Thursday, April 11, 2024

Effect of punch biopsy on sarcoid growth

 The common belief that taking biopsies of suspected sarcoids could make them worse may not be justified.

 Sarcoids, are the most common skin tumour of horses. Although typically benign, they can be locally aggressive and difficult to manage. They appear in various forms, including flat, nodular, verrucous, fibroblastic, and occult types. Bovine papillomavirus (BPV) has been implicated in the development of sarcoids, although the exact mechanism is not fully understood.

 

In standard veterinary practice, biopsies are a useful diagnostic tool for identifying the nature of swellings and masses. However, the fear of inadvertently worsening the condition has led many veterinarians to avoid biopsy procedures for sarcoids.

 

A recent small-scale study investigating the impact of punch biopsies on the growth of equine sarcoids challenges this assumption. The study failed to confirm the notion that biopsies could exacerbate the aggressiveness or spread of sarcoids.

 

Lien Gysens carried out the study with her colleagues at the Department of Large Animal Surgery, Anaesthesia and Orthopaedics of Domestic Animals, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium. A full rereport of tth research is published in Veterinary Dermatology.

 

The study included six client-owned horses with a total of 11 sarcoids. These horses, all Belgian Warmbloods, presented with a range of clinical types: three occult, four nodular, two verrucous, and two fibroblastic sarcoids.

 

To qualify for inclusion in the study, the horses had to test positive for BPV-1/-2. This was determined using superficial swabs, scrapings, or fine needle aspirates (FNA), which were then subjected to quantitative PCR (qPCR).

 

 The research team examined the dynamics of tumour growth, focusing on factors such as thickness, area, and circumference, as well as viral load (VL) and Visual Analog Scale (VAS) scores in horses affected by sarcoids who underwent a single diagnostic punch biopsy.

 

The growth of each sarcoid was closely monitored on a weekly basis for nine months: from 12 weeks prior to the punch biopsy to 24 weeks following the procedure.

 

In this preliminary study, the researchers didn't find any clear trend in how sarcoids grew after a single punch biopsy. 

 

They observed significant changes in all growth parameters after the biopsy, but there wasn't a consistent direction of change – some grew larger, some smaller, and some stayed the same.

Drawing definite conclusions is challenging due to the limited number of tumours (11 in total) from only six horses with four different types of clinical sarcoids.

 

They conclude: “Our results indicate that post-biopsy lesion deterioration is not a general concept that applies to all sarcoids, and both deterioration or improvement are possible outcomes over a 24-week period. Further clinical studies with a larger sample size are needed before a definitive conclusion can be made.”

 

 

For more details, see:

 

Gysens L,  Martens A,  Haspeslagh M.  

Longitudinal pilot study examining the effect of punch biopsy on equine sarcoid growth dynamics. 

Vet Dermatol.  2024; 35: 148–155.

https://doi.org/10.1111/vde.13236

1 comment:

peggy said...

Years ago I inherited a lovely TB gelding who had sarcoids. They became very large and bleeding. I called Cornell where a vet said they had some good luck in treating affected horses with 10 times the normal dose of a benzimidazole wormer. I gave him 5 tubes a day for 2 days. In a short time they dried up and just disappeared. The exact reason was not really known. There were no negative side effects. I've not seen this mentioned in the many articles I've read over the years since.