Clinical and complementary diagnosis of sinus neoplasia in horses

Background: Sinus neoplasms are reported as low frequency in horses. Its clinical characteristics are often nonspecific, depend on complementary methods for diagnosis, and when diagnosed, generally they are already advanced, limiting therapeutic possibilities. The objective of this case series was to detail clinical aspects and complementary exams for sinus neoplasms for early diagnosis, comparing them with the literature. Cases: Four horses were treated at the College of Veterinary Medicine and Animal Science of the University of São Paulo, with different clinical signs and previous diagnoses, which when evaluated by respiratory endoscopy, radiography, oral cavity evaluation and histopathological exams, revealed the diagnosis of anaplastic carcinoma, poorly differentiated carcinoma, ossifying fibroma and lymphoma. Previous diagnosis, based mainly on clinical signs, were sinusitis secondary to apical infection, ethmoidal hematoma, sinus cyst and sinusitis secondary to periapical disease. The cases of anaplastic carcinoma (case 1) and lymphoma (case 4) presented with an advanced degree of the disease with involvement and destruction of paranasal structures and adjacent tissues, in addition to a poor general condition, which made surgical treatment impossible and led to euthanasia. In these cases, previous treatment was made to apical infection and periodontal disease with secondary sinusitis, but negative evolution led to suspicion of neoplasia, confirmed by histopathological exam of incisional biopsy of the mass in oral cavity. Benign ossifying fibroma (case 3) presented with progressive respiratory difficulty due to occlusion of the lumen of some nasal meatus and radiographic signs of invasion and deformation of the adjacent bones, it was submitted for surgical excision and there was no recurrence until hospital discharge. The poorly differentiated carcinoma (case 2) was a multilobulate neoformation in the ethmoidal region, similar to ethmoid hematoma in endoscopic and radiographic evaluation, it was submitted for excision and two sessions of electrochemotherapy with bleomycin, associated with administration of piroxicam, which obtained a good result until the period of 1 year after discharge. Discussion: It was found that many characteristics are common with these types of neoplasms, and the clinical signs, such as nasal secretions, airway obstruction, increased facial volume, severe alterations in oral cavity, although unspecific, suggest the differential diagnosis for neoplasms. It is important to differentiate from other diseases noting the evolution and growth of these tumors, like in cases 1 and 4, especially the growth to internal tissues, using complementary methods described here, like endoscopic and radiographic examination. Late identification or even manipulation of neoplasms, without proper diagnosis, leads to a few prognoses regarding life. When it is possible to perform surgical excision, complementary methods are important to guide the procedure, and definitive diagnosis is made through histopathologic exam and some need immunohistochemistry analysis. Cases 2 and 3 had surgical access, were submitted to excision and treatment with good results, both with close monitoring in first months and prolonged quality of life. These results highlight the importance of complementary methods for early diagnosis, correct intervention and monitoring of evolution.

Hematoma etmoidal progressivo em equino revisão de literatura e relato de caso / Progressive ethmoid hematoma in horses review and case report

O hematoma etmoidal progressivo (HEP) trata-se de uma massa não neoplásica que se expande a partir de hemorragias sucessivas da camada submucosa do labirinto etmoidal ou dos seios paranasais. Técnicas de diagnóstico, como endoscopia das vias aéreas superiores, radiografia e tomografia computadorizada, visam determinar a extensão das lesões. O tratamento é preconizado de acordo com o tamanho e localização do HEP, além da disponibilidade de equipamentos. As opções de tratamento incluem a ressecção cirúrgica, redução da massa por aplicação de agentes criogênicos ou laser e, a injeção de formaldeído intralesional. O prognóstico a longo prazo é reservado a desfavorável devido a alta taxa de recidivas da lesão. Este artigo fornece uma visão geral sobre a doença e descreve um caso de HEP tratado com sucesso pelo uso de injeção de formaldeído intralesional.

Progressive ethmoid hematoma (PEH) is a non-neoplastic mass which expands following repeated hemorrhage in the submucosa of the ethmoidal labyrinth or paranasal sinuses. Diagnostic techniques, as upper airway endoscopy, radiography and computed tomography, aims to determine the extent of the lesions. Treatment is based on size and location of the PEH, along with consideration of equipment availability. Treatment options include surgical resection, mass reduction with application of cryogens or laser, and intralesional formaldehyde injection. Prognosis for long-term resolution remains guarded to poor due to high rates of recurrence. This article provides an overview of the disease and reports a case of PEH successfully treated by the use of intralesional formaldehyde injection.

