Equine Sarcoid

Question 1

What does the term sarcoid mean?

Answer 1

Sarcoma-like

Question 2

What is the most common tumor in the horse?

Answer 2

Sarcoids

Question 3

What percentage of all equine tumors do sarcoids represent?

Answer 3

20%

Question 4

What percentage of all skin tumors do sarcoids represent?

Answer 4

90%

Question 5

What is a sarcoid?

Answer 5

A benign, non-metastatic growth that is both invasive and recurrent.

Question 6

What is the cause of sarcoids?

Answer 6

A papova virus

Question 7

What age do we typically see sarcoids?

Answer 7

3-6 years

Question 8

Where do we typically see sarcoid?

Answer 8

Anywhere on the body, but often on the head and neck, ventrum and limbs.

Question 9

What percentage of sarcoids do we see on the limbs?

Answer 9

45%

Question 10

What percentage of sarcoids do we see on the head and neck?

Answer 10

32%

Question 11

What percentage of sarcoids do we see on the ventrum?

Answer 11

20%

Question 12

Regarding sarcoids on the limbs, which limb is most affected?

Answer 12

Hindlimbs > forelimbs

Question 13

Regarding sarcoids on the limbs, what location on the limb is most affected?

Answer 13

Above tarsus/carpus > below

Question 14

Regarding sarcoids on the head and neck, what are seems most affected?

Answer 14

Periorbital > ears and rest of head

Question 15

What are the 4 forms of sarcoids?

Answer 15

Verrucous
Fibroblastic
Mixed
Occult

Question 16

Describe the verrucous sarcoid.

Answer 16

Warty, dry and scaly.

NOTE: Tends to transform into the fibroblastic form if traumatized.

Question 17

Describe the fibroblastic sarcoid.

Answer 17

Proudflesh-like. Epithelium is often ulcerated.

Question 18

Describe mixed sarcoids.

Answer 18

A combo of both verrucous and fibroblastic.

Question 19

Describe occult sarcoids.

Answer 19

Inflammatory, slightly raised nodules on the skin.

Question 20

How to we confirm sarcoids?

Answer 20

Biopsy and histopathology

Question 21

How do we often treat sarcoids?

Answer 21

Note in the record, show the owner, biopsy and histopath to confirm and then treat with benign neglect.

Question 22

How can you differentiate fibroblastic sarcoids from proudflesh?

Answer 22

Biopsy and histopathology.

Question 23

What are 5 differentials for sarcoids?

Answer 23

Exuberant granulation tissue
Fibrosarcoma
Fibroma
SCC
Habronemiasis (If you tx with Ivomec, will regress)

Question 24

Why do you need to send possible sarcoid samples to a veterianry pathologist?

Answer 24

Because there is NO similarity between human and equine sarcoids

Question 25

What will you see on a histopath slide of a sarcoid?

Answer 25

Dermal spindle cells

Question 26

What sarcoids would you refer out?

Answer 26

Any that are refractory or fast growing.

Question 27

There are 7 different therapies for sarcoids, list 4 of them.

Answer 27

``` Surgical excision Cryosurgery Hyperthermia Laser therapy Immunotherapy Brachytherapy Chemotherapy ```

Question 28

What 4 things help you choose which therapy you use for sarcoids?

Answer 28

Size Number Anatomical location Histologic type

Question 29

What is the prognosis with surgical excision of sarcoids?

Answer 29

Guarded

Question 30

What is a downside to surgical excision of sarcoids?

Answer 30

Recurs within 3 years, most regrow within 6 months.

Question 31

What is a big thing to remember when using surgical excision to treat sarcoids?

Answer 31

Careless handling of instruments can contaminate and re-seed.

Question 32

What are 3 different cryogens that can be used in cryosurgery?

Answer 32

Liquid nitrogen Nitrous oxide Freon

Question 33

When using cryosurgery to treat sarcoids, what must you remember to do around the area?

Answer 33

Protect it with an insulator.

Question 34

Describe the cryosurgery procedure for treating sarcoids.

Answer 34

Pre-treat with NSAIDs. Sedate. Freeze to a temp of -20 or -30C. Repeat at least once. Provide tetanus prophylaxis.

Question 35

What is the average healing time post-cryosurgery?

Answer 35

2.4 months

Question 36

What are 4 concerns with cryosurgery for treating sarcoids?

Answer 36

Protection of surrounding tissue Deeper structures (eg. tendons) Inadequate necrosis leading to recurrence Delayed healing

Question 37

What is hyperthermia treatment for treating sarcoids?

Answer 37

Application of heat of 50C for 60 seconds per site.

Question 38

When using hyperthermia for sarcoids, how often do you treat?

Answer 38

Three treatments, two weeks apart.

Question 39

If using chemotherapy for treatment of sarcoids, what is the best way of doing this?

Answer 39

Using a small concentration locally to save money, have greater effect and lessen the risk of kidney damage.

Question 40

What was the treatment regimine in lecture for using Cisplatin to treat sarcoids?

Answer 40

4 intratumoral injections at 2 week intervals.

Question 41

What do we need to be careful about when treating sarcoids with Cisplatin?

Answer 41

Do it yourself and wear proper protection because it can cause skin reactions in humans.

Question 42

What is Xxterra and what is it used to treat?

Answer 42

It's a caustic agent to treat sarcoids. It changes the antigenicity of the sarcoid so the body recognizes it as foreign and produces antibodies.

Question 43

How do you use Xxterra to treat sarcoids?

Answer 43

Apply to sarcoid and place a bandage over it for 4 days.

Question 44

What might you see at the treated area when using Xxterra to treat sarcoids?

Answer 44

Area might ooze purulent material and become malodorous.