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Abstract
Epulides account for 0–7.8% of tumors in surveys of feline oral neoplasms. A review of the literature revealed no reports of multiple epulides in cats. Multiple, concurrent epulides were diagnosed microscopically in 13 cats. Fibromatous and ossifying epulides were diagnosed in 11 of 13 cats and fibromatous epulides were diagnosed in 2 of 13 cats. Microscopically, these epulides were nonencapsulated, well-vascularized, infiltrative, highly cellular neoplasms that expanded the gingiva and were composed of haphazardly arranged, spindle-shaped to stellate cells amid a dense, collagenous stroma. Osseous foci were a feature in the fibromatous and ossifying epulides. The mitotic rate was low and there was marked hyperplasia of the overlying gingