.6%) cats in group B, however, severe toxicity (grade 3) occurred. Neither onset nor severity of toxicity could be associated with any of the tested variables, including anatomic site, tumour size, clinical stage and duration of neoadjuvant medical treatment. Given the potential severe acute effects and the impact on quality of life after chemo‐radiotherapy, owners must be clearly informed about the risks of treatment. With the overall poor outcome and high occurrence of acute toxicity, we cannot recommend the use of this accelerated radiation protocol combined with anti‐angiogenic therapy for oral SCC in cats.     

Long-term outcome of treatment of a squamous cell carcinoma of the foot by amputation of the distal limb in a pony

This report describes a rare case of squamous cell carcinoma (SCC) in a 10-year-old Shetland pony. The pony was presented for evaluation of a chronic, ulcerating mass of the foot associated with a nonweightbearing lameness of the right forelimb. Foot radiographs revealed an aggressive bone lesion with severe osteolysis of the distal phalanx. Amputation of the digit was performed under general anaesthesia at the level of the metacarpophalangeal joint using a palmar flap technique and a transfixation cast for protection of the stump. Avascular necrosis, infection and dehiscence of the stump occurred 3 weeks later and a second amputation was performed at the level of the proximal third of the third metacarpal bone. Histopathology revealed a squamous cell carcinoma. After healing of the stump, a prosthesis was fitted to the limb for improved ambulation of the pony. Two years after the amputation, telephone follow-up with the referring veterinarian and the owner, revealed that the pony was healthy and able to go out daily in a paddock with its prosthesis. SCC represents an unusual indication for limb amputation. Successful outcome is rarely reported in horses.     

Predicting clinical outcome in feline oral squamous cell carcinoma: tumour initiating cells,telomeres and telomerase

Feline oral squamous cell carcinoma (SCC) has very poor prognosis. Here, a retrospective pilot study was conducted on 20 feline oral SCC patients who underwent stereotactic radiation therapy (SRT), to evaluate: (1) the value of putative tumour initiating cell (TIC) markers of human head and neck SCC (CD44, Bmi‐1); (2) telomere length (TL) specifically in putative TICs; and (3) tumour relative telomerase activity (TA). Significant inverse correlations were found between treatment outcomes and Bmi‐1 expression, supporting the predictive value of Bmi‐1 as a negative prognostic indicator. While TL exhibited a wide range of variability, particularly in very short fractions, many tumours possessed high levels of TA, which correlated with high levels of Bmi‐1, Ki67 and EGFR. Taken together, our results imply that Bmi‐1 and telomerase may represent novel therapeutic targets in feline oral SCC, as their inhibition – in combination with SRT – would be expected to have beneficial treatment outcome.     

Successful treatment of a squamous cell carcinoma in a white rhinoceros, Ceratotherium simum

A captive 33-year-old male white rhinoceros with seasonal dermatitis was diagnosed with a malignant squamous cell carcinoma on the right flank. Staphylococcus aureus was cultured from the skin lesions. No fungal or yeast was isolated. The dermatitis was treated with a combination of oral antibiotics (trimethoprim-sulphadiazine) and topically with weekly chlorhexidine washes and a mixture of a zinc oxide, balsam peru and bismuth oxide cream. Under azaperone and butorphanol anaesthesia, the skin tumour was surgically removed. The tumour was excised with wide margins and allowed to heal by secondary intention as primary wound closure was not possible. A post-mortem performed 2 years later for an unrelated condition revealed no metastases or recurrence of the skin tumour. It was presumed that chronic irritation or trauma may have contributed to the development of the skin tumour. This is the first detailed report of the successful treatment of a squamous cell carcinoma not associated with the horn in a rhinoceros.     

Evaluation of piroxicam for the treatment of oral squamous cell carcinoma in dogs

OBJECTIVE: To evaluate the use of piroxicam for the treatment of oral squamous cell carcinoma in dogs. DESIGN: Prospective case series. ANIMALS: 17 dogs with measurable oral squamous cell carcinoma. PROCEDURE: Dogs were treated with piroxicam at a dosage of 0.3 mg/kg (0.14 mg/lb) of body weight, PO, every 24 hours until progressive disease or unacceptable signs of toxicosis developed or the dog died. RESULTS: One dog had a complete remission (maxillary tumor), and 2 dogs had partial remissions (lingual tumor and tonsillar tumor). An additional 5 dogs had stable disease, including 1 with a maxillary tumor, 2 with mandibular tumors, and 2 with tonsillar tumors. Variables associated with tumor response were not identified. Median and mean times to failure for the 3 dogs that had a remission were 180 and 223 days, respectively. Median and mean times to failure for the 5 dogs with stable disease were 102 and 223 days, respectively. Time to failure was positively associated with tumor response and negatively associated with tumor size. One dog had mild adverse gastrointestinal tract effects that resolved with the addition of misoprostol to the treatment regimen. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that piroxicam may be useful in the treatment of dogs with oral squamous cell carcinoma; response rate was similar to that reported for other cytotoxic treatments. Larger-scale studies are warranted to determine what role piroxicam may have, alone or in combination with other treatments, for the treatment of dogs with oral squamous cell carcinoma.     

