Solitary eosinophilic granulocytic sarcoma in a dog.

A 6-year-old male golden retriever presented with swelling of the left upper eyelid of 2 months duration, which did not improve following a course of antibiotics. Routine serum biochemistry, complete blood count and diagnostic imaging identified no clinically significant abnormalities. The mass was surgically excised, and histopathologic examination was performed. Eosinophilic granulocytic sarcoma (GS) was diagnosed based on the results of histopathology and immunohistochemistry. This is the first report of GS affecting the eyelid of a dog.

Standard and modified glabellar flap for medial canthus reconstruction following mass removal in three dogs and two cats.

PURPOSE: To describe the surgical technique and clinical outcomes of the glabellar flap and its modification for the reconstruction of the medial canthus following resection of tumors in three dogs and two cats. METHODS: Three dogs (7-, 7-, and 12.5-year-old mixed breeds) and two cats (10- and 14-year-old Domestic shorthair) presented with a 7-13 mm tumor affecting the eyelid and/or conjunctiva in the medial canthal region. Following en bloc mass excision, an inverted V-shaped skin incision was made in the glabellar region (i.e., the area between the eyebrows in humans). The apex of the inverted V-shaped flap was rotated in three cases, whereas a horizontal sliding movement was performed in the other two cases to better cover the surgical wound. The surgical flap was then trimmed to fit the surgical wound and sutured in place in two layers (subcutaneous and cutaneous). RESULTS: Tumors were diagnosed as mast cell tumors (n = 3), amelanotic conjunctival melanoma (n = 1), and apocrine ductal adenoma (n = 1). No recurrence was noted in a follow-up time of 146 ± 84 days. Satisfactory cosmetic outcome with normal eyelids closure was achieved in all cases. Mild trichiasis was present in all patients and mild epiphora was noted in 2/5 patients, but there were no associated clinical signs such as discomfort or keratitis. CONCLUSIONS: The glabellar flap was easy to perform and provided a good outcome in terms of cosmetic, eyelid function, and corneal health. Postoperative complications from trichiasis appear to be minimized by the presence of the third eyelid in this region.

Mucocutaneous subdermal plexus flap for complete excision of a malignant dermal and conjunctival melanoma in a dog.

PURPOSE: To perform a reconstructive blepharoplasty to obtain complete surgical excision of a darkly pigmented raised conjunctival-eyelid mass of the lower eyelid in a dog. ANIMAL STUDIED: A 7-year-old, female-spayed, Yorkshire Terrier was evaluated for a slowly progressive, dark brown-to-black raised mass of the lower left eyelid. Sampling of the mass via fine-needle aspirate or incisional biopsy was declined, and an excision of the mass with the goal to obtain complete margins and maintain normal eyelid function with cosmesis was elected. PROCEDURES: The lower palpebral conjunctival-eyelid pigmented mass was excised en bloc and the lower eyelid was reconstructed with a mucocutaneous subdermal plexus flap. RESULTS: Histopathology revealed a malignant dermal and conjunctivalmelanoma excised with complete margins (1-2 mm). Short-term complications included corneal ulceration and eschar formation, which resolved completely at the 1-month follow-up. Long-term complications included mild trichiasis with epiphora and porphyrin staining. Tumor recurrence was not observed during an 8-month follow-up period. CONCLUSIONS: The en bloc excision with mucocutaneous subdermal plexus flap was successful in obtaining complete surgical margins for a malignant conjunctival-eyelid melanoma. An excellent functional and cosmetic outcome was achieved without tumor recurrence during an 8-month follow-up period. A mucocutaneous subdermal plexus flap can be considered as a surgical option for malignant melanoma of the lower eyelid.

A novel DDB2 mutation causes defective recognition of UV-induced DNA damages and prevalent equine squamous cell carcinoma.

