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Equine Med and Surgery II > Lecture 14: Equine Neoplasia > Flashcards

Lecture 14: Equine Neoplasia Flashcards

1
Q

What is the most common neoplasm of horses, donkeys and mules

A

equine sarcoids

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2
Q

equine sarcoids are __skin tumors

A

nonmetastatic

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3
Q

where are equine sarcoids most commonly located

A

head, ventral, abdomen, limbs

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4
Q

what are the 4 morphologic types of equine sarcoids

A
  1. Flat
  2. Verrucous
  3. Fibroblastic
  4. Mixed
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5
Q

flat (occult sarcoids) are often __thickness

A

partial

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6
Q

what wrong/type

A

flat (occult) sarcoid

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7
Q

verrucous (horny) sarcoids will grow if __ or __

A

injured or biopsied

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8
Q

verrucous (horny) sarcoids may be __thickness

A

partial

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9
Q

what wrong/type

A

Verrucous (horny) sarcoid

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10
Q

fibroblastic sarcoids are usually __thickness

A

full thickness

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11
Q

what wrong/type

A

fibroblastic sarcoid

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12
Q

what wrong/type

A

mixed sarcoid

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13
Q

what are some differentials for sarcoids

A
  1. Exuberant granulation tissue
  2. Habronemiasis
  3. Fibroma
  4. Fibrosarcoma
  5. Neurofibroma
  6. Rare mesenchymal tumors
  7. Infectious/non-infectious granulomas
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14
Q

what do you need for histo dx of sarcoids

A

skin

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15
Q

what does histo of sarcoid look like

A

capillary poor, fibroblastic proliferation, fibroblasts oriented perpendicular, hyperplastic epidermis

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16
Q

what type of sarcoids must be treated

A

fibrogranulomatous lesions

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17
Q

do verrucous or flat sarcoids need to be tx immediately

A

no, but should be evaluated closely

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18
Q

if you are going to biopsy sarcoids what you need to do

A

excisional biopsy- need to take all of it

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19
Q

If you can’t do excisional biopsy what is other option, but you wont have skin

A

trucut biopsy

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20
Q

what are the sarcoid therapy options

A
  1. Sx excision (laser or conventional)
  2. Laser vaporization (CO2)
  3. Local chemo (always)
  4. Hyperthermia
  5. Immunotherapy
  6. Cryotherapy
  7. Radiation
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21
Q

What is procedure for surgical excision of sarcoid

A

margins as wide as possible, primary closure if possible

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22
Q

what tx of sarcoids has best prognosis

A

complete excision (wide and deep) with primary closure

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23
Q

with surgical resection with primary closure you can avoid __tissue

A

granulation

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24
Q

How does CO2 laser excision and vaporization work

A

resects and evaporates tissue, follow with primary closure or second intention healing

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25
Q

cryotherapy has __% free of recurrence

A

70%

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26
Q

cryotherapy is best applied via __

A

direct spray

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27
Q

what is procedure for cryotherapy

A
  1. Freeze rapidly to -20 to -30 C
  2. Monitor with thermocouples
  3. Don’t freeze bone
  4. 2-3 freeze-thaw cycles needed
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28
Q

what are some complications of cryotherapy

A

Swelling, hyperemia, hemorrhage, edema, necrosis, destruction of hair follicles, new hair-white, facial paralysis, septic arthritis, loss of eyelid, significant tissue contraction

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29
Q

70% strength loss in cryotherapy if __

A

freeze cortical bone

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30
Q

what is immunotherapy bacillus of calmette and Guerin (BCG) made of

A

attenuated strain of M. Bovis

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31
Q

what is downside of BCG immunotherapy

A

tuberculin +

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32
Q

what location of sarcoids is BCG most effective in

A

peri ocular

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33
Q

what is XXterra

A

herbal formulation of bloodroot powder and zinc chloride

34
Q

what can XXterra tx

A

small sarcoid lesions

35
Q

how does hyperthermia tx work

A

heat 50 C for 30 seconds, repeated

36
Q

what is rationale for using CO2 laser removal on partial thickness sarcoids

A
  1. Partial thickness wounds don’t granulate- sarcoids tend to recur in granulating wounds
  2. More durable/efficient wound healing- no scar tissue epithelium
37
Q

Perform partial thickness vaporization on this sarcoid- what wrong what you need to do

A

Pink spots still tumor- need to remove

38
Q

what are your chemotherapy options for sarcoids

A
  1. Cisplatin beads or injections
  2. Fluoroacil crème
  3. Mitomycin C
39
Q

__% fluororacil crème is used for tx of penis and stays in sheath. how often and how many days

A

5%, BID 7-10 days

40
Q

__% fluorouracil crème is used for ocular/periocular SCC, how often

A

1%, 4-7 days, repeat same off period and then do 2-3 more times

41
Q

what is difference between cisplatin beads and injections

A

beads: 1 month intervals, injections: 2 weeks
Injections must infiltrate entire mass because does not diffuse, beads diffuse 15mm