Cryosurgical treatment of ocular squamous cell carcinoma of cattle.

A total of 718 ocular squamous cell carcinomas of cattle were treated with various cryosurgical units and techniques during a 2.5-year study. In 609 of the lesions, a single freeze was used, with a cure rate (total regression) of 66%. In 109 lesions treated with a double freeze-thaw cycle (rapid freeze to - 25 C, and unaided thaw followed immediately by refreezing to -25 C), the cure rate was 97%. Cryosurgical units designed for delivery of liquid nitrogen provided a more rapid rate of freezing and, thus, a higher cure rate than did units designed for delivery of nitrogen vapor. It was concluded that cryosurgery for treatment of squamous cell carcinoma is a simple and rapid procedure; is economical; provides analgesia itself, due to sensory nerve injury; requires minimal preoperative and no postoperative medication; causes minimal side effects; may be repeated; and is excellent for use on suspect premalignant lesions.     

Delayed metastasis of ocular squamous cell carcinoma following treatment in five horses

Identification of regional and/or distant metastasis following treatment and local resolution of primary ocular squamous cell carcinoma (SCC) was observed in 5 horses. In all cases, identification of metastasis occurred at least 18 months following treatment of the primary ocular lesions. In 3 cases, invasion of blood or lymphatic vessels by neoplastic cells was identified in the excisional biopsies of the primary tumour. Two horses developed SCC at 2 or more separate sites. At the time metastases were identified, there was no evidence of local recurrence of the ocular tumour in any of the horses. These cases confirm the importance of long‐term monitoring of horses for metastatic disease following treatment of ocular SCC even in the absence of local recurrence.     

Electrochemotherapy for the treatment of squamous cell carcinoma in cats: a preliminary report

Squamous cell carcinomas (SCC) of the skin are commonly described in cats. Reported treatments include surgery, radiation therapy and photodynamic therapy. This preliminary study reports on the management of these lesions combining the local administration of bleomycin (plus hyaluronidase for a more uniform distribution) with permeabilizing biphasic electric pulses. Nine cats with SCC graded T(2)-T(4) were treated over a 5 year period, and each cat received two sessions of electrochemotherapy (ECT) 1 week apart. The side effects of this treatment were minimal and limited to mild erythema of the nose. Seven of the cats (77.7%) had a complete response lasting up to 3 years. ECT seems to be a safe and effective option for the treatment of feline sun-induced squamous cell carcinomas and warrants further investigation.     

Surgical treatment of 45 horses affected by squamous cell carcinoma of the penis and prepuce

The medical records of 45 horses treated for suspected squamous cell carcinoma of the penis and/or prepuce were reviewed. The age of 40 horses was known, and these had a mean age of 17.4 years. The duration of neoplasia was known for only 3 of the 45 horses. The results of histological evaluation of lesions, available for 35 horses, confirmed that the diseased tissue was squamous cell carcinoma. The location of gross neoplastic lesions was recorded for 43 horses; the glans penis was involved in 24 horses, the body of the penis or the inner lamina of the preputial fold in 27 horses, and the external fold of the prepuce in 10 horses. Surgical treatments of these horses included phallectomy (penile amputation) in 35 horses, segmental posthectomy in 4 horses, phallectomy plus segmental posthectomy in 2 horses, and en bloc resection of the penis, prepuce and superficial inguinal lymph nodes with penile retroversion in 4 cases. Short-term complications in the immediate postoperative period included preputial oedema and haemorrhage at the end of urination. One horse developed acute urinary retention because of severe urethral oedema. Long-term (>1 year) follow-up information was obtained for 31 horses. Neoplasia of the penis and/or prepuce recurred in 6 of these 31 horses (19%), and in 5 of these the recurrence necessitated euthanasia of the horse.     

Carbon dioxide laser ablation for treatment of limbal squamous cell carcinoma in horses

Limbal squamous cell carcinoma in 4 horses was treated successfully, using carbon dioxide laser ablation. Tumors were removed, with minimal to no postoperative inflammation or discomfort to the horses. Carbon dioxide laser ablation represents a promising new option in the treatment of limbal squamous cell carcinoma in horses.     

Hypofractionated radiation therapy for the treatment of malignant melanoma and squamous cell carcinoma in dogs and cats

This study describes the experience with hypofractionated radiation therapy of squamous cell carcinoma and melanoma in dogs and cats. A total dose of 32-48 Gray (Gy) was delivered once a week in 8 Gy fractions. 34 animals in which a complete surgical excision was impossible were treated. There was no tumor detectable macroscopically in 14 patients at the beginning of radiation therapy. In 20 animals the median volume of the tumor was 9.9 cm3. The median survival times and the local tumor control of squamous cell carcinoma of the oral and nasal cavities and of the body are comparable to results which were reached with a Monday-Wednesday-Friday scheme. For the treatment of Melanoma the hypofractionated radiation therapy is first choice. There are no significant side effects. Late side effects did not occur. 88% of the owners are satisfied with this kind of treatment and would choose it again.