Canine limbal melanoma: 30 cases (1992-2004). Part 1. Signalment, clinical and histological features and pedigree analysis

Diagnosing Corneal Pigmentation in Small Animals

The transparency of the cornea is critical to its role in transmitting light. Loss of corneal transparency results in visual impairment. Corneal pigmentation results from melanin accumulation in the epithelial cells of the cornea. Differential diagnosis for corneal pigmentation include corneal sequestrum, corneal foreign body, limbal melanocytoma, iris prolapse, and dermoid. These conditions must be excluded to reach a diagnosis of corneal pigmentation. A myriad of ocular surface conditions are associated with corneal pigmentation, including qualitative and quantitative tear film deficiency, adnexal disease, corneal ulceration, and breed-related corneal pigmentation syndromes. Accurate etiologic diagnosis is critical to determining effective treatment.

Hereditary Eye Diseases in German Shepherd Dog

Hereditary eye diseases occur to varying degrees in all dog breeds. Individual purebred breeds have specific predispositions to various eye disorders. The German Shepherd is diagnosed mainly with chronic superficial keratitis/pannus, but also with: distichiasis, plasmoma/atypical pannus, corneal dystrophy, persistent pupillary membranes, cataract, cone degeneration, retinal dysplasia, optic nerve hypoplasia/micropapilla, and limbal melanoma. Individual ocular abnormalities are manifested by characteristic clinical manifestations and ophthalmological findings. Some eye diseases can lead to blindness, others affect the comfort of life or work use of the dog to varying degrees. A thorough knowledge of individual ocular pathologies in a particular breed leads not only to the identification of the diagnosis but also to the correct assessment of the dog’s breeding usability.

Current Therapeutics and Future Perspectives to Ocular Melanocytic Neoplasms in Dogs and Cats

Neoplasms of melanocytic origin are diseases relevant to dogs and cats' ophthalmic oncology due to their incidence, potential visual loss, and consequent decrease in life quality and expectancy. Despite its non-specific clinical presentation, melanocytic neoplasms can be histologically distinguished in melanocytomas, which present benign characteristics, and malignant melanomas. The diagnosis often occurs in advanced cases, limiting the therapeutic options. Surgery, cryotherapy, radiotherapy, photodynamic therapy (PDT), and laser are currently available therapeutic strategies. As no clinical guidelines are available, the treatment choice is primarily based on the clinician's preference, proficiency, and the owner's financial constraints. While surgery is curative in benign lesions, ocular melanomas present a variable response to treatments, besides the potential of tumour recurrences or metastatic disease. This review presents the currently available therapies for ocular melanocytic neoplasms in dogs and cats, describing the therapeutic, indications, and limitations. Additionally, new therapeutics being developed are presented and discussed, as they can improve the current treatment options.

Canine Primary Corneal Fibrosarcoma - Case Report

This is the first report of a primary corneal fibrosarcoma in a canine. A 4-year-old male dog, Blue Heeler, owas examined because of a reddish nodular mass in the right eye. A complete ophthalmic exam was conducted, including slit-lamp biomicroscopy, applanation tonometry, fundoscopy, ocular and abdominal ultrasound, hemogram, serum biochemistry profile, and a thoracic X-ray. After the ophthalmic evaluation of the right eye, conjunctival hyperemia and the presence of a .5 cm diameter mass was found in the cornea. The diagnosis of fibrosarcoma was confirmed by histopathological analysis. The keratectomy showed satisfactory results in the removal of the corneal fibrosarcoma. The patient was followed up on for 18 months after the surgical procedure, and there were not any signs of local recurrence or metastasis.

Progressive retrocorneal pigmentation in dogs: A clinical report of 34 cases

OBJECTIVES

To describe the signalment, ophthalmic examination findings, and follow-up of dogs affected with a previously unreported retrocorneal pigmentary lesion.

MATERIALS AND METHODS

Retrospective record evaluation spanning 2009-2019.

