Cutaneous epitheliotropic lymphoma in a Lhasa Apso

Background: Lymphoma neoplasms originate from the lymphocytes. Anatomically, these tumors can be classified into multicentric, digestive, mediastinal, and cutaneous forms. The etiology of cutaneous lymphoma remains unclear; however, it has been associated with chronic skin inflammation. The definitive diagnosis is based on histological analysis and immunohistochemistry, although fine-needle aspiration cytology has shown good results. The aim of this paper is to describe the clinicopathological aspects of a case of cutaneous epitheliotropic T cell lymphoma, classified as mycosis fungoides, in a Lhasa Apso dog. Case: A 8-year-old bitch Lhasa Apso with multiple non-pruritic skin nodules and history of 10-day evolution was referred to the Veterinary Hospital of the Centro Universitário do Espírito Santo (UNESC), Colatina, ES, Brazil. The nodules were erythematous, exophytic, firm, circumscribed, and measured 0.2-4 cm in diameter in locations throughout the animal's body. An incisional biopsy was performed with an 8-mm punch and sent for histopathological examination. An infiltrative, poorly demarcated, non-encapsulated, densely cellular neoplasm, which was replacing the dermal collagen and displacing the adnexa, was observed in the dermis. The tumor was composed of a population of round cells, with generally distinct cell borders and a small-to-moderate amount of eosinophilic cytoplasm. The nuclei were irregularly rounded and occasionally edentulous, with vesicular chromatin, a visible nucleus, and 11 mitotic figures in an area of 2.37 mm2 . The immunohistochemical test, which was positive for the CD3 marker, confirmed the diagnosis of T cell lymphoma. On an ultrasound to identify metastasis, the liver showed heterogeneous parenchyma, heterogeneous expansive formation, areas of cavitary appearance, and cytology compatible with lymphoma. Antineoplastic chemotherapy was administered using the CHOP regimen (cyclophosphamide, doxorubicin, vincristine, and prednisone). However, the animal died after 45 days. Discussion: A diagnosis of the mycosis fungoides type of cutaneous epitheliotropic T cell lymphoma was established based on clinical, laboratory, anatomopathological, and immunohistochemical findings. Pruritus is a common clinical condition in animals with mycosis fungoides, particularly in those with the erythrodermic form of the disease. Epitheliotropic lymphomas have no sexual or racial predilections and usually affect dogs over 9 years of age. The Cocker Spaniel, English Bulldog, Boxer, Golden Retriever, Scottish Terrier, Briard, English Springer Spaniel, Beagle, German Shepherd, and English Cocker Spaniel breeds are frequently affected by these lymphomas. These neoplasms can have a primary skin origin, or they can be secondary and associated with lymphoma found elsewhere in the body. Chemotherapy is the treatment of choice, especially in cases with multifocal distribution. Protocol preference varies with disease stage, patient clinical and laboratory conditions, and the degree of toxicity. Commonly used chemotherapy regimens include L-CHOP (vincristine, cyclophosphamide, doxorubicin, L-asparaginase, and prednisolone), CHOP, COP (cyclophosphamide, vincristine, and prednisone), LAP (lomustine, L-asparaginase, and prednisolone), LOPP (lomustine, vincristine, procarbazine, prednisolone), chlorambucil, and prednisolone. The prognosis of canine epitheliotropic cutaneous lymphoma is unfavorable, with a survival time ranging from a few months to 2 years. The animal in this study survived for 105 days. In addition, epitheliotropic cutaneous T cell lymphoma is aggressive, which may result in a shorter survival time in animals affected by this type of tumor.

Mesotelioma pleural em mediastino em uma cadela - remoção com esternotomia mediana / Mediastinal mesothelioma in a bitch - removal with median sternotomy

