Chapter 28 - Grafting Flashcards
What is the predominant type of skin disease in horses requiring surgical consultation?
sarcoids, which are neoplastic in origin
What are the clinical subtypes of sarcoids based on their appearance?
- Occult,
- verrucous,
- nodular fibroblastic,
- ulcerative fibroblastic,
- mixed tumors, and
- malevolent.
Which subtype of sarcoid is considered the most aggressive?
Malevolent sarcoids.
Where on the horse’s body do sarcoids commonly occur?
Common sites include the face, distal limbs, neck, ventral abdomen, and areas of previous injury
Which breed of horse is statistically more likely to develop sarcoids?
Quarter Horses and related stock breeds.
What genetic component is associated with the risk of developing equine sarcoids?
Equine leukocyte antigens (ELA) alleles, particularly A3 and W13.
How does age correlate with the development of sarcoids in horses?
Sarcoids generally develop in younger individuals, suggesting a genetic predisposition or exogenous factor.
What virus is closely associated with the presence of sarcoids in horses?
Bovine papillomavirus (BPV).
Do papillomaviruses trigger transformation alone in horses?
No, viral infection alone is not sufficient for transformation; other factors are involved.
What role do the viral proteins E5 and E6 play in the context of sarcoids?
They have the capability to transform cells into a malignancy.
What clinical outcome was observed in 48% of affected Franches-Montagnes horses over a study period of 2 to 5 years?
Spontaneous regression of sarcoids.
Which subtype of sarcoids is more likely to undergo spontaneous regression?
Occult sarcoids.
Why Standardbred are resistant to sarcoids?
The absence of the W13 allele in the Standardbred population may confer relative resistance to sarcoid.
What impact does incomplete or unsuccessful treatment of sarcoids have on future treatments?
It can transform the tumors into a more aggressive phenotype, making them harder to resolve.
What factors complicate the assessment of treatment efficacy for sarcoids?
The variability in treatment success and the lack of controlled early studies.
What is a potential triggering event that may activate a latent viral state in sarcoids?
Previous injury or trauma.
What does the evidence suggest about the relationship between environmental factors and sarcoid occurrence?
Sarcoid occurrence is likely due to a combination of host, viral, and environmental factors.
Why is it challenging to assess the efficacy of treatment options for sarcoids?
Most early studies were not controlled and based on a subset of cases.
What type of sarcoids are commonly referred for treatment?
More aggressive variants or tumors that have recurred after treatment.
What can incomplete or unsuccessful treatment of sarcoids lead to?
Transformation into a more aggressive phenotype.
How successful is surgical excision alone for treating sarcoids, based on reported recurrence rates?
Recurrence rates range from 15.8% to 82%.
What factor may contribute to the low success rates of surgical excision?
The presence of malignant cell projections into surrounding tissue.
What treatment method showed the best success rate in a recent retrospective study?
Electrosurgical excision.
What success rate was reported for laser ablation of sarcoids?
An overall success rate of 83%.
What is a significant benefit of laser ablation compared to traditional excision methods?
t causes less damage to surrounding tissues and reduces malignant cell spread.
What challenge is associated with cryotherapy for periorbital sarcoids?
A high recurrence rate of 91%.
How can cryotherapy achieve better outcomes?
With experienced practitioners and multiple treatment sessions.
What treatment method involves the use of thermal energy to treat sarcoids?
Hyperthermia.
What does radiotherapy using iridium-192 reportedly achieve in treating sarcoids?
Low recurrence rates, with some studies showing up to 100% initial success.
What are some potential complications of radiotherapy in equine sarcoid treatment?
Hair loss, pigmentation changes, fibrosis, cataract formation, and corneal ulceration.
What role does immunotherapy play in treating equine sarcoids?
It enhances immune recognition and can lead to tumor resolution.
Which immunotherapeutic agent has been used successfully against equine sarcoids?
Bacille Calmette-Guérin (BCG) vaccine.
What outcome is associated with the use of autogenous tumor vaccines in treating sarcoids?
Clinical resolution was achieved in 68.8% of cases.
What aspect of intralesional cisplatin treatment is critical for success?
The concentration and administration in an oily emulsion.
How effective was imiquimod found to be in pilot studies for treating sarcoids?
It resulted in over 75% size reduction in 80% of treated sarcoids.
What is the mechanism of action of aciclovir in treating equine sarcoids?
It inhibits viral DNA synthesis.
What treatment option had a resolution rate of 66% for small tumors?
5-fluorouracil (5-FU).
What is the preferred protocol for administering imiquimod?
Every-other-day application.
What does electrochemotherapy (ECT) combine to improve treatment outcomes?
Chemotherapeutic drugs and high-voltage electric pulses.
What reported resolution rate exists for sarcoids treated with electrochemotherapy in retrospective studies?
Between 92.3% to 100%.
Why might combined treatment modalities be necessary in managing equine sarcoids?
They are often larger, more aggressive, or occur in multiple locations.
What potential benefit does cryotherapy provide beyond direct treatment?
It may initiate an immune response against distant untreated sarcoids.
What systemic effects can be mitigated by using cisplatin in an oily emulsion?
It prevents significant systemic levels and maintains effective tissue levels for prolonged periods.