RESULTS

Retrocorneal pigmentary lesions were described in 34 patients (46 eyes). German Shepherds (n = 7), Jack Russel terriers (n = 5), and terrier crosses (n = 4) made up 16/34 (47.1%) of the cases. The mean age was 13.5 years (range 1.4-14.2 years), and 16/30 (53.3%) dogs were female. Most dogs were affected unilaterally (22/34 (64.7%)), the others bilaterally, and 5/34 (14.7%) were referred for it while the others were incidentally diagnosed. The lesions affected the ventral, peripheral, inner cornea and had a round/undulated leading edge. The number of corneal clock hours affected was known for 41/46 (89.1%) eyes and involved 1-3 clock hours in 32/41 (78.1%) eyes, 4-6 in 6/41 (14.6%), 7-9 in 2/41 (4.9%), and 10 in 1/41 (2.4%). The central cornea was affected in 9/46 (19.6%) eyes, and in 5/9 (55.6%), the median corneal clarity score was G2 (scale: G0-G4). The commonest additional findings included free-floating uveal cysts (11/34 dogs, 32.4%), cataracts (6/34 dogs, 17.6%), and primary glaucoma (5/34 dogs, 14.7%). Gonioscopy was available in 16/34 (47.1%) dogs and was normal except in primary glaucoma cases. Follow-up was documented in 13/34 (38.2%) dogs with a mean follow-up of 17 months (range: 5-26 months). Lesion progression was documented in 6/13 (46.2%) dogs.

CONCLUSIONS

Retrocorneal pigmentation occurs as a slowly progressive lesion of older dogs that could impact vision. Histological studies of affected eyes are warranted.

Choroidal melanocytic tumors in dogs: A retrospective study

OBJECTIVE

To describe clinical features of dogs diagnosed with choroidal melanocytic tumors at a veterinary teaching hospital.

ANIMALS STUDIED

Retrospective case series of 13 dogs (14 melanocytic tumors) with choroidal melanocytic tumors.

PROCEDURES

Medical records of dogs evaluated by the Cornell University ophthalmology service with a clinical diagnosis of a choroidal melanocytic tumor between 2008 and 2020 were reviewed. A choroidal melanocytic tumor was clinically defined as any well-demarcated, raised pigmented choroidal lesion underlying the retina. Histopathology results were consulted when available. Signalment and clinical features were recorded, including fundoscopic location, histopathologic findings, treatment, and outcome.

RESULTS

Choroidal melanocytic tumors were identified in 14 eyes of 13 dogs. The mean (±standard deviation) of dogs was 8.6 (±3.5) years. Seven different breeds were represented, with Labrador/Labrador mix being the most common. Ten of the 14 melanocytic tumors were diagnosed incidentally. Four dogs presented for vision loss and ocular discomfort, and diagnosis was made on histopathology examination following enucleation. Pulmonary metastasis was suspected in one dog with an incidentally found choroidal melanocytic tumor OD. Fundoscopic location was available for 8 melanocytic tumors, with 6 (75%) located in the tapetal fundus. Histopathologic diagnosis was melanocytoma for 3 and malignant melanoma in 1 globe, with optic nerve head invasion in 50%. Local recurrence was not seen in any orbit following enucleation.

CONCLUSION

Choroidal melanocytic tumors are uncommon in dogs. Metastasis appears to be rare and was only suspected in one dog, but intraocular tumor growth can lead to retinal detachment, glaucoma, and necessitate enucleation.

Deep lamellar keratectomy and penetrating scleroplasty using CO2 laser photoablation and bimodal grafting for the treatment of a limbal melanoma in a dog

A novel approach for en bloc resection of a limbal melanoma using a CO2 laser in a dog. Benefits of this advanced technique include excellent surgical precision, improved hemostasis, and the induction of coagulative necrosis of neoplastic cells.

