Successful Treatment of an Equine Preputial Fibrosarcoma Using 5-Fluorouracil/Evaluation of the Treatment Using Quantitative PCNA and KI67 (MIB 1) Immunostaining (Case Report)

Abstract

An 18-month-old cross-bred Fjord pony colt presenting a fibrosarcoma of the prepuce with severe infiltrative growth, was treated by topical application of 5-fluorouracil. Biopsies were taken before and after a treatment period of 2 months. As a control, preputial tissue from a healthy horse was biopsied. Tissue sections were stained immunohistochemically for Proliferating Cell Nuclear Antigen (PCNA) and Proliferation related factor - Ki67 (MIB1). Using computerized quantitative image analysis of these sections, Mitotic index (PCNA), Growth Fraction (Ki67) and total nuclear area percentage of the dermis were calculated. The Mitotic index, growth fraction and total nuclear area percentage were significantly (P < 0.001) reduced at the end of the treatment period compared to the initial biopsy tissue, but they still were significantly higher than the control values, due to a remnant inflammatory reaction to the cytostatic drug. After treatment of the lesion, the pony fully recovered with no visible residual lesions on the prepuce. On follow-up 6 months after treatment, the horse showed no signs of recurrence. The success of the present treatment should encourage further clinical trials in cases of malignant fibrous tumours of skin in horses. The quantitative analysis of cell proliferation in biopsies can be used to evaluate treatment follow-up.