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equine oncology Flashcards

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1
Q

What is the most common neoplasia of the horse

A

Sarcoids
Up to 2% prevalence

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2
Q

What is the cause of sarcoids and what cells are neoplastic

A

Bovine papillomavirus 1 and 2 are involved
= neoplastic proliferation of fibroblasts

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3
Q

What are the 6 types of sarcoids

A

Occult
Verrucose
Neodular
Fibroblastic
Mixes
Malevolent

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4
Q

What do occult sarcoids look like

A

Just a hairless raise area; = first early lesions and easy to miss

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5
Q

What do verrucose sarcoids look like

A

Warty, crusty dry lesions
Start discretely but can spread

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6
Q

What area are nodular sarcoids especially infiltrative

A

Periocular region

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7
Q

What do fibroblastic sarcoids look like

A

Ulcerated skin mass, often discrete and simple to treat

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8
Q

What are malevolent sarcoids

A

Rare form that spreads quickly along lymph vessels and are poorly defines

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9
Q

What are some predilection sites for sarcoids

A

Anywhere with less hair i.e periocular, axillary, inguinal, sheath
+ sites of previous wounds

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10
Q

what is the correlation between histopath of sarcoids and their clinical appearance; what about prognosis

A

No correlation
Makes biopsy harder to justify when there is a high sensitivity/specificity of presumptive visual diagnosis

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11
Q

What are the treatment options for sarcoids (in success order)

A

Radiotherapy is best
Laser surgical resection = good first line treatment for most lesions since more accessible

Electrochemotherapy
Intralesional treatments
Topical treatments; very variable success

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12
Q

What is plesiotherapy

A

= radiotherapy using strontium90 beta paricles; short penetration so good for small superficial lesions

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13
Q

What is brachytherapy

A

Radiotherapy using iridium gamma therapy
Has good penetration so can be used for any lesion
= gold standard for periocular lesions

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14
Q

What is teletherapy

A

Using linear accelerator to create beta or gamma beams
Needs GA so rarely done

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15
Q

What is the gold standard treatment for periocular sarcoids

A

Iridium brachytherapy

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16
Q

What are some complications that can occur with radiotherapy

A

White hair formation, alopecia
Can get scar tissue formation

May see transient uveitic with brachytheraphy near eye

Osteoradionecrosis, non-healing wounds, damage to tooth roots rare

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17
Q

How does laser surgical resection

A

Cut out region with laser and leave open wounds to granulte by second intention

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18
Q

What is the success of laser surgical resection

A

High; ~80% per lesion
So is a practical, effective and accessible first line treatment for many

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19
Q

Complications of laser surgical resection

A

Non-healing wound
Recurrence + aggressive transformation

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20
Q

What is electrochemotherapy

A

= where chemotherapeutic (e/g cisplatin) agents are injected into the lesion and then electrodes are used to enhance the penetration

Can be used in conjunction with other treatments

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21
Q

What are some considerations and complications of electrochemotherapy

A

Needs a GA for the horse
Health and safety concerns

Can lead to necrosis and wide slough, pain and oedema, non-healing wound

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22
Q

What must we remember when considering intralesional therapy for sarcoids

A

Need a lesion to inject into
Cannot do on verrucose or occult sarcoids since these are flat; will get very large slough and risk of leakage of drug

i.e for nodular and fibroblastic

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23
Q

What are some agents for intralesional therapy

A

Cisplatin
Mitomycin C (DNA damaging chemo)
Tigilanol tiglate
Immunocidin

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24
Q

How does Tigalanol tiglate (Stelfonta) work (intralesional therapy)

