"Epulis" TUMOR TIDBITS, A BIWEEKLY VETERINARY ONCOLOGY E-LETTER Editor: Kevin A. Hahn, DVM, PhD, Dipl - ACVIM (Oncology) & Overall Nice Guy! drhahn@gcvs.com ANNOUNCEMENTS * We still enrolling dogs with lymphoma into our clinical trials. Please check the web site regularly for updates. * Most of us will be in Dallas next week for the American College of Veterinary Internal Medicine Annual Forum, see you in Dallas? * Don't forget our Oncology Nurses. If you have any questions - ask for Aimee, Amy, Lloyd and Sherry! THIS WEEK'S TUMOR TIDBIT: EPULIS OVERVIEW OF WHAT'S IN THE TEXTBOOKS: * Categories of epulides are fibromatous, ossifying, and acanthomatous * Tumors of nonodontogenic origin that arise from periodontal squamous cell epithelial cell residues and surface epithelium * Usually solitary and most frequently located in the molar region, especially around the carnassial teeth and least commonly around the incisors * Fourth most common oral malignancy in dogs * Rare oral malignancy in cats * Most tumors adhere to bone and are nonencapsulated with a smooth to slightly nodular surface. SIGNALMENT * May have a familial distribution in the boxer breed * Mean age, 7 years * Most commonly occurs in brachycephalic breeds SIGNS * Often none (i.e., incidental finding) * Excessive salivation * Halitosis * Bloody oral discharge * Oral or gingival mass * May be ulcerated and infected * Possible facial deformity DIFFERENTIAL DIAGNOSES * Fibroma * Benign polyp * Ameloblastoma * Malignant oral tumor * Abscess DIAGNOSTIC RESULTS * Laboratory results usually normal * A large, deep tissue biopsy (down to bone) required for definitive diagnosis * Skull radiography to evaluate for bone involvement * Thoracic radiography to detect evidence of pulmonary metastasis (presence indicates not an epulis) TREATMENT * Radical excision the treatment of choice (e.g., hemimandibulectomy) * Mean survival time after surgery, 43 months (range, 6-134 months) * Mean survival times for patients with acanthomatous, ossifying, and fibromatous epulides are 52, 29, and 47 months, respectively. * Most epulides are cured when excisional margins are free of neoplastic cells. * Recurrence is likely if excision is incomplete. * Radiotherapy also offers long-term control in dogs with an acanthomatous epulis that is deemed inoperable. Mean survival after treatment, 37 months (range, 1-102 months). The 1-year survival rate is 85%; the 2-year survival rate is >67%. FOLLOW-UP * These tumors do not metastasize. * The long-term prognosis after excision or radiation therapy is good. * Acanthomatous epulides are highly invasive to bone. WHAT DO WE DO AT GULF COAST? * If the above therapy options cannot be considered, there is some anecdotal responses observed using intralesional chemotherapy (5-FU, Bleomycin, Carboplatin) as palliation from signs. Don't hesitate to call or email us at Gulf Coast Veterinary Oncology! Kevin Kevin A. Hahn, DVM, PhD drhahn@gcvs.com Diplomate American College of Veterinary Internal Medicine (Oncology) & Overall Nice Guy Gulf Coast Veterinary Diagnostic Imaging & Oncology 1111 West Loop South, Suite 150, Houston, TX 77027 P: 713.693.1166 F: 713.693.1167 W: www.gcvs.com