Atypical Fibroepithelial Polyp in the Cornea of a Lhasa Apso Dog

Abstract

Background: Fibroepithelial polyps are benign tumors of mesenchymal and ectodermal origin. Regarding the localization related to the cutaneous region, they may affect the eyelid and periocular area. In veterinary medicine, polyps located in the urethra of dogs and monkeys, vagina of bitches and on the skin have been described.  Fibroepithelial polyps may present as single to multiple nodules, exophytic to pedunculated, usually arising on a smooth surface of a common base. The aim of this paper is to describe the ocular and histopathological changes of a corneal fibroepithelial polyp of recurrent character in a dog.

Case: A 20-year-old Lhasa Apso dog, with a history of progressive corneal neoformation in the right eye for 4 months. Patient was submitted to routine ophthalmic evaluation. At biomicroscopy, a discrete mucopurulent discharge was observed in the nasal corner, a nodule in the lower eyelid (± 3 mm), moderate conjunctival hyperemia, vascularization and corneal edema between 12 and 5 h, presence of a pinkish proliferative mass in 3 h, affecting the anterior stroma and opacity of the lens, Schirmer's Tear Test (STT) 20 mm/min and intraocular pressure (IOP) 10 mm/Hg.  In the left eye, the STT and IOP were within normal range (17 mm/min and 11 mg/Hg, respectively) and at biomicroscopy only lens opacity was observed. Given the presence of the neoformation in the cornea, the patient underwent lamellar keratectomy to excise the mass and third eyelid flap. The tissue was then submitted to histopathology. The histopathological examination showed a proliferation of fibrous component with areas presenting reactive fibroblasts, with acidophilic cytoplasm and with little volume and slight neovascularization, presence of hyperplasia of the lining epithelium and cells with round to oval nuclei, with inconspicuous nucleoli, compatible with fibroepithelial polyp, without evidence of malignancy. After 18 months, the patient presented recurrence of the condition with a history of slow evolution (about ten months). The ophthalmic evaluation showed lesions very similar to the initial one, describing a recurrence of the lesion.

Discussion: Corneal neoplasms are uncommon in dogs. The clinical findings in patients with ocular neoplasms include irregular to nodular masses, gray to reddish in color, and typically associated with a vascular supply. These features are related to the type of tumor and its degree of evolution. There are reports in the literature of ocular neoplasms such as squamous cell carcinoma, papilloma, melanocytoma, fibrosarcoma, hemangiosarcoma, melanoma, lymphoma. Related to fibroepithelial polyp with ocular involvement, there are rare reports in human literature and none in veterinary medicine. There is a human description of the presence of a polyp affecting the cornea associated with a corneal dermoid and e other cases of polyps of conjunctival origin.  As far as treatment is concerned, the polyp should be surgically removed because of the possibility of recurrence, tissue metaplasia, or even transformation into a malignant tumor, as seen in the case reported here, in which even with surgical removal there was recurrence and metaplasia of the cells. Based on the histopathological findings, it can be concluded that this is a fibroepithelial polyp with a recidivating characteristic, not well described in the veterinary literature, with an atypical presentation affecting the cornea.

Keywords: tumor, corneal, neoformation, canine.

Título: Pólipo Fibroepitlial atípico em córnea de um cão Lhasa Apso

Descritores: tumor, cornea, neoformação, cão.