Squamous cell carcinoma (SCC) occurs frequently in the human Xeroderma Pigmentosum (XP) syndrome and is characterized by deficient UV-damage repair. SCC is the most common equine ocular cancer and the only associated genetic risk factor is a UV-damage repair protein. Specifically, a missense mutation in horse DDB2 (T338M) was strongly associated with both limbal SCC and third eyelid SCC in three breeds of horses (Halflinger, Belgian, and Rocky Mountain Horses) and was hypothesized to impair binding to UV-damaged DNA. Here, we investigate DDB2-T338M mutant's capacity to recognize UV lesions in vitro and in vivo, together with human XP mutants DDB2-R273H and -K244E. We show that the recombinant DDB2-T338M assembles with DDB1, but fails to show any detectable binding to DNA substrates with or without UV lesions, due to a potential structural disruption of the rigid DNA recognition ß-loop. Consistently, we demonstrate that the cellular DDB2-T338M is defective in its recruitment to focally radiated DNA damages, and in its access to chromatin. Thus, we provide direct functional evidence indicating the DDB2-T338M recapitulates molecular defects of human XP mutants, and is the causal loss-of-function allele that gives rise to equine ocular SCCs. Our findings shed new light on the mechanism of DNA recognition by UV-DDB and on the initiation of ocular malignancy.

Adenosquamous Carcinoma of the Upper Eyelid in a Dog.

A 12-year-old, male mongrel dog was presented for a 6-month history of a progressive eyelid mass of the right upper eyelid. The dog's medical history reported long-term bilateral topical application of 0.03% tacrolimus ophthalmic ointment for third eyelid plasmoma and treatment cycles with systemic corticosteroids for a long-standing atopic dermatitis. Complete physical and ophthalmologic examination of the dog as well as complete blood count, serum biochemical analysis, urinalysis, thoracic radiographs, and abdominal ultrasonography were performed. The mass involved the skin and the margin of the upper eyelid, which was ulcerated. Conjunctival hyperemia, and the thickening and partial depigmentation of the third eyelid due to plasmoma were present. The plasmoma was observed bilaterally. Histological examination of the eyelid mass showed an invasive proliferation of malignant epithelial cells with intermixing of both adenocarcinomatous and malignant squamous cell components. An eyelid adenosquamous carcinoma was diagnosed. To the best of the authors' knowledge, this is the first report on an adenosquamous carcinoma of the eyelid in a dog. Immunosuppression has been found to be a significant clinical risk factor for cutaneous adenosquamous carcinoma in humans and was considered a possible risk factor for this dog.

Caudal Auricular Axial Pattern Flap for the Reconstruction of the Upper Eyelid in Three Cats.

Three cats bearing malignant tumors (two squamous cell carcinomas and one peripheral nerve sheath tumor) affecting the upper eyelid (UE) were treated by en bloc tumor removal. A caudal auricular axial pattern flap was used for reconstruction, and its margin was sutured to only the medial and lateral canthus in two cats; in the third cat, a narrow strip of spared conjunctiva was sutured to the flap margin. Postoperatively, superficial corneal ulcers occurred in two cats, but they healed with topical treatment. Apart from a reduced ability to blink, no further functional deficits persisted, and the long-term cosmetic appearance was considered satisfactory by the owners. Tumor-free excisional margins were achieved in two cases. Tumor recurrence in the long-term was observed for two cats, 350 and 380 days after surgery, one of whom had excisional noninfiltrated margins on histologic examination. UE reconstruction to preserve eyelid function following tumor excision without exenteration is challenging. In selected cases, caudal auricular axial pattern flap is one of the surgical options available to reconstruct the defect resulting from en bloc UE removal without any replacement of the mucosal layer.

Squamous cell carcinoma with clear cell differentiation in an equine eyelid.

A 15-y-old Miniature horse mare had a 6-mo history of an ulcerated mass on the right lower eyelid. An incisional biopsy and a subsequent excisional biopsy were submitted to the Michigan State University Veterinary Diagnostic Laboratory for microscopic evaluation. Histologically, the incisional biopsy was composed of sheets of large neoplastic vacuolated polygonal cells. A few regions contained poorly differentiated neoplastic round-to-basaloid cells that rimmed the sheets of highly vacuolated polygonal cells. Both vacuolated and basaloid cells exhibited strong perimembranous and cytoplasmic immunoreactivity for E-cadherin and cytokeratin 5/6, respectively. Vacuolated polygonal cells were histochemically negative for periodic acid-Schiff, mucicarmine, and oil red O, consistent with a diagnosis of poorly differentiated carcinoma. Within the excisional biopsy specimen, there were anastomosing cords and nests of neoplastic squamous epithelial cells that merged with sheets of similar vacuolated polygonal cells. These findings are consistent with a squamous cell carcinoma with clear cell differentiation. In addition, in the adjacent dermis, there was solar elastosis suggestive of ultraviolet (UV) damage. A clear cell variant of squamous cell carcinoma is a rare entity in humans that previously has not been described in animals, to our knowledge, and is often associated with chronic UV exposure.