Background: Malignant pleural mesothelioma (MPM) is a neoplasm with low incidence in small animals, and the possible causes are poorly elucidated but may be related to contact with asbestos. In the thoracic cavity, MMP can be localized or generalized to all cavity structures, and its clinical signs depend on this localization. Although some alternative therapies are being discussed, few studies are conclusive, with surgical intervention as the leading therapeutic option. Given this context, this report aimed to describe a case of MMP located in the mediastinum of a bitch treated with radical excision through mediated sternotomy. Case: A 7-year-old bitch of the Shar-pei breed was referred for care due to progressive weight loss and intense dyspnea. During the physical examination, dyspnea and muffled lung sounds were noted. The patient underwent hemodialysis, which showed neutrophilic leukocytosis. An abdominal ultrasound was also performed and revealed mild abdominal effusion, and chest radiography revealed an extensive tumor covering the entire chest cavity. Thoracocentesis was performed, and the material analyzed was a malignant exudate; the patient was referred to median sternotomy for exploratory purposes, and afterward, total macroscopic extirpation of the tumor was performed. A sample was sent for histopathology, and malignant mesothelioma was confirmed. The patient was discharged after 8 days of hospitalization with home treatment and did not return to the hospital. Upon contacting the guardian, we were informed that the animal had died 154 days after the procedure due to unknown causes. Discussion: Malignant pleural mesothelioma affects humans and animals; it is associated with the risk factor of contact with asbestos and the use of flea antiparasitic drugs. In small animals, its incidence is rare, albeit mesotheliomas have been reported in wild and large animals. The clinical signs are related to the location of the neoplasm. When it is located in the thoracic region, dyspnea, muffled lung sounds, cyanosis, and pleural effusion are observed in most cases. Diagnosis is usually late and incidental, although some tests, such as ultrasonography, magnetic resonance imaging, tomography, radiography, and needle biopsy, can help in the diagnosis. Histopathology is the exam of choice for definitive diagnosis, as it helps one observe the proliferation of neoplastic mesothelial cells, atypical mitosis figures, and marked cellular pleomorphism. Many therapeutic options have been discussed, including chemotherapy, immunotherapy, and anti-tumor immunization, although there is little scientific proof of their efficacy in animals. The current treatment of choice is tumor excision by surgical procedure with a palliative objective since the prognosis of the disease is unfavorable. Minimally invasive video surgery has been gaining more and more space in veterinary medicine and has proven successful in numerous cases of thoracic masses. In the present report, we chose to perform median sternotomy for total excision due to the extension of the mass that occupied the thoracic cavity practically in its entirety. Further research should be conducted to help in palliative treatments and increase the survival of patients with mesotheliomas, given that most studies are done in humans and not animals. We conclude that median sternotomy is still the therapeutic option of choice for the palliative treatment of patients with extensive thoracic pleural mesotheliomas.

Tricoblastoma em cão: uma análise clínica, diagnóstica e terapêutica / Trichoblastoma in a dog: a clinical, diagnostic and therapeutic analysis

Background: Trichoblastoma is a rare skin neoplasm derived from the primitive hair follicle, having epithelial and mesenchymal components. Despite being commonly described as a benign tumor, there are reports in the literature of tumors with characteristics of malignant neoplasia. It affects adult dogs and cats, with no predilection for sex. Although rare, in studies in Brazil the pathology shows variable rates of occurrence. This work describes a case of tricoblastoma in a 4-year-old mixed breed dog, submitted to care at the Veterinary Hospital of the Federal University of Western Bahia (HVU-UFOB). Case: A 4-year-old male mixed breed dog with 7 kg of body weight, was referred to the HVU-UFOB. The main complaint reported by the canine’s tutor was an increase in volume in the region of the animal’s face, which evolved slowly, associated with itching, bleeding and sensitivity to touch. During the physical examination, a round, elevated mass was observed in the subcutaneous tissue of the left face, in the mandible region, with local alopecia. On palpation, the neoformation showed a firm consistency, well-defined and fluctuating, with no solutions for continuity or discomfort to touch. The animal’s physiological parameters were within the normal for the species. CBC, chest X-rays, abdominal ultrasound and aspiration cytology of the mass were requested. The blood count and image tests did not reveal any changes. On cytological examination, small, grouped basal epithelial cells were observed, characterized by a high nucleus-cytoplasm ratio, monomorphic nuclei and intensely basophilic and pigmented cytoplasm, a suggestive diagnosis of basal cell tumor. Due to the findings, an excisional biopsy of the mass was performed, with margins of 2 cm. The mass with its margins was sent for histopathological examination at the Animal Pathology Laboratory of the HVU...