Primary bilateral corneal nerve sheath neoplasm in a dog

A 15-year-old, neutered male, Shih Tzu cross developed progressive corneal stromal thickening and vascularization of the right eye, and 5 months later, of the left eye. Both eyes became blind due to extensive corneal opacification and were enucleated. Light microscopic examination revealed a diffuse corneal infiltrate of neoplastic mesenchymal cells, and immunohistochemistry revealed diffuse cytoplasmic vimentin immunoreactivity and variable cytoplasmic and nuclear immunoreactivity for S100 in the neoplastic cells. Transmission electron microscopy revealed desmosomes between contiguous cells, thread-like cytoplasmic processes coated with basement membrane, extracellular bundles of collagen, and axonal degeneration consistent with features of a nerve sheath neoplasm. This is the first report of primary, bilateral corneal nerve sheath sarcoma in a canine.

The combined use of surgical debulking and diode laser photocoagulation for limbal melanoma treatment: a retrospective study of 21 dogs

OBJECTIVE

To evaluate effectiveness and safety of debulking and diode laser photocoagulation (DPC) for the treatment of limbal melanoma (LM).

PROCEDURE

Retrospective multi-institutional case series. Medical records of animals diagnosed with LM at the Centro Veterinario Specialistico (CVS) and at the Long Island Veterinary Specialists from 1994 to 2014 were retrieved. Signalment, location, extent of tumors, recurrence rate, and early and late complications were reported. Patient follow-up information was obtained from veterinary ophthalmologists, primary care veterinarians, and where appropriate, owners.

RESULTS

Twenty-one eyes of 21 dogs (13 females and 8 males) were included in this study. The dogs' average age was 6 years (range: 7 months-11 years). The follow-up period ranged from 1-108 months (median 48 months) after the last DPC procedure. Long-term follow-up was obtained by telephone interviews in 6 of 20 cases and by clinical re-evaluations in 14 of 20 cases. The most common early complications were a moderate anterior uveitis and peripheral corneal edema (21/21 eyes). Late complications included corneal fibrosis and/or pigmentation (20/21). In one case, a severe bullous keratopathy associated with extensive corneal fibrosis was observed (1/21). One case was blind due to concurrent Sudden Acquired Retinal Degeneration (SARD). However, after surgery 2 of 20 eyes lost vision and one of these was enucleated.

CONCLUSIONS

Debulking, in addition to diode laser photocoagulation, was technically straightforward to perform, minimally invasive, well tolerated, and highly successful in this case series.

Comparative Aspects of Canine Melanoma

Melanomas are malignant neoplasms originating from melanocytes. They occur in most animal species, but the dog is considered the best animal model for the disease. Melanomas in dogs are most frequently found in the buccal cavity, but the skin, eyes, and digits are other common locations for these neoplasms. The aim of this review is to report etiological, epidemiological, pathological, and molecular aspects of melanomas in dogs. Furthermore, the particular biological behaviors of these tumors in the different body locations are shown. Insights into the therapeutic approaches are described. Surgery, chemotherapy, radiotherapy, immunotherapy, and the outcomes after these treatments are presented. New therapeutic perspectives are also depicted. All efforts are geared toward better characterization and control of malignant melanomas in dogs, for the benefit of these companion animals, and also in an attempt to benefit the treatment of human melanomas.

Histologic and immunohistochemical predictors of clinical behavior for feline diffuse iris melanoma

OBJECTIVE

To determine histologic and immunohistochemical predictors of metastasis of feline diffuse iris melanoma (FDIM).

ANIMALS

Globes from 47 client-owned cats enucleated for FDIM between January 1985 and December 2013.

PROCEDURES

Hematoxylin and eosin-stained sections were evaluated for neoplastic invasiveness and cell morphology, necrosis within the neoplasm, inflammation, and glaucoma. Sections were immunolabeled with antibodies against melan-A, PNL2, E-cadherin, or B-Raf, and label intensity, percentage of labeled cells, and label homogeneity were semi-quantitatively graded. Medical records were evaluated, and referring veterinarians and clients were contacted to determine whether cats developed metastasis following enucleation. The log-rank test or Cox proportional hazards model was used to determine associations between histologic or immunohistochemical parameters and metastasis.