Clinical and immunophenotypic findings in 4 forms of equine lymphoma.

The clinical, histological, and immunophenotypic findings are presented for 4 horses affected by different types of lymphoma. Diagnoses of a monomorphic epitheliotropic intestinal T-cell lymphoma, a diffuse splenic large B-cell lymphoma, a peripheral T-cell lymphoma, and a T-cell rich large B-cell lymphoma of the third eyelid were made.

Constatations cliniques et immunophénotypiques pour quatre formes de lymphomes équins. Les constatations cliniques, histologiques et immunophénotypiques sont présentées pour quatre chevaux affectés par différents types de lymphome. Des diagnostics d'un lymphome intestinal épithéliotrope et monomorphe à cellules T, d'un lymphome splénique diffus à grandes cellules B, d'un lymphome périphérique à cellules T et d'un lymphome à grandes cellules B riche en cellules T de la troisième paupière ont été posés.(Traduit par Isabelle Vallières).

Hübner's eyelid reconstruction using a free tarsomarginal autograft in eight dogs. A retrospective study.

OBJECTIVE: The aim of our work was to study the potential of tarsomarginal grafting technique, in canine. ANIMAL STUDIED: All dogs included in this study had tumors of the upper or lower eyelid. Furthermore, resection of the tumor necessitated excision of the eyelid margin comprising 1/4 and 2/3. PROCEDURE: Harvesting of the graft with the length of half the length of the tumor, including its free margins was performed via a full-thickness incision on the ipsilateral healthy eyelid. The cutaneous layer and all of the muscle fibers of the transplant were meticulously removed except a 3 mm strip along the free lid margin. A full-thickness tumor excision was then performed. The graft was sutured at the level of the defect to be reconstructed. A sliding H flap was generated. The resulting nourishing myocutaneous flap was then sutured along the free margin of the tarso-conjunctivo-marginal graft. The lateral edges of the advancement flap were sutured to the edges of the receiving sites. RESULTS: The average size of the reconstructed area was 17.8 mm. The resulting stretched lid fissure length after surgery was shortened over 7 to 11 mm. This technique for grafting was used to reconstruct an eyelid that had lost tissue measuring between 1/4 and 2/3 of its length. The few complications that were encountered were mainly the occurrence of keratitis or suture dehiscence. CONCLUSIONS: This tarsomarginal grafting technique has yielded encouraging results in dogs. This technique can fill large lid defects with a physiologic lid margin but is shortening the stretched lid fissure length.

Outcome of secondary intention healing of full thickness lower eyelid defects in dogs.

OBJECTIVES: To assess healing of the canine lower eyelid without anatomical reconstruction. MATERIALS AND METHODS: Retrospective case series of three client-owned dogs with lower eyelid defects. These dogs that underwent debridement of lower eyelid wounds that were left to heal by secondary intention were assessed for anatomical, functional and aesthetic outcomes. RESULTS: Two of the cases had previously undergone tumour resection with a lip-to-lid reconstruction and, following flap failure, developed a full thickness defect. The third dog presented with a traumatic laceration. Each dog lost approximately 70 to 90% of the lower eyelid margin. Two received topical antimicrobial eye drops after debridement, while the third dog required no further treatment. Follow-up periods of 3 years, 15 months and 4 months were available. All owners were satisfied with the cosmetic outcome and provided pictures. One owner reported epiphora but no other ophthalmic complications occurred. CLINICAL SIGNIFICANCE: The result of this small case series supports the notion that not all lower eyelid injuries or tumour resections require anatomical reconstruction. Selected cases can be left to heal by secondary intention with minimal post-operative complications.

T cell-lymphoma in the eyelid of a 9-year-old English Setter.