Tricoblastoma em cão: uma análise clínica, diagnóstica e terapêutica / Trichoblastoma in a dog: a clinical, diagnostic and therapeutic analysis

Background: Trichoblastoma is a rare skin neoplasm derived from the primitive hair follicle, having epithelial and mesenchymal components. Despite being commonly described as a benign tumor, there are reports in the literature of tumors with characteristics of malignant neoplasia. It affects adult dogs and cats, with no predilection for sex. Although rare, in studies in Brazil the pathology shows variable rates of occurrence. This work describes a case of tricoblastoma in a 4-year-old mixed breed dog, submitted to care at the Veterinary Hospital of the Federal University of Western Bahia (HVU-UFOB). Case: A 4-year-old male mixed breed dog with 7 kg of body weight, was referred to the HVU-UFOB. The main complaint reported by the canines tutor was an increase in volume in the region of the animals face, which evolved slowly, associated with itching, bleeding and sensitivity to touch. During the physical examination, a round, elevated mass was observed in the subcutaneous tissue of the left face, in the mandible region, with local alopecia. On palpation, the neoformation showed a firm consistency, well-defined and fluctuating, with no solutions for continuity or discomfort to touch. The animals physiological parameters were within the normal for the species. CBC, chest X-rays, abdominal ultrasound and aspiration cytology of the mass were requested. The blood count and image tests did not reveal any changes. On cytological examination, small, grouped basal epithelial cells were observed, characterized by a high nucleus-cytoplasm ratio, monomorphic nuclei and intensely basophilic and pigmented cytoplasm, a suggestive diagnosis of basal cell tumor. Due to the findings, an excisional biopsy of the mass was performed, with margins of 2 cm. The mass with its margins was sent for histopathological examination at the Animal Pathology Laboratory of the HVU...(AU)

Diffuse thoracic and peritoneal papillary mesothelioma in an adult cow: case report

Mesothelioma is a rare tumor of mesothelium and usually spread by implantation in the same cavity it arises. Regarding bovine mesotheliomas, the abdominal cavity is the most affected site. This article describes a case of diffuse papillary mesothelioma within both thoracic and abdominal cavity with nodal metastasis in an adult cow – based on cytology, histopathology, and immunohistochemical analysis. A 7-years-old cow, Nelore breed (Brazilian beef cattle), with clinical signs of tachypnea, abdominal distention, and positive jugular venous pulse was slaughtered and necropsied due to persistent weight loss. The main gross findings were several verrucous and yellowish nodules spread on pericardium, pleura, and peritoneum. Mediastinal lymph nodes were enlarged and hemorrhagic with multiples yellowish spots on cut surface. The diagnoses of diffuse mesothelioma with nodal metastasis was established and ratified by the microscopic analysis. Immunohistochemical results had strong positivity for cytokeratin and the Ki-67 showed proliferative index of 28%. Vimentin was positive only in the cells of fibrous tissue. In this case, the initial site of the mesothelioma was not recognized. Although it is a post-mortem study, cytology may be very helpful in vivo investigation. Equally important, is the IHC to better comprehend this tumor and its behavior.

Diffuse thoracic and peritoneal papillary mesothelioma in an adult cow: case report

Mesothelioma is a rare tumor of mesothelium and usually spread by implantation in the same cavity it arises. Regarding bovine mesotheliomas, the abdominal cavity is the most affected site. This article describes a case of diffuse papillary mesothelioma within both thoracic and abdominal cavity with nodal metastasis in an adult cow based on cytology, histopathology, and immunohistochemical analysis. A 7-years-old cow, Nelore breed (Brazilian beef cattle), with clinical signs of tachypnea, abdominal distention, and positive jugular venous pulse was slaughtered and necropsied due to persistent weight loss. The main gross findings were several verrucous and yellowish nodules spread on pericardium, pleura, and peritoneum. Mediastinal lymph nodes were enlarged and hemorrhagic with multiples yellowish spots on cut surface. The diagnoses of diffuse mesothelioma with nodal metastasis was established and ratified by the microscopic analysis. Immunohistochemical results had strong positivity for cytokeratin and the Ki-67 showed proliferative index of 28%. Vimentin was positive only in the cells of fibrous tissue. In this case, the initial site of the mesothelioma was not recognized. Although it is a post-mortem study, cytology may be very helpful in vivo investigation. Equally important, is the IHC to better comprehend this tumor and its behavior.(AU)

Imunomarcação da transição epitélio-mesenquima na neoplasia mamária primária de cadelas e sua metástase em linfonodo / Epithelial to mesenchymal transition immunostaining in canine primary mammary tumor and lymph node

