Clinical features, surgical management and outcome of squamous and basal cell carcinoma in squamates and chelonians.

BACKGROUND: Squamous cell carcinoma (SCC) is one of the most commonly diagnosed neoplastic disorders in reptiles. Recently, however, it has been demonstrated that basal cell carcinomas (BCCs) are frequently misclassified as SCCs. Several histological SCC and BCC variants have been characterised and their classification may allow the establishment of appropriate prognosis estimation and treatment approaches. HYPOTHESIS/OBJECTIVES: To describe the clinical features and surgical outcomes of SCCs and BCCs diagnosed between 2010 and 2022 in reptiles. ANIMALS: Thirty-three captive reptiles (21 squamates and 12 chelonians). MATERIALS AND METHODS: Detailed clinical history, including staging and surgical outcomes, were performed. Statistical analysis assessed significant factors using Prism (v8.2.1). RESULTS: While SCC was predominantly diagnosed in lizards, BCC was most commonly diagnosed in chelonians, and both neoplasms mainly occurred in adult to aged, male individuals. Although the gross pathological findings were highly comparable between SCC and BCC, considerable variation could be seen according to the primary location (oral, cutaneous or epidermis of the shell). Humane euthanasia or noncurative intent surgeries were performed in a minority of the cases. Curative intent surgeries were successful in 19 of 27 cases during a 1- to 7-year follow-up period, yet recurrence was seen in 8 cases. The results of this study allowed the identification of significant high-risk prognostic factors for SCC and BCC in reptiles. CONCLUSIONS AND CLINICAL RELEVANCE: This study contributes to predicting the clinical behaviour and prognosis of distinct SCC and BCC histological variants, and selecting the most appropriate treatment protocol.

The association of bacterial agents and flagellated protozoans in the etiopathogenesis of subspectacular abscesses in snakes.

OBJECTIVES: To describe the etiology, clinical pathology, and treatment of subspectacular abscesses (SAs) in 16 snakes. ANIMALS STUDIED: Sixteen snakes from private captive collections that were presented at a veterinary teaching hospital and diagnosed with SAs. PROCEDURES: Exudate was collected from SAs via percutaneous aspiration or by performing a partial spectaculectomy and submitted to direct light microscopic examination and/or microbiological examination. RESULTS: Bacterial isolates were cultured from exudate samples in 12 out of 16 snakes and comprised Pseudomonas aeruginosa isolates that showed identical antimicrobial susceptibility patterns in seven cases. Direct light microscopic examination demonstrated the presence of flagellated protozoa in the exudate in 10 out of 16 snakes and in all of these snakes, concurrent oropharyngeal flagellated protozoan infection could be demonstrated. Combined flagellated protozoan and bacterial SA infection was demonstrated in six snakes. Comparison of small subunit ribosomal RNA gene sequences of flagellated protozoans that were detected in the exudate of SAs from four snakes revealed they represented the parabasalians Monocercomonas colubrorum and Hypotrichomonas acosta in one and three cases, respectively. In all snakes, successful treatment of the SAs was achieved following surgical debridement of the subspectacular space combined with antimicrobial treatment. CONCLUSION: Bacteria as well as flagellates are considered to reach the subspectacular space through ascending infection from the oral cavity via the lacrimal duct. Although opportunistic bacterial infection presumably constitutes the predominant cause of SAs in snakes, the role of flagellate infection in the pathogenesis of this disorder should be further elucidated.

Histological Variants of Squamous and Basal Cell Carcinoma in Squamates and Chelonians: A Comprehensive Classification.

In the present study, the histological characteristics of squamous cell carcinomas (SCCs) and basal cell carcinomas (BCCs) obtained from 22 squamate and 13 chelonian species were retrospectively evaluated. While the examined tissues were originally diagnosed as 28 SCCs and 7 BCCs based on histological evaluation by a specialty diagnostic service, eight SCCs could be re-classified as BCCs and three SCCs proved to be non-neoplastic lesions. In addition, all SCCs and BCCs were classified into distinct histological variants. The SCCs could be categorized as one SCC in situ, three moderately differentiated SCCs, seven well-differentiated SCCs, and six keratoacanthomas. BCCs were classified as five solid BCCs, four infiltrating BCCs, five keratotic BCCs, and one basosquamous cell carcinoma. In addition, the present study reports the occurrence of BCCs in seven reptile species for the first time. In contrast to what has been documented in humans, IHC staining with the commercially available epithelial membrane antigen and epithelial antigen clone Ber-EP4 does not allow differentiation of SCCs from BCCs in reptiles, while cyclooxygenase-2 and E-cadherin staining seem to have discriminating potential. Although the gross pathological features of the examined SCCs and BCCs were highly similar, each tumor could be unequivocally assigned to a distinct histological variant according to the observed histological characteristics. Based on the results of this study, a histopathological classification for SCCs and BCCs is proposed, allowing accurate identification and differentiation of SCCs and BCCs and their histological variants in the examined reptile species. Presumably, BCCs are severely underdiagnosed in squamates and chelonians.

Anatomy, Physiology, and Disorders of the Spectacle, Subspectacular Space, and Its Lacrimal Drainage System in Squamates.

Various squamate species have completely fused eyelids that make up a transparent spectacle. The spectacle is a continuation of the integument that is renewed with each shedding cycle and creates a narrow subspectacular or corneospectacular space that is filled with lacrimal fluid. The latter is considered as the analogue of the conjunctival sac in other vertebrates. Almost all reptiles that have a spectacle lack a nictitating membrane, bursalis muscle, and lacrimal glands. The lacrimal fluid in the subspectacular space is secreted by the Harderian gland. The features of the spectacle and its lacrimal drainage system are an illustration of the enormous variation of the morphological adaptations that are seen in reptiles and one of the most distinguishable traits of snakes and most gecko species. Whereas ocular disease in squamates with a spectacle is infrequently seen in practice, disorders of the spectacle and the subspectacular space are commonly encountered. In order to apply an adequate diagnostic and therapeutic approach for these conditions, a sound knowledge and understanding of the anatomical and physiological peculiarities of the spectacle, subspectacular space, and lacrimal drainage system are fundamental.