Large segmental mandibulectomy for treatment of an undifferentiated sarcoma in a horse.
Authors: Carmalt James L, Linn Kathleen A
Journal: Veterinary surgery : VS
Summary
# Editorial Summary Undifferentiated sarcomas of the equine mandible present significant surgical challenges due to their aggressive nature and the functional importance of jaw structures; this case report documents the successful management of such a tumour through advanced imaging and radical surgical intervention. A 10-year-old mare underwent computed tomography imaging to characterise a large right mandibular mass, with three-dimensional reconstruction proving essential for pre-operative planning of an extensive segmental mandibulectomy that extended from 3 cm below the temporomandibular joint to caudal to the fourth premolar tooth. Despite the surgical marathon of 11 hours 35 minutes operative time under general anaesthesia, the mare achieved remarkable functional recovery—eating normally within three days—with only minor postoperative skin sloughing and good cosmetic outcome maintained at the 24-month follow-up with no evidence of tumour recurrence. The findings challenge assumptions about the functional reserve of the equine mandible and suggest that substantial portions can be resected without unacceptable compromise to mastication or appearance. For practitioners managing oral neoplasia, this case reinforces the value of three-dimensional CT reconstruction in surgical planning and indicates that, with appropriate case selection and technical expertise, even aggressive mandibular tumours may be managed surgically rather than through euthanasia alone.
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Practical Takeaways
- •Large segmental mandibulectomy is technically feasible in horses with acceptable functional outcomes for eating and cosmetics, offering a treatment option for extensive mandibular neoplasia.
- •Advanced imaging (3D CT reconstruction) is valuable for pre-operative planning of complex mandibular surgery to improve surgical precision and outcomes.
- •Horses can tolerate and adapt to substantial mandibular bone loss with relatively rapid return to oral function (within 3 days in this case).
Key Findings
- •A 10-year-old mare successfully underwent segmental mandibulectomy removing a large right mandibular sarcoma with en-bloc resection under general anesthesia.
- •The mare was eating well by post-operative day 3 despite removal of a large portion of mandible extending from 3 cm below the temporomandibular joint to caudal to tooth 407.
- •At 24 months post-surgery, the mare showed good cosmetic and functional outcome with no evidence of disease recurrence despite minor post-operative skin sloughing.
- •3D CT reconstruction was instrumental in surgical planning for this complex procedure.