A

Causes haemorrhagic necrosis of the tumour

Risk = very large area of sloughing inc down to bone

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25
How does immunocidin work (intralesional therapy for sarcoids)+ risks
Contains mycobacterium wall fraction Immune modifying Risks = swellin, pain, abscessation
26
How does 5-fluorouracil work and which lesions is it good for
DNA damaging chemo cream Good for verrucose and occult lesions (flat) 2/3 success Can get sore and cruty, skin scald may happen
27
What is AW-5 liverpoor cream
Secret formula chemo agent
28
What complications can occur with AW-5 cream
Wide local slough, severe pain, oedema
29
What is imiquimod and which sarcoid lesions is it good for
Immune-modifying agent Good for occult lesions i.e superficial Treat 3 x per week until lesion goes away Must clean lesion each time
30
How does bleomycin work and which sarciods is it good for
DNA damaging chemo cream (but less risky than other chemos if gets into eye etc) Only for occult lesions
31
What is tazarotene and what use might it have in dealing with sarcoids
Retinoid cream Can be used to reduce the crust on verrucose lesions before applying 5-FU crean Some effect alone
32
What is the best first line treatment for most sarcoids
laser surgical resection
33
Where do we typically see skin squamous cell carcinomas
Non-pigmented skin; third eyelid, limbus, cornea all related to solar exposure
34
What does a typical SCC look like
Rapidly proliferating cauliflower lesions But can look much less obvious
35
What should we suspect a squamous cell carcinoma in a horse
Any unusual ocular or periocular presentation Corneal and conjunctival infiltrates may be very artypical Biopsy a good idea
36
What is the most common squamous cell carcinoma in the horse
3rd eyelid
37
Are genetics involved in SCCs
Yes one of the syndromes is genetic
38
What is the cause of genital SCC
Virally-mediated; equine papilloma virus 2 Classic cauliflower lesiosn
39
What are pale white lesions near a genital SCC
early SCC plaques i.e precancerous change
40
Where do we see gastric SCCs and what is the prognosis
= rare type of SCC: typically seen at pylorus OFten diagnosed late and already metastasised so poor prognosis
41
What do sinus SCCs present like
Primary sinusitis so often just put on antibiotics and get to a late stage before proper diagnosis Eventually erode through bone and cause facial deformation
42
How do we treat squamous cell carcinomas
Wide surgical excisino = treatment of chocie Radiotherapy can be a good adjunctive since SCCs are very sensitive May do topical/intralesional treatments
43
What is the prognosis for SCCs like after treatment
about 1/3 of eye lesions recur 10-30% of penile ones do Can recur years later
44
What radiotherapy would we use for squamous cell carcinomas
Strontium90 plesiotherapy
45
What prophylactic drugs do we put a horse on before giving tigilanol tiglate
Place subpalpebral lavage and use prophylactic topical NSAIDs and atropine and systemic NSAIDs Due to risk of uveitis
46
How does 5-FU work
structural analogue of thymine so inhibits DNA formatino by blocking thymidylate synthetase Taken up more by tumour cells
47
Why might we use piroxicam in equine SCCs
BEcause COX-2 is overexpressed and this is an inhibitor No clear evidence; could be a good adjunctive
48
Why should we always stage SCCs
Because many have already metastasised at first presentation (~10%); so should tell owner care will be palliative
49
Characteristics of melanoma in the horse and predilection sites
Usually benign Predilection sites = perianal, tail, sheath, parotid salivary glands
50
Which horses do we see melanomas in
Mostly grey horses; almost all have one in middle to old age
51
How do melanomas change over horse lifetime
Grow and multiply Can become necrotic, ulcerated and lead to seconday issues e.g maggots in sheath, rectal impaction Benign but may eventually metastasise
52
What are the treatment options for melanoma
Surgical excision is treatment of choice if possible Laser resection also good There is oncept melanoma vaccine
53
How does oncept melanoma vaccine work
Xenogenic human DNA vaccine against tyrosinase Can stabilise melanoma by preventing further growth or new lesions But won't cause regression
54
How common is lymphoma in horses and what are the forms
Rare - but most common of the haematopoietic neoplasms Forms = multicentric, alimentary, mediastinal, cutaneous, solitary
55
How do we treat solitary lymphoma
Wide local excision usually curative
56
Characteristics of cutaneous lymphoma and treatment
Can wax and wane for years Prednisolone is a palliative treatment Chemo has been described
57
What types of haemangiosarcoma are possible and where do we see disseminated disease
Rare Cutaneous, locally invasive or disseminated Disseminated goes to lung, pleura, skeletal muscle, spleen
58
What are some common clinical complaints with disseminated haemangiosarcoma
Dyspnnoea Swelling Epistaxis Lameness
59
Can we treat haemagiosarcomas
Cutaneous lesions can be surgically resectable Locally invasive and disseminated forms mostly untreatable
60
Characteristics of mast cell tumours in horses
Generally benign Respond well to surgical excision/intralesional corticosteroids
61
Where do we tend to find basal cell carcinoma in horses
Ditsal limb and tail Otherwise look like sarcoids Treat with wide local excision
62
What are the different SCC syndromes in the horse
Skin lesions; non-pigmented skin Genetic Genitalisa Gastric + others
63
Which tumours are paraneoplastic syndromes esp common with
Lymphoma (paraneoplastic fever, thrombocytopaenia, pruritis)

Equine (26 decks)

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