BACKGROUND: Eyelid tumours are frequently found in dogs, most of these being benign. In case of an ulcerating eyelid tumour, malignancy must be considered. We report a unique case of a low-grade peripheral T-cell lymphoma in the eyelid of a 9-year-old English Setter. CASE PRESENTATION: A 9-year-old Setter presented with a 6-month history of an eyelid ulcer. A malignant eyelid neoplasm was suspected, and the lesion was surgically excised. No other treatment was applied, and 19 months after excision the dog was still well. Histopathology revealed a diffuse lymphocytic infiltrate in the eyelid skin. Ulceration of the epithelium was seen, and the underlying tumour was composed of round and poorly demarcated pleomorphic tumour cells. The cytoplasm was pale and the nuclei heterogeneous. Numerous mitoses were present. The tumour cells stained strongly for CD3. The final diagnosis was a peripheral T-cell lymphoma not otherwise specified (NOS). CONCLUSIONS: This is the first described case of a solitary T-cell lymphoma NOS in the haired eyelid skin in a dog. Lymphoma should be considered in case of a persistent eyelid ulcer and a biopsy should be performed. T-cell lymphoma is generally an aggressive disease; however, indolent cases are well known, and as this case shows, complete excision of a solitary T-cell lymphoma can be curable. Canine cutaneous epitheliotropic T-cell lymphoma is an important differential diagnosis, which must be recognized as the prognosis is very poor and systemic treatment is mandatory. The sub-classification of canine lymphoma is not complete, and further studies are needed to identify lymphoma subgroups and provide treatment guidelines.

Histocytic-like Atypical Mast Cell Tumours in Horses.

This report describes a series of four equine mast cell tumours (MCTs) with atypical morphological features. The tumours were 1-2 cm in diameter and mostly localized to the eyes (one eyelid, two conjunctiva). Histologically, they were composed of very large (up to 35 µm) round pleomorphic cells with a large central to paracentral nucleus and abundant granular cytoplasm. A large number of viable mature eosinophils were detected intermingled with the large round cells. Histochemical staining (toluidine blue and Perls' Prussian blue) and immunohistochemistry (KIT, mast cell tryptase, lysozyme and proliferating cell nuclear antigen) confirmed the mast cell origin of the atypical cells and identified an aberrant KIT protein expression in three cases. Based on morphological and immunohistochemical features, we propose to call the lesions equine histiocytic-like atypical MCTs.

Evidence of Vasculogenic Mimicry in a Palpebral Melanocytoma in a Dog.

A 7-year-old neutered female Doberman pinscher was presented with a palpebral nodule on the haired eyelid of the left eye. The nodule was removed surgically. Microscopically, the nodule was consistent with eyelid melanocytoma. The tumour was characterized by the presence of numerous lacunar and slit-like spaces filled by erythrocytes and interspersed throughout the neoplastic melanocytes. Immunohistochemically, these spaces were lined by cells expressing PNL2, but the cells were negative for factor VIII and CD31. [corrected] These findings were consistent with neoplastic melanocytes without endothelial cell participation. This feature was interpreted as 'vasculogenic mimicry', a mechanism of tumour angiogenesis that is well-recognized in human melanomas, but has not yet been reported in melanomas in animals.

Orbital invasive squamous cell carcinoma with adnexal involvement clinically mimicking feline restrictive orbital myofibroblastic sarcoma: 19 cases (1990-2016).

OBJECTIVE: To describe the clinical presentations of patients diagnosed with ocular adnexal or orbital squamous cell carcinoma (SCC), which possess features similar to feline restrictive orbital myofibroblastic sarcoma (FROMS). PROCEDURES: A retrospective review of adnexal and/or orbital SCC was performed. Cases were collected from the University of Georgia College of Veterinary Medicine and the Comparative Ocular Pathology Laboratory of Wisconsin (COPLOW) (1990-2016). Data included signalment, ophthalmic clinical signs, nonophthalmic history and clinical signs, clinician suspicion of FROMS, advanced imaging results, and subsequent histopathologic diagnosis. FROMS cases from the COPLOW over the same time span were reviewed and compared statistically to the SCC cases with a significance threshold of 0.05. RESULTS: Nineteen cases (20 eyes) were identified with adnexal SCC with features similar to FROMS, including keratitis and eyelid/third eyelid restriction and/or thickening. There were no statistically significant differences between clinical findings in the SCC cases and the identified and compared FROMS cases (57 cases; 67 eyes), except for exophthalmos and/or resistance to retropulsion, which was less common in SCC cases (20%) than in FROMS cases (47.8%) (P = 0.027); and clinical or imaged presence of an overt eyelid or orbital mass, which was more common in the SCC cases (30%) than in the FROMS cases (4.5%) (P = 0.0010). CONCLUSIONS: SCC with adnexal involvement has many features similar to FROMS. In addition to FROMS, SCC should be considered a differential diagnosis in cats with restrictive adnexal or orbital signs and corneal changes.