RESULTS

Metastasis was suspected or confirmed in 9/47 (19%) cats. Extrascleral extension, necrosis within the neoplasm, a mitotic index of >7 mitoses in 10 high-power (×400) fields, choroidal invasion, and increased E-cadherin and melan-A label intensity were each associated with increased rate of metastasis. PNL2 label homogeneity was associated with decreased rate of metastasis. Decreased PNL2 label intensity and an increasing percentage of neoplastic cells labeled for melan-A each approached significance for increased rate of metastasis.

CONCLUSIONS

We report four histologic and three immunohistochemical parameters helpful in determining cats at risk of metastasis of FDIM. Further studies should determine if B-Raf mutations identified in human malignant melanomas are found in cats with FDIM and assess benefits of adjunctive therapy following enucleation of eyes with FDIM bearing poor prognostic indicators.

Melanocytic Ophthalmic Neoplasms of the Domestic Veterinary Species: A Review

Melanocytic neoplasms in veterinary species occur in various ophthalmic locations including the eyelid, conjunctiva, cornea, sclera, anterior and posterior uvea, and orbit. Histology usually provides the definitive diagnosis for melanocytic ocular neoplasias. The degree of tissue invasiveness and anaplastic cellular characteristics are more reliable indicators of biological behavior than is mitotic index in most ophthalmic melanocytic tumors. Melanocytic neoplasias of the eyelid are predominantly benign in canines and equines, though in felines, there is the potential for metastasis, especially if the conjunctiva is involved. Limbal melanocytic tumors are predominantly benign in all the studied species, though there is a bimodal occurrence with this tumor type in canines, where those that appear in dogs younger than 4 years tended toward active growth, whereas those that appear in dogs older than 8 years tended to progress more slowly, and may not require therapy. The most common location for melanocytic ocular neoplasias in both canines and felines is the anterior uvea. Feline diffuse iris melanoma in particular has a higher incidence of metastasis than does canine nodular anterior uveal melanocytoma. In contrast, posterior uveal melanocytic tumors are rare in both canine and feline species and are considered benign. Orbital melanoma is rare in both canine and feline species; however, it generally carries a grave prognosis owing to its malignant nature. Knowledge of the general biological behavior and its variability among locations within the eye and between species is essential in therapeutic planning.

Isolation and cultivation of canine uveal melanocytes

OBJECTIVES

To establish a method for isolation and culture of canine uveal melanocytes.

ANIMALS STUDIED

Uveal explants from five mixed-breed dogs.

PROCEDURES

Donor globes were dissected, and the anterior uvea removed. The uveal explants were placed in trypsin solution for enzymatic digestion. Extracted cells were cultured in modified F12 media. Immunocytochemistry was performed to confirm the identity of the extracted cells.

RESULTS

Melanocytes were successfully isolated from uveal explants. Contaminating cell types were not observed. Repeated passaging of the melanocytes resulted in a gradual decrease in intracellular pigment. Melanocyte cell lines could be cryopreserved, thawed, and cultures successfully reestablished.

CONCLUSIONS

This extraction technique allows for generation of large populations of canine uveal melanocytes in a relatively short period of time. This technique could be a useful tool for future studies investigating both normal cellular characteristics and alterations found in melanocytes from dogs with ocular melanocytic disorders.