What is electrochemotherapy (ECT) and what are its reported resolution rates for sarcoids?
ECT combines chemotherapeutics and electric pulses to enhance drug efficacy, with reported resolution rates of 92.3% to 100%.
Marteens study mentions surgical excision of sarcoid of minimum ______ mm
12 mm and gloove changes
success rate 86.8%
How effective was aciclovir in decreasing tumor mass according to reported findings?
Complete regression occurred in 32 out of 47 tumors (68%).
What successful treatment method for sarcoids was highlighted in recent studies?
Electrosurgical excision with an overall success rate of 86.8%.
What factor contributes to the low success rate of surgical excision of sarcoids?
The presence of malignant cell projections into surrounding normal tissue that may be missed during histopathology.
What percentage of ocular SCC cases occur in horses with no periocular pigmentation?
69%
What is the reported nonrecurrence rate for β-irradiation in treating small corneal lesions?
89%
What is the proposed cause of SCC in poorly pigmented horses?
Ultraviolet light-induced damage
Squamous cell carcinoma is what type of neoplasia?
a malignant, locally invasive neoplasia of squamous epithelial cells
What is the second most common neoplasia in horses?
SCC
What are the predilected areas for SCC?
areas lacking pigmentation, poorly haired regions, and skin near mucocutaneous junctions
eye, conjunctiva, ocular adnexal structures, and external genitalia
It should be considered in horses with chronic refractory foot abcesses?
Yes
Proposed irritants include topically
applied chemicals, smegma, and flies.
What breeds are predisposed to SCC?
Breeds with poorly pigmented, pink-skinned areas, including Appaloosas and paint-colored horses, draft horses are more prone to develop SCC
What virus has been detected in a subset of genital SCC?
equus caballus papillomavirus 2 (EcPV2)
SCC can be classified in 2 types name them
ulcerative - mistaken for nonhealing wounds
proliferative -
SCC has also been reported in the nasal cavity, paranasal sinuses, pharynx, larynx, and hoof capsule TRUE or FALSE
TRUE
How are caractherized teh ocular lesion?
can begin as small ulcerative lesions on lid margins, or as keratitic plaques on the cornea
Proliferative pedunculated lesions on the penis often have a _____________(1w) appearance
Proliferative pedunculated lesions on the penis often have a cauliflower-like appearance
SCC typically spreads to surrounding tissues and local lymph nodes, but distant metastasis is rare - TRUE or FALSE
TRUE
Name the tx
- Surgical excision
- Radiation therapy
- Topical application
- Antimitotics
- Intralesional chemotherapy
- Cryotherapy
- Laser excision
- Hyperthermia
- immunotherapy
- Photodynamic
Why is β-irradiation considered effective for small corneal SCC lesions?
It has a very short penetration depth, making it useful for small lesions.
What are the limitations of radiation therapy for treating SCC in horses?
It requires specialized equipment, licensure, and special housing, limiting its use to referral practices.
How does intralesional chemotherapy work in the treatment of SCC?
It involves injecting chemotherapy directly into the tumor, often after surgical cytoreduction.
What is the advantage of using intralesional cisplatin in treating SCC?
t is effective in achieving local control, particularly in genital SCC cases.
What are some side effects or drawbacks of intralesional chemotherapy for SCC?
Multiple treatments, high cost, and potential exposure of staff to chemotherapy agents.
In what cases is topical 5-FU recommended for SCC treatment?
For small, superficial tumors of the external genitalia.
What are some adverse effects associated with the use of topical 5-FU?
Local inflammation and swelling.
How is mitomycin C used in treating ocular SCC in horses?
It can be used alone or in combination with surgical excision to treat SCC.
What are the comparative cure rates for mitomycin C and CO2 photoablation in treating ocular SCC?
Both treatments have similar cure rates, according to a retrospective study.
How does the nonsteroidal anti-inflammatory drug piroxicam treat SCC?
By inhibiting COX enzymes, which are overexpressed in some neoplastic tissues.
What was the outcome of using piroxicam to treat recurrent SCC of the lower lip in horses?
Both lower lip and metastatic lesions resolved with no recurrence after 5 years.
What is photodynamic therapy and how is it used in treating SCC in horses?
It involves using a photoactive agent and light to generate reactive oxygen species, causing local tissue necrosis.
What was the result of using photodynamic therapy as an adjunct treatment for periocular SCC?
Horses remained tumor-free for the duration of the follow-up period.
What was the recurrence rate of SCC when photodynamic therapy was compared to cryotherapy?
Photodynamic therapy showed a significantly lower recurrence rate than cryotherapy.
What types of SCC lesions might benefit from β-irradiation treatment?
Small corneal lesions.
Why is SCC often more challenging to treat when it affects the periorbital region?
Periorbital SCC is less responsive to treatment than genital SCC.
What is the benefit of combination therapy over single-modality treatment for ocular SCC?
Combination therapy has a higher success rate.
What role does cyclooxygenase-2 (COX-2) overexpression play in SCC?
It is overexpressed in some SCC tissues and is targeted by drugs like piroxicam.
How effective is the combination of mitomycin C and surgical excision for treating ocular SCC?
It has a high cure rate.
What challenges are associated with the use of radiation implants in SCC treatment?
Hospitalization and special housing are required, along with specialized equipment.