Periocular Neoplasia in the Horse.

Periocular neoplasia is common in horses. Treatment of the periocular skin and ocular adnexal structures can be technically challenging. Common neoplastic conditions, a treatment algorithm, surgical principles, and therapeutic modalities are reviewed. Regardless of the type of neoplasia found or the treatment that is applied, success is most likely when the neoplastic tumor is small.

Temporal horizontal H-figure sliding skin flap for central eyelid reconstructive surgery in dogs: a retrospective study.

OBJECTIVE: To describe a modified H-figure sliding skin flap for treating eyelid central neoplasms and to evaluate the cosmetic and functional results of this reconstructive blepharoplasty. MATERIAL AND METHODS: Eight dogs affected by eyelid neoplasia involving more than one-third of the central part of the margin underwent an en bloc rectangular surgical removal of the neoplasia. Reconstructive surgery was performed using a temporal horizontal H-figure sliding skin flap. RESULTS: At short-term follow-up visits, seven dogs showed no signs of ocular discomfort, whilst one exhibited mild blepharospasm and ocular discharge associated with partial necrosis of the flap. At the 60-day follow-up, all dogs showed good eyelid margin reconstruction and no signs of lagophthalmos or ocular discomfort. Secondary trichiasis was observed in one dog. CLINICAL SIGNIFICANCE: The procedure allowed a well-positioned, fully mobile eyelid. The secondary trichiasis observed in one dog did not cause evident ocular discomfort at 6-month follow-up.

Basal cell adenocarcinoma in the gland of the third eyelid of a brown bear (Ursus arctos).

The right third eyelid of an adult female brown bear (Ursus arctos) was swollen and removed. Histopathology revealed a tumor exhibiting proliferation with mild infiltration, consisting of multi-stratified glandular structures of the innermost laminal neoplastic cells and the basaloid neoplastic cells, and with eosinophilic thick basal lamina material around the glandular structures. Both types of neoplastic cells exhibited moderate anisokaryosis, and mitotic figures were observed in the basaloid neoplastic cells. The laminal neoplastic cells were cytokeratin (CK) 8/18-positive. In contrast, the basaloid neoplastic cells were CK14- and p63-positive, but α-smooth muscle actin- and calponin-negative. The case described herein is the first report of basal cell adenocarcinoma in the gland of the third eyelid of a bear.

Use of a subdermal plexus flap to reconstruct an upper eyelid following radical tumor resection in a cat.

CASE DESCRIPTION A 15-year-old neutered male domestic shorthair cat was examined for treatment of a recurrent neoplastic mass in the left upper eyelid that had been excised 6 months earlier by the referring veterinarian. CLINICAL FINDINGS An apparently nonpainful firm cutaneous mass (approx 2 × 2 mm) was located on the lateral third of the left upper eyelid near the scar from the previous surgical excision. TREATMENT AND OUTCOME Approximately one-third of the left upper lip was used as a subdermal plexus (lip-to-lid) flap to cover the defect created by en bloc excision of the eyelid mass. A bridge incision between the donor and recipient sites was used so that the eyelid could be reconstructed in 1 procedure. Histologic evaluation confirmed that the mass had been completely excised. Both the donor and recipient flap sites healed well without complications. The procedure resulted in excellent functional and cosmetic results with no recurrence of the mass at 14 months after surgery. CLINICAL RELEVANCE The described lip-to-lid technique was a simple 1-stage method for reconstructing an upper eyelid of a cat following radical tumor resection that provided excellent functional and cosmetic results.