Penetrating sclerokeratoplasty and autologous pinnal cartilage and conjunctival grafting to treat a large limbal melanoma in a dog

A four-year-old neutered male Labrador retriever presented to Portland Veterinary Specialists Ophthalmology Service for evaluation of a pigmented mass oculus sinister (OS) of approximately 4-month duration. Complete ophthalmic examination revealed a large, pigmented, raised, well-demarcated, epibulbar mass appearing to originate from the nasodorsal limbal region. The mass was smooth and roughly circular, extending approximately 4 mm into the sclera and 14 mm into the nasodorsal cornea. Gonioscopy directly under the mass was not possible due to mass size. The visible iridocorneal angle was normal. High-resolution B-scan ultrasound showed mass extension to Descemet's membrane and deep sclera, but no intraocular invasion. Penetrating sclerokeratoplasty was performed followed by autologous pinnal cartilage and conjunctival grafting to repair the corneoscleral defect (20 mm x 19 mm) and to restore globe integrity and function. Histopathology confirmed the mass to be a benign limbal melanoma with complete excision. The surgery site healed without complication, and the pinnal cartilage became fully incorporated into the globe. Twelve months postoperatively, the patient remains visual with a normal intraocular and fundic examination. The pinnal harvest site on the right ear healed without complication. To the authors' knowledge, this is the first reported case of corneoscleral grafting using autologous pinnal cartilage. This may represent a viable alternative to other corneoscleral grafting procedures for large defects and is an attractive treatment option due to lack of host rejection, readily available source of donor cartilage, and provision of tectonic support to the globe.

Multiple distinct malignancies in dogs: 53 cases

Despite the clinical recognition of multiple distinct types of neoplasia in individual dogs, a detailed description of such cases has not recently been published. Canine oncology cases that were diagnosed with multiple, confirmed, distinct malignancies were prospectively collected for analysis. Approximately 3% of 1722 dogs that were presented to the oncology service at the Colorado State University Veterinary Medical Center were diagnosed with multiple distinct primary tumors. No significant breed or sex predisposition was apparent. Dogs with mast cell tumor, malignant melanoma, and thyroid carcinoma were significantly overrepresented and thus more likely to be diagnosed with multiple tumor types. These findings emphasize the importance of thorough, whole-body evaluation for dogs presented with mast cell tumor, malignant melanoma, and thyroid carcinoma. Furthermore, because approximately 33% of dogs that were presented with thyroid tumors were found to have additional distinct tumors, complete staging is justified in all dogs presented with thyroid tumors.

Presumed primary uveal melanoma with brain extension in a dog

A 13-year-old, female, mixed, cocker spaniel was examined for a unilateral exophthalmia and protruding mass in episcleral region of the right eye. Mode B ocular ultrasonography revealed a mass extended intraocular from anterior chamber to posterior pole without evidence of extraocular extension. A presumptive diagnosis of melanocytic tumour was made. A complete blood count and chemistry and thoracic radiographs did not show any abnormal changes. The recommended treatment was enucleation, and melanocytic nature of the tumour was confirmed by immunohistochemistry. Three months after surgery, the animal showed a status epilepticus refractory to treatment. Computed tomographic examination of the brain revealed changes compatible with a tumour. Cerebrospinal fluid analysis was normal. Because of the poor clinical prognosis, the owners elected to have the dog euthanased.

Epibulbar melanoma in a foal

A case of epibulbar melanoma in a 6-month-old, gelded, chestnut Hanoverian foal is reported. The location and clinical appearance upon initial presentation led to the tentative diagnosis of staphyloma or a congenital mass of unknown origin. An attempt was made to surgically excise the mass under general anesthesia, but due to its infiltrative nature and intraoperative appearance, most, but not all was removed without compromising the integrity of the globe. Histopathological evaluation revealed a multinodular to packeted, poorly demarcated, unencapsulated, infiltrative exophytic melanocytic neoplasm composed of bundles and nests of plump spindloid to polygonal heavily pigmented epithelioid neoplastic cells interspersed with pigment-laden macrophages within a fine fibrovascular stroma. Upon examination after enucleation, neoplastic cells were found to infiltrate into the lateral cornea, sclera and the choroid. This is a unique case of an epibulbar melanoma with choroidal invasion in a foal. Based on the sudden onset and rapid growth as well as the histological evidence of invasion, well-differentiated features, heavy pigmentation, and no apparent mitoses, this neoplasm was considered to be a low-grade malignant melanoma. At 14 months after excision there is no evidence of recurrence.