42
Q

where do you not want to put cisplatin beads around eye and why

A

dorsal to eye- result in cisplatin slough

43
Q

what is MOA of topical fluorouracil

A

inhibits RNA and DNA synthesis (pyrimidine analog)

44
Q

treat __days with topical fluorouracil or until hypersensitivity appears

A

10-4 days

45
Q

how should you apply topical fluorouracil and why

A

Q-tips- big reaction

46
Q

what is protocol/days for ophthalmic ointment 1% fluorouracil

A

topical bid 4-7 days, same period off, repeat twice more

47
Q

what is sarcoid tx plan for periocular sarcoids

A

Excision, laser, chemo

48
Q

What is sarcoid tx plan for trunk and limbs

A

excision, debunk with laser or scalpel

49
Q

during sarcoid tx you want to avoid __bed

A

granulation bed

50
Q

what part of sarcoid tx plan helps avoid granulation bed

A

chemo

51
Q

mass on flank- what is it likely and how do you remove it

A

Dx: subdermal fibroma
Can just pop it out of skin

52
Q

what wrong and can you tx this

A

Malevolent sarcoid
Not going to win this

53
Q

cutaneous SCC are common in what horses

A

lightly pigmented: Appaloosas, pintos, and paints

Draft horses

54
Q

what 2 factors contribute to cutaneous SCC

A

UV light, altitude

55
Q

what are some common locations of SCC

A
  1. Cornea/limbus, 3rd eyelid
  2. External genitalia geldings and mares
  3. Mucocutaneous junctions
  4. Hoof wall
  5. Secondary to burns
56
Q

what wrong

A

precancerous lesion on penis- likely will turn into SCC

57
Q

histo of mass- what is dx and what is characteristic of this histo

A

Dx: SCC
Histo: keratin pearl

58
Q

what are some early physical manifestations of SCC

A

small, superficial nodules

59
Q

what are some later physical manifestations of SCC

A

ulceration, necrosis, odor

60
Q

what wrong

A

Erosive conjunctival SCC

61
Q

what wrong

A

3rd eyelid SCC

62
Q

after resection of SCC what do you always need to follow with

A

chemo

63
Q

what are the tx options for SCC

A
  1. Laser or sharp resection/ vaporization
  2. Chemo- cisplatin
  3. Hyperthermia
  4. Debulking-cryotherapy
  5. Beta irradiation
  6. Corneal/conjunctival chemo (fluorouracil, mitomycin)
64
Q

what chemos are used in corneal/conjunctival SCC tx

A

fluorouracil and mitomycin C

65
Q

penile SCC- what is tx

A

amputate penis, chemo

66
Q

what wrong and is this low or high risk

A

vulvar SCC- high risk can lose mares to this

67
Q

Horse ear: what this

A

aural plaques

68
Q

t or f: aural plaques do not resolve and do not have effective tx

A

true

69
Q

What wrong

A

equine melanoma

70
Q

what is melanocytic nevi

A

uncommon, younger horses, subepithelial melanin

71
Q

what is dermal melanoma/ melanomatosis

A

very common, horses middle to older age, dermal melanin

72
Q

what is anaplastic malignant melanoma

A

non gray horses, non-pigmened
Almost always fatal

73
Q

which is melanocytic nevus vs dermal melanoma

A

left: melanocytic nevus- subepithelial melanin
Right: Dermal melanoma- dermal melanin

74
Q

anaplastic malignant melanoma has extremely __ cells with numerous __ figures

A

pleomorphic cells, numerous mitotic figures

75
Q

t or f: anaplastic malignant melanoma is rare, extremely metastatic

A

true

76
Q

equine melanocytic tumors are typical in older __horses

A

gray or white

77
Q

what are some common locations for dermal melanoma

A

ventral tail, perineum, external genitalia, parotid salivary gland, limb, neck, ears, eyelids, internal, lip, comminuted of mouth

78
Q

dermal melanomas are ___when exceed blood supply

A

ulcerated/draining

79
Q

what wrong- and how would you name these 2

A

Left: dermal melanoma
Right: dermal melanomatosis

80
Q

what is tx for melanocytic tumors

A
  1. Wide sx margins
  2. Cisplatin sensitive
  3. Cryonecrosis- regrow to
  4. Laser hyperthermia
81
Q

t or f: BCG immunotherapy and cimetidine are effective against melanocytic tumors

A

false

Equine Med and Surgery II (15 decks)

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