Multiple Simultaneous Proliferative Lesions on the Prepuce and Penis of a Gelding.

Authors: Veado Henrique Caetano, Silva Anahí Souza, Fagundes Jéssyca Lauar de Almeida, Bittencourt Alexandra Ariadne, de Castro Márcio Botelho, Câmara Antonio Carlos Lopes

Journal: Journal of equine veterinary science

DOI: 10.1016/j.jevs.2021.103426 PubMed: 33993933Log in to save

Summary

# Editorial Summary An 18-year-old gelding presenting with preputial enlargement presented a diagnostically complex case of simultaneous proliferative lesions affecting the genital region—an area already recognised as the third most common site for equine tumours and tumour-like conditions. Histopathological and immunohistochemical examination of multiple lesions ranging from 2.0 mm to 6.0 cm across the prepuce and penis revealed three distinct pathologies occurring concurrently: squamous cell carcinoma, squamous viral papilloma, and cutaneous habronemiasis. This multiplicity of lesion types, combined with overlapping clinical presentations of ulceration and exophytic proliferation, underscores the substantial risk of misdiagnosis and consequently ineffective or inappropriate treatment protocols. The authors emphasise that thorough tissue sampling and definitive histological diagnosis are essential before initiating therapy, particularly given the differing prognoses and treatment requirements of these three conditions; relying solely on clinical appearance or treating presumptively based on the most visually prominent lesion could result in incomplete management. For practitioners managing genital skin disease in horses, this case reinforces that multiple biopsies should be considered standard practice when faced with heterogeneous proliferative lesions, especially in older animals where concurrent neoplastic and parasitic conditions may coexist.

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Practical Takeaways

•Multiple proliferative lesions in the equine prepuce and penis require histopathological and immunohistochemical confirmation rather than clinical diagnosis alone, as misdiagnosis can lead to ineffective treatment
•The urogenital region is the third most commonly affected body location for tumors in horses; practitioners should maintain high suspicion for malignancy in this area and refer for appropriate diagnostics
•When encountering proliferative lesions in the preputial region, consider multiple concurrent conditions as a diagnostic possibility, particularly habronemiasis coexisting with malignancy

Key Findings

•An 18-year-old gelding presented with three distinct concurrent proliferative lesions in the prepuce and penis: squamous cell carcinoma, squamous viral papilloma, and cutaneous habronemiasis
•Lesions ranged from 2.0 mm to 6.0 cm in diameter with variable presentations including ulcerated hardened wounds and cauliflower-like exophytic lesions
•Pathological and immunohistochemical examination was essential for definitive diagnosis and differentiation of the three lesion types
•Concurrent habronemiasis and squamous cell carcinoma can present simultaneously in the equine urogenital region, complicating clinical diagnosis and treatment selection

Conditions Studied

squamous cell carcinoma of penissquamous viral papillomacutaneous habronemiasispreputial enlargementmultiple proliferative skin lesions

Related References

Penile and preputial tumours in the horse: literature review and proposal of a standardised approach.

Van Den Top J G B, Ensink J M, Gröne A, Klein W R, Barneveld A, Van Weeren P R(2010)Equine veterinary journal

Surgical treatment of 45 horses affected by squamous cell carcinoma of the penis and prepuce.

Mair T S, Walmsley J P, Phillips T J(2000)Equine veterinary journal

Penile and preputial tumours in the horse: a retrospective study of 114 affected horses.

van den Top J G B, de Heer N, Klein W R, Ensink J M(2008)Equine veterinary journal

Penile and preputial squamous cell carcinoma in the horse: a retrospective study of treatment of 77 affected horses.