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EQUINE > 19.4.2: The lumpy horse > Flashcards

19.4.2: The lumpy horse Flashcards

1
Q
A

Melanoma
* Occurs mostly in grey horses (more common in whit and lighter greys compared to dark, dappled grey and flea bitten)
* Usually develops 4-8 y.o. and change increases with age

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2
Q

Aetiology of melanomas

A
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3
Q

Types of melanomas

A
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4
Q

Typical melanoma locations

A
  • Tail
  • Perineum
  • Parotid region
  • Commisure of lips / eyes
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5
Q

Diagnosis of melanoma

A
  • Visual inspection
  • Ultrasound
  • FNA
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6
Q

Signalment for malignant melanoma

A

a.k.a. anaplastic malignant melanoma
* Seen in older, non-grey horses
* Tail and tail heads = very common site
* Have metastasised by the time of diagnosis
* Rare

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7
Q
A

Sarcoid

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8
Q

Characteristics of equine sarcoids

A
  • Benign, non-metastatic
  • Locally aggressive
  • Found in all equids
  • Have high recurrence
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9
Q

Types of sarcoids

A
  1. Occult
  2. Verrucose
  3. Nodular
  4. Fibroblastic
  5. Mixed
  6. Malignant / malevolent
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10
Q

Characteristics of occult sarcoids

A
  • Mildest/ most stable/ most superficial form of sarcoid
  • Can remain unchanged for years
  • Hairless skin
  • 1 or more 2-5 cm cutaneous nodules or roughened areas with mild hyperkeratotic region around
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11
Q
A

Occult sarcoids

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12
Q

Characteristics of verrucose sarcoids

A
  • Rarely aggressive until injuried
  • Rough hyperkeratotic appearance with some flaking or scaling around it
  • Warty-looking
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13
Q
A

Verrucose sarcoid

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14
Q

Characteristics of nodular sarcoids

A
  • Usually not an issue until injuried
  • Firm, spherical, subcutaneous nodules of variable sizes (0.5-20cm)
  • 2 types: Type A confined to subcutaneous tissues, Type B have some involvement of overlying skin
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15
Q
A

Nodular sarcoid

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16
Q

Characteristics of fibroblastic sarcoids

A
  • Ulcerated fleshy aggressive appearance
  • 2 types
  • Type 1: pedunculated with limited/ small base palpable under the skin
  • Type 2: wide base, often diffuse / ill-defined margins
17
Q
A

Fibroblastic sarcoid

18
Q

Characteristics of mixed sarcoids

A
  • Mixture of 2 or more types of sarcoids
  • Transient state between verrucous/ occult/ nodular to fibroblastic
19
Q
A

Mixed sarcoid

20
Q

Characteristics of malignant / malevolent sarcoids

A
  • Most severe, highly invasive form
  • There is infiltration of lymphatic vessels
  • Often following trauma or failed treatment
  • There is a cord of palpable tumour
21
Q

Causes and transmission of equine sarcoids

A

Causes
* Bovine papillomavirus (BPV) type 1 and sometimes 2 is found in the sarcoid tissue but also in normal skin of several horses
* Carriers = sarcoid-affected horses and horses living with cattle
* BPV is one factor among others

Transmission
* Not fully understood
* Direct contact with sarcoids/ direct contact with cattle or horses carrying BPV
* BPV transmission by stable fly is possible
* More likely after fly has been in contact with BPV than horse sarcoids

22
Q

How could sarcoids develop after trauma?

A
  • Skin trauma allows BPV direct access to the subepidermal layer, and can lead to abnormal proliferation of fibroblasts
  • However sarcoids do appear on wound-free skin too
23
Q

Characteristics of equine squamous cell carcinoma

A
  • Second most common tumour in the horse
  • Locally invasive
  • Predilection for areas lacking pigmentation (Appaloosa, Quarter Horse, Paint Horse), poorly haired areas, mucocutaneous junctions, external genitalia
  • Most common neoplasia of the equine eye -> affects the conjunctiits and ocular adnexal structurs
24
Q
A

SCC

25
Q

Predisposing factors to SCC

A
  • Equus caballus papillomavirus 2 (EcPV2) and others
  • Flies
  • Smegma
  • UV light exposure
26
Q
A

SCC

27
Q

Treatment options for melanomas

A

Local treatment
* Surgical excision
* Hyperthermia
* Topical chemotherapy (either direct application or intralesional chemotherapy)
* Radiotherapy

Systemic therapy
* Systemic chemotherapy
* Systemic immunotherapy (vaccine, cytokine therapy)

28
Q

Treatment options for sarcoids

A
  • Surgery
  • Chemotherapy
  • Immunotherapy
  • Gene therapy
  • Radiotherapy
  • Photodynamic and phytotherapy
  • Combination therapies of some of the above
29
Q

Examples of topical creams available in first opinion and when not to use

A
  • Appropriate for low mass burden only
  • Do NOT use close to eyes
  • Usually need multiple applications
  • No standardised protocol available
  • Examples: 5-fluorouracil, Mitomycin C cream
30
Q

When is banding appropriate?

A
  • Appropriate for sarcoids with a thin peduncle only
  • Not to be used is the mass has a root
  • No evidence of success published but frequently used
  • Takes a few weeks and leaves an open wound
  • Most successful with topical treatment too
31
Q

Examples of intralesional chemotherapy

A

(Experienced vets only)
* Cisplatin (beads/ injectable) every 2-4 weeks for 4 cycles
* Mitomycin C (injectable)
* Carboplatin (injectable)

32
Q

When is surgical excision useful?

A

Useful for melanomas and SCCs; not for sarcoids

33
Q

Diagnosis of masses

A

Don’t be afraid to take an excisional biopsy

EQUINE (59 decks)

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