Os carcinomas mamários em cães apresentam alta capacidade metastática o que confere menor sobrevida para os pacientes com este tipo de neoplasia. O fenótipo transição epitélio-mesênquima, caracterizado pela troca dos filamentos intermediários de citoqueratina por vimentina, além da perda da proteína de adesão entre células (E-caderina) está relacionado com a maior ocorrência de metástase. Diante disto, objetivou-se avaliar, por meio de imunomarcações, a expressão de vimentina, citoqueratina e E-caderina nos tumores mamários caninos e suas metástases em linfonodo, a fim de avaliar o comportamento celular frente a esta neoplasia. Foram analisados cinco casos de neoplasias mamárias primárias caninas e suas respectivas metástases em linfonodos. Foram comparadas as médias de imunomarcações do grupo de neoplasias primárias com as médias do grupo metástase. Não houve diferença estatística nas imunomarcações da citoqueratina (p=0,1407) e E-caderina (p= 0,312) entre os grupos, apesar da média de expressão da E-caderina ter sido maior no grupo de metástases. A expressão da vimentina foi maior nos sítios das metástases (p=0,0462). Conclui-se que a expressão de vimentina aumenta no foco da metástase em relação aos seus respectivos tumores primários mamários caninos, caracterizando alteração estrutural celular, conferindo um fenótipo transição epitélio-mesênquima. Além da E-caderina apresentar fortes indícios de aumento no foco da metástase caracterizando maior adesão.(AU)

Mammary carcinomas in dogs have a high metastatic capacity which gives a shorter survival rate for patients with this type of tumor. The epithelial-mesenchymal transition phenotype, characterized by the trade of intermediary filaments of cytokeratin by vimentin, also by the loss of the adhesion protein between cells (E-cadherin) is associated with metastasis. Due to this fact, it was aimed to evaluate, by immunostaining, the expression of vimentin, cytokeratin and E-cadherin in canine mammary tumors and the metastasis in lymph node, in order to assess the cell behavior when facing this cancer. Five cases of canine mammary tumors and metastasis in lymph node were evaluated. The averages of immunostainings of the group of primary neoplasms were compared with the averages of the lymph node group. The results showed that immunostaining for cytokeratins (p=0,1407) and E-caderina (p=0,312) were not significant between the groups, despite the expression mean of cadherin was higher in the metastase group. The expression of vimentin (p=0,04) was greater at sites of metastases. It is concluded that the expression of vimentin increases in the focus of the metastase in relation to their respective primary canine mammary tumors, characterizing cellular structural alteration, conferring a transient epithelial-mesenchymal phenotype. And cadherin present strong evidence of increased focus on metastasis characterizing increased adhesion.(AU)

Imunomarcação da transição epitélio-mesenquima na neoplasia mamária primária de cadelas e sua metástase em linfonodo / Epithelial to mesenchymal transition immunostaining in canine primary mammary tumor and lymph node

Os carcinomas mamários em cães apresentam alta capacidade metastática o que confere menor sobrevida para os pacientes com este tipo de neoplasia. O fenótipo transição epitélio-mesênquima, caracterizado pela troca dos filamentos intermediários de citoqueratina por vimentina, além da perda da proteína de adesão entre células (E-caderina) está relacionado com a maior ocorrência de metástase. Diante disto, objetivou-se avaliar, por meio de imunomarcações, a expressão de vimentina, citoqueratina e E-caderina nos tumores mamários caninos e suas metástases em linfonodo, a fim de avaliar o comportamento celular frente a esta neoplasia. Foram analisados cinco casos de neoplasias mamárias primárias caninas e suas respectivas metástases em linfonodos. Foram comparadas as médias de imunomarcações do grupo de neoplasias primárias com as médias do grupo metástase. Não houve diferença estatística nas imunomarcações da citoqueratina (p=0,1407) e E-caderina (p= 0,312) entre os grupos, apesar da média de expressão da E-caderina ter sido maior no grupo de metástases. A expressão da vimentina foi maior nos sítios das metástases (p=0,0462). Conclui-se que a expressão de vimentina aumenta no foco da metástase em relação aos seus respectivos tumores primários mamários caninos, caracterizando alteração estrutural celular, conferindo um fenótipo transição epitélio-mesênquima. Além da E-caderina apresentar fortes indícios de aumento no foco da metástase caracterizando maior adesão.(AU)

