Electrochemotherapy for the treatment of an incompletely excised subcutaneous low-grade epithelioid hemangioendothelioma in a budgerigar parakeet (Melopsittacus undulatus)

Abstract

Background: Cutaneous tumors are rarely described in avian and are frequently of viral origin. Solid tumors of vascular origin are seldom reported and usually result in difficult management by surgery alone. We describe the outcome of a subcutaneous low-grade epithelioid hemangioendothelioma (EHE) treated with the combination of surgery and electrochemotherapy. Case Description: A 10-year-old male budgerigar parakeet (Melopsittacus undulatus) was referred for evaluation of a 2-month non-healing exophytic mass on the left wing. The bird was bright, alert, and responsive, with a 2 × 1 cm proliferative lesion on the wing. Signs of discomfort were elicited by the clinical manipulation of the wing; no other abnormalities were detected during physical evaluation. Following hematological and imaging analysis, the parakeet was anesthetized and the mass was surgically removed. The histopathology report came back with a diagnosis of incompletely excised subcutaneous low-grade EHE. A surgical revision was not feasible due to the anatomical location and tumor extension. Adjuvant electrochemotherapy was chosen to increase the chance of tumor control. Two sessions of electrochemotherapy were performed with a 2-week interval between treatments using intralesional bleomycin followed by trains of permeabilizing electric pulses. Side effects were not observed and the parakeet was disease-free for 12 months when he died of acute renal failure. Conclusion: In lieu of the incomplete surgical excision of the tumor, electrochemotherapy resulted in good local control and cosmetic appearance and should be added to the standard oncological therapies for avian.