Concomitant melanoma and keratoma affecting the equine digit: clinical, pathological, and long-term follow-up findings.

IF 2.3 2区 农林科学 Q1 VETERINARY SCIENCES BMC Veterinary Research Pub Date : 2024-10-01 DOI:10.1186/s12917-024-04269-4
Fernando Bulnes, David Argüelles, Antonio Buzón, Karelia García-Álamo, Irene M Rodríguez-Gómez, Eduardo Hernández, Elena Mozos
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Abstract

Background: This case report details a long-term follow-up of a hoof melanoma with dermo-epidermal activity (resembling Spreading Superficial Melanoma (SSM)) in a bay horse with a history of a right front hoof keratoma. Melanomas involving the horse's foot are seldom reported and usually diagnosed as anaplastic melanomas based on signalment and post-mortem examination. The clinical-pathological characteristics of the foot melanoma in this bay horse are consistent with SSM-like described in humans, which is considered an intermediate malignant tumour attending their biological behaviour. However, a definitive diagnosis is limited by the single case and the lack of references in horses.

Case presentation: A 12-year-old bay Andalusian gelding underwent keratoma removal on the lateral aspect of the hoof wall. A partial resection of the hoof wall was performed for this purpose. Additionally, a plaque-like, hyperkeratotic pigmented lesion, 2 × 2X0,4 cm in size, was observed at the lateral aspect of the coronary band and was also resected for histopathological examination. Microscopically, a melanocytic tumour, characterised by small nests of large polygonal or epithelioid cells infiltrating the basal and suprabasal epidermis, the dermo - epidermal junction, and the superficial dermis, was observed. The neoplastic cells exhibited large euchromatic nuclei, prominent nucleoli, moderate pleomorphism and 4 mitotic figures per 2,37mm2; variable amounts of dark granules (melanin) were present in the cytoplasm, as well as in numerous peritumoral macrophages. The immunophenotype of the tumour cells was PNL2 +  +  + , S100 +  + , AE1/AE3-. A diagnosis of melanoma with dermo-epidermal junction and marked intraepidermal activity (consistent with superficial spreading melanoma) was made. A magnetic resonance imaging (MRI) performed, revealed no further invasion into surrounding structures. Treatment was based on surgical resection and multiple local chemotherapy sessions with cisplatin were applied. The biopsies obtained after treatment showed partial regression of the tumour and different stages of healing. After 26 months of follow-up, there was no signs of malignant spreading into surrounding structures including the pedal bone and distal metastasis but a dark - coloured area persists over the lateral aspect of the coronary band.

Conclusions: This case presents a concomitant keratoma and melanoma with dermo - epidermal activity, resembling a spreading superficial melanoma. After a follow - up of 26 months the horse remains healthy and sound providing new information for clinicians and pathologists. Despite the poor prognosis associated with foot malignant melanocytic tumours, it is important that an early and accurate diagnosis is reached through different diagnostic modalities such as advanced imaging techniques and histopathology. Additionally, these findings demonstrate that the current classification and prognosis for equine foot melanomas are insufficient.

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影响马指骨的黑色素瘤和角化瘤并发症:临床、病理和长期随访结果。
背景:本病例报告详细介绍了对一匹曾患右前蹄角化瘤的骝马所患的具有表皮活性的蹄黑色素瘤(类似于扩散性表皮黑色素瘤 (SSM))的长期随访情况。涉及马蹄的黑色素瘤很少见报道,通常根据信号和死后检查诊断为非增生性黑色素瘤。这匹黑马足部黑色素瘤的临床病理特征与人类描述的 SSM 相似,被认为是一种符合其生物学行为的中间型恶性肿瘤。然而,由于该病例仅为一例,且缺乏马的相关参考资料,因此明确诊断受到了限制:病例介绍:一匹 12 岁的安达卢西亚骝马接受了蹄壁外侧角膜瘤切除术。为此对蹄壁进行了部分切除。此外,在冠状带外侧还发现了一个斑块状角化过度色素病变,大小为 2 × 2X 0.4 厘米,也被切除进行了组织病理学检查。显微镜下观察到黑色素细胞瘤,其特征是浸润基底和基底上表皮、真皮-表皮交界处和真皮浅层的大多角形或上皮样细胞的小巢。肿瘤细胞核大,核仁突出,呈中度多形性,每 2.37 平方毫米有 4 个有丝分裂象;细胞质和大量瘤周巨噬细胞中含有不同数量的深色颗粒(黑色素)。肿瘤细胞的免疫表型为 PNL2 + + + 、S100 + + + 、AE1/AE3-。诊断结果为黑色素瘤,具有真皮-表皮交界和明显的表皮内活动(与浅表扩散型黑色素瘤一致)。核磁共振成像(MRI)显示,瘤体没有进一步侵犯周围结构。治疗以手术切除为主,并使用顺铂进行多次局部化疗。治疗后获得的活检结果显示肿瘤部分消退,并处于不同的愈合阶段。经过 26 个月的随访,没有发现恶性肿瘤向周围结构扩散的迹象,包括蹬骨和远端转移,但冠状带外侧仍有一个深色区域:该病例同时伴有角化瘤和黑色素瘤,表皮活动,类似于扩散性浅表黑色素瘤。经过 26 个月的随访,这匹马仍然健康无恙,为临床医生和病理学家提供了新的信息。尽管足部恶性黑色素细胞瘤的预后较差,但通过先进的成像技术和组织病理学等不同诊断方式及早做出准确诊断非常重要。此外,这些研究结果还表明,目前对马足黑色素瘤的分类和预后评估还不够充分。
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来源期刊
BMC Veterinary Research
BMC Veterinary Research VETERINARY SCIENCES-
CiteScore
4.80
自引率
3.80%
发文量
420
审稿时长
3-6 weeks
期刊介绍: BMC Veterinary Research is an open access, peer-reviewed journal that considers articles on all aspects of veterinary science and medicine, including the epidemiology, diagnosis, prevention and treatment of medical conditions of domestic, companion, farm and wild animals, as well as the biomedical processes that underlie their health.
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