Mammary carcinomas in dogs have a high metastatic capacity which gives a shorter survival rate for patients with this type of tumor. The epithelial-mesenchymal transition phenotype, characterized by the trade of intermediary filaments of cytokeratin by vimentin, also by the loss of the adhesion protein between cells (E-cadherin) is associated with metastasis. Due to this fact, it was aimed to evaluate, by immunostaining, the expression of vimentin, cytokeratin and E-cadherin in canine mammary tumors and the metastasis in lymph node, in order to assess the cell behavior when facing this cancer. Five cases of canine mammary tumors and metastasis in lymph node were evaluated. The averages of immunostainings of the group of primary neoplasms were compared with the averages of the lymph node group. The results showed that immunostaining for cytokeratins (p=0,1407) and E-caderina (p=0,312) were not significant between the groups, despite the expression mean of cadherin was higher in the metastase group. The expression of vimentin (p=0,04) was greater at sites of metastases. It is concluded that the expression of vimentin increases in the focus of the metastase in relation to their respective primary canine mammary tumors, characterizing cellular structural alteration, conferring a transient epithelial-mesenchymal phenotype. And cadherin present strong evidence of increased focus on metastasis characterizing increased adhesion.(AU)

Quimioterapia antineoplásica associada ao bloqueio perineural neurolítico no tratamento de carcinoma de célular escamosas na face de um equino / Antineoplasic chemotherapy associated with perineural neurolitic infiltration for treatment of head squamous cell carcinoma in an equine / Quimioterapia antineoplásica asociada con infiltración perineural neurolítico en tratamiento del carcinoma de células escamosas en la cabeza de un caballo

O carcinoma de células escamosas (CCE) é uma neoplasia comum em diversas espécies animais, sendo que nos equinos frequentemente acomete o epitélio escamoso da cabeça, olhos, a nexose genitais. A recidiva após excisão cirúrgica isolada é bastante comum, sendo utilizadas terapias complementares como crioterapia, uso adjuvante de anti-inflamatórios não esteróides (piroxicam),hipertermia ou quimioterapia intralesional (5-fluouracil, cisplatina e mitomicina C). Este trabalho tem por objetivo relatar o caso de uma égua Quarto de Milha de 11 anos acometida com carcinoma de células escamosas na face, tratada através de duas formas distintas de quimioterapia, a sistêmica utilizando um sal metálico (cisplatina), e local de forma intralesional com a mitomicina C (MMC), além de bloqueio perineural com cloreto de amônio 2%, buscando analgesia e melhora da qualidade de vida do paciente. A utilização de quimioterapia intralesional (MMC) e sistêmica (cisplatina intravenosa na dose de 1 mg/kg), associada a excisão cirúrgica não foram eficazes para regressão do CCE na face do equino tratado, além do fármaco cloreto de amônio 2% ser efetivo como agente neurolítico com duração aproximada de efeito de 35 dias.

The squamous cell carcinoma (SCC) is a common neoplasia in several animal species, and inhorses often affects the squamous epithelium of the head, eyes, genitals and attachments. Recurrenceafter surgical excision alone is very common and are used complementary therapies such as cryotherapy, piroxicam, hyperthermia or intralesional chemotherapy with 5-fluorouracil, cisplatin and mitomycin C. This paper aims to report the case of a Quarter Horse mare of 11 years affected with squamous cell carcinoma on the face, where it was used systemic chemotherapy with cisplatin and local mitomycin C (MMC), and perineural blockade with ammonium chloride 2% aiming analgesia and increased patient quality of life. Theuse of intralesional chemotherapy (MMC) and systemic (intravenous cisplatin at a dose of 1 mg / kg), associated with surgical excision were not effective for regression of OHC on the face of the treated horse,addition of ammonium chloride drug 2% is effective as a neurolitic agent lasting about 35 days effect.

EI carcinoma de células escamosas (CCE) es un cáncer común en varias especies animales, y en los caballos con frecuencia afecta el epitelio escamoso de Ia cabeza, los ojos y los genitales. La recurrencia después de Ia escisión quirúrgica sola es bastante común y se utilizan terapias complementarias como Ia crioterapia, piroxicam, hipertermia o quimioterapia intralesional con 5-fluorouracilo, cisplatino ymitomicina C. Este trabajo tiene como objetivo informar sobre el caso de una yegua Cuarto de Milla de 11anos afectada con carcinoma de células escamosas en Ia cabeza, donde se utilizó Ia quimioterapia sistémica con cisplatino y mitomicina C local (MMC), y el bloqueo perineural con cloruro de amonio 2% en busca deIa analgesia y el aumento de Ia calidad de vida dei paciente. EI uso de quimioterapia intralesional (MMC) ysistémica (cisplatino por vía intravenosa a una dosis de 1 mg / kg), asociada con Ia escisión quirúrgica nofueron eficaces para Ia regresión de CCE en Ia cabeza dei caballo tratado y Ia adición de drogas de clorurode amonio 2% es eficaz como agente neurolítico com aproximadamente 35 días de efecto.

