Large fibrosarcoma of the equine distal limb treated by surgical excision using a harmonic scalpel

Abstract

SummaryAn 18‐year‐old Warmblood gelding was presented for investigation of a large, firm mass over the medial and plantar aspect of the left distal metatarsal and fetlock region. The mass was first identified 4 months prior to referral, following a traumatic incident, and had over time gradually increased in size. Clinical examination and diagnostic imaging revealed a large soft tissue mass adjacent to the metatarsophalangeal joint and digital flexor tendon sheath, with no overt involvement of underlying bone. The mass was surgically excised under general anaesthesia using a harmonic scalpel with limited margins to avoid compromise of adjacent anatomical structures. Following histology, the mass was diagnosed as a fibrosarcoma. Twelve months after surgical resection, no signs of recurrence were evident. This report demonstrates that fibrosarcoma of the equine distal limb may be successfully managed with surgical excision. The use of a harmonic scalpel should be considered as an alternative to sharp excision when treating fibrosarcoma or other infiltrative tumours, particularly those located in regions where only limited surgical margins may be achieved.

Treatment challenges in equine fibrosarcomas: Can the harmonic scalpel help in the treatment success?

“…Successful treatment of fibrosarcoma can be challenging in equine and recurrence is a common late complication. The accompanying paper by Bellitto et al (2023, Equine Veterinary Education, 10.1111 illustrates the successful surgical treatment of a large fibrosarcoma over the medial and plantar aspect of the left distal limb in an 18-year-old Warmblood gelding. The authors report on the success of treatment after surgical excision of the tumour under general anaesthesia using a harmonic scalpel.…”

“…Fibrosarcomas have a high rate of recurrence due to inadequate surgical margins or seeding of the neoplastic cells (Lechartier et al, 2015;Riggot & Quarmby, 1980). Since recurrence is common after surgical excision of fibrosarcomas, regular examinations are recommended to ensure the absence of new growths, as Bellitto et al (2023) did in the described gelding after 5, 9 and 12 months after surgical excision.…”

“…In this case report, Bellitto et al (2023) have described an innovative and helpful procedure for the surgical excision of a large fibrosarcoma over the distal limb in an 18-year-old gelding using a harmonic scalpel.…”

“…Fibrosarcoma is most commonly observed in mature animals (Bass et al, 2017;Bellitto et al, 2023;Govaere et al, 2011;Kannegieter et al, 2010;Lechartier et al, 2015). Nevertheless, young animals are also at risk (Horbal & Dixon, 2016;Hyde, 2016;Roels et al, 1998).…”

“…The aetiology and pathophysiology of fibrosarcoma are still unknown. Nevertheless, fibrosarcoma has been recorded following an equine influenza vaccine (Kannegieter et al, 2010), a burn injury (Schumacher et al, 1986) and a traumatic incident (Bellitto et al, 2023).…”