+ Fibromatous and Ossifying Epulides
- Benign
- Fibromatous epulis is the most common epulis (57%) followed by ossifying (23%), acanthomatous (18%), and giant cell epulis (2%)
- Mean age 8-9 years with male predisposition
- Site: maxillary premolar teeth
- Gross appearance: pedunculated masses arising from the periodontal ligament and extending through gingival sulcus
- Ossifying epulis has a broader base of attachment and are less pedunculated than fibromatous epulis
- Fibromatous and ossifying epulides are not ulcerative or invasive, covered by epithelium, and are grossly similar to gingival hyperplasia
- Classification of ossifying or fibromatous depends on the histologic presence or absence of bone
- Treatment: conservative surgical excision ± cryosurgery or electrocautery
- Recurrence is common in cats with multiple epulides
+ Acanthomatous Epulides
- Mean age 7.8 years
- No sex predisposition
- Breed predisposition: Shetland Sheepdog
- Site: mandibular canines (60%) and incisors
- Acanthomatous epulides are locally invasive with bone lysis but do not metastasize
- Epulides arise from the periodontal stroma or ligament
- 80%-90% of dogs have radiographic evidence of bone involvement
+ Treatment
- Synonyms: rodent ulcer and indolent ulcer
- Eosinophilic granuloma is most common in female cats with a mean age of 5 years
- Etiology unknown
- Location: upper lip near midline is most common but can occur anywhere in the oral cavity
- Slowly progressive (months to years) erosion of the lip
- Biopsy required to differentiate from oral cancers
- Treatment: prednisone (1-2 mg/kg q 12 hours for 30 days), methylprednisolone acetate (20 mg SC q 2 weeks), megestrol acetate, hypoallergenic diets, radiation therapy, surgery, immunomodulation, or cryosurgery
- Prognosis: fair for complete and permanent recovery
+ Prognosis
- prognosis is excellent
- surgery: MST 36 months with 12-month survival rate 90% and 4% local tumor recurrence rate
- orthovoltage radiation therapy: MST 37 months with < 5% local tumor recurrence rate < 5% recurrence rate, but complications include 5%-20% malignant transformation and 6% bone necrosis