Quimioterapia antineoplásica associada ao bloqueio perineural neurolítico no tratamento de carcinoma de célular escamosas na face de um equino / Antineoplasic chemotherapy associated with perineural neurolitic infiltration for treatment of head squamous cell carcinoma in an equine / Quimioterapia antineoplásica asociada con infiltración perineural neurolítico en tratamiento del carcinoma de células escamosas en la cabeza de un caballo

O carcinoma de células escamosas (CCE) é uma neoplasia comum em diversas espécies animais, sendo que nos equinos frequentemente acomete o epitélio escamoso da cabeça, olhos, a nexose genitais. A recidiva após excisão cirúrgica isolada é bastante comum, sendo utilizadas terapias complementares como crioterapia, uso adjuvante de anti-inflamatórios não esteróides (piroxicam),hipertermia ou quimioterapia intralesional (5-fluouracil, cisplatina e mitomicina C). Este trabalho tem por objetivo relatar o caso de uma égua Quarto de Milha de 11 anos acometida com carcinoma de células escamosas na face, tratada através de duas formas distintas de quimioterapia, a sistêmica utilizando um sal metálico (cisplatina), e local de forma intralesional com a mitomicina C (MMC), além de bloqueio perineural com cloreto de amônio 2%, buscando analgesia e melhora da qualidade de vida do paciente. A utilização de quimioterapia intralesional (MMC) e sistêmica (cisplatina intravenosa na dose de 1 mg/kg), associada a excisão cirúrgica não foram eficazes para regressão do CCE na face do equino tratado, além do fármaco cloreto de amônio 2% ser efetivo como agente neurolítico com duração aproximada de efeito de 35 dias.(AU)

The squamous cell carcinoma (SCC) is a common neoplasia in several animal species, and inhorses often affects the squamous epithelium of the head, eyes, genitals and attachments. Recurrenceafter surgical excision alone is very common and are used complementary therapies such as cryotherapy, piroxicam, hyperthermia or intralesional chemotherapy with 5-fluorouracil, cisplatin and mitomycin C. This paper aims to report the case of a Quarter Horse mare of 11 years affected with squamous cell carcinoma on the face, where it was used systemic chemotherapy with cisplatin and local mitomycin C (MMC), and perineural blockade with ammonium chloride 2% aiming analgesia and increased patient quality of life. Theuse of intralesional chemotherapy (MMC) and systemic (intravenous cisplatin at a dose of 1 mg / kg), associated with surgical excision were not effective for regression of OHC on the face of the treated horse,addition of ammonium chloride drug 2% is effective as a neurolitic agent lasting about 35 days effect.(AU)

EI carcinoma de células escamosas (CCE) es un cáncer común en varias especies animales, y en los caballos con frecuencia afecta el epitelio escamoso de Ia cabeza, los ojos y los genitales. La recurrencia después de Ia escisión quirúrgica sola es bastante común y se utilizan terapias complementarias como Ia crioterapia, piroxicam, hipertermia o quimioterapia intralesional con 5-fluorouracilo, cisplatino ymitomicina C. Este trabajo tiene como objetivo informar sobre el caso de una yegua Cuarto de Milla de 11anos afectada con carcinoma de células escamosas en Ia cabeza, donde se utilizó Ia quimioterapia sistémica con cisplatino y mitomicina C local (MMC), y el bloqueo perineural con cloruro de amonio 2% en busca deIa analgesia y el aumento de Ia calidad de vida dei paciente. EI uso de quimioterapia intralesional (MMC) ysistémica (cisplatino por vía intravenosa a una dosis de 1 mg / kg), asociada con Ia escisión quirúrgica nofueron eficaces para Ia regresión de CCE en Ia cabeza dei caballo tratado y Ia adición de drogas de clorurode amonio 2% es eficaz como agente neurolítico com aproximadamente 35 días de efecto.(AU)