Hematoma etmoidal progressivo em equino revisão de literatura e relato de caso / Progressive ethmoid hematoma in horses review and case report

O hematoma etmoidal progressivo (HEP) trata-se de uma massa não neoplásica que se expande a partir de hemorragias sucessivas da camada submucosa do labirinto etmoidal ou dos seios paranasais. Técnicas de diagnóstico, como endoscopia das vias aéreas superiores, radiografia e tomografia computadorizada, visam determinar a extensão das lesões. O tratamento é preconizado de acordo com o tamanho e localização do HEP, além da disponibilidade de equipamentos. As opções de tratamento incluem a ressecção cirúrgica, redução da massa por aplicação de agentes criogênicos ou laser e, a injeção de formaldeído intralesional. O prognóstico a longo prazo é reservado a desfavorável devido a alta taxa de recidivas da lesão. Este artigo fornece uma visão geral sobre a doença e descreve um caso de HEP tratado com sucesso pelo uso de injeção de formaldeído intralesional.(Au)

Progressive ethmoid hematoma (PEH) is a non-neoplastic mass which expands following repeated hemorrhage in the submucosa of the ethmoidal labyrinth or paranasal sinuses. Diagnostic techniques, as upper airway endoscopy, radiography and computed tomography, aims to determine the extent of the lesions. Treatment is based on size and location of the PEH, along with consideration of equipment availability. Treatment options include surgical resection, mass reduction with application of cryogens or laser, and intralesional formaldehyde injection. Prognosis for long-term resolution remains guarded to poor due to high rates of recurrence. This article provides an overview of the disease and reports a case of PEH successfully treated by the use of intralesional formaldehyde injection.(AU)

Histopatologia de lesões tumoriformes presentes na cavidade nasal de eqüídeos do Brasil

The purpose of the present study was to analyze the microscopic aspects of tumor-like masses present in the nasal cavity of equids and also to emphasize the importance of histopathological examination for determining the diagnosis. Tissue sections of tumor-like masses from the nasal cavity of 11 equids were microscopically examined. These samples were sent to the Anatomic Pathology Service of the Veterinary Medicine College from the Fluminense Federal University, Niterói, Rio de Janeiro, from 2000 to 2004. Three cases of rhinosporidiosis, one of amyloidosis, six of nasal polyps and one of progressive ethmoid hematoma were diagnosed.

Este estudo foi realizado com o objetivo de analisar os aspectos microscópicos e enfatizar a importância do exame histopatológico na determinação do diagnóstico de lesões tumoriformes na cavidade nasal de eqüídeos. Para tanto, foram estudados microscopicamente cortes de tecido de 11 eqüídeos com lesões tumoriformes na cavidade nasal. Essas amostras foram enviadas ao Serviço de Anatomia Patológica da Faculdade de Medicina Veterinária da Universidade Federal Fluminense, Niterói, Rio de Janeiro, no período de 2000 a 2004. Foram diagnosticados três casos de rinosporidiose, um de amiloidose, seis de pólipos nasais e um de hematoma etmoidal progressivo.

Histopatologia de lesões tumoriformes presentes na cavidade nasal de eqüídeos do Brasil

The purpose of the present study was to analyze the microscopic aspects of tumor-like masses present in the nasal cavity of equids and also to emphasize the importance of histopathological examination for determining the diagnosis. Tissue sections of tumor-like masses from the nasal cavity of 11 equids were microscopically examined. These samples were sent to the Anatomic Pathology Service of the Veterinary Medicine College from the Fluminense Federal University, Niterói, Rio de Janeiro, from 2000 to 2004. Three cases of rhinosporidiosis, one of amyloidosis, six of nasal polyps and one of progressive ethmoid hematoma were diagnosed.

Este estudo foi realizado com o objetivo de analisar os aspectos microscópicos e enfatizar a importância do exame histopatológico na determinação do diagnóstico de lesões tumoriformes na cavidade nasal de eqüídeos. Para tanto, foram estudados microscopicamente cortes de tecido de 11 eqüídeos com lesões tumoriformes na cavidade nasal. Essas amostras foram enviadas ao Serviço de Anatomia Patológica da Faculdade de Medicina Veterinária da Universidade Federal Fluminense, Niterói, Rio de Janeiro, no período de 2000 a 2004. Foram diagnosticados três casos de rinosporidiose, um de amiloidose, seis de pólipos nasais e um de hematoma etmoidal progressivo.

Histopatologia de lesões tumoriformes presentes na cavidade nasal de eqüídeos do Brasil

The purpose of the present study was to analyze the microscopic aspects of tumor-like masses present in the nasal cavity of equids and also to emphasize the importance of histopathological examination for determining the diagnosis. Tissue sections of tumor-like masses from the nasal cavity of 11 equids were microscopically examined. These samples were sent to the Anatomic Pathology Service of the Veterinary Medicine College from the Fluminense Federal University, Niterói, Rio de Janeiro, from 2000 to 2004. Three cases of rhinosporidiosis, one of amyloidosis, six of nasal polyps and one of progressive ethmoid hematoma were diagnosed.

Este estudo foi realizado com o objetivo de analisar os aspectos microscópicos e enfatizar a importância do exame histopatológico na determinação do diagnóstico de lesões tumoriformes na cavidade nasal de eqüídeos. Para tanto, foram estudados microscopicamente cortes de tecido de 11 eqüídeos com lesões tumoriformes na cavidade nasal. Essas amostras foram enviadas ao Serviço de Anatomia Patológica da Faculdade de Medicina Veterinária da Universidade Federal Fluminense, Niterói, Rio de Janeiro, no período de 2000 a 2004. Foram diagnosticados três casos de rinosporidiose, um de amiloidose, seis de pólipos nasais e um de hematoma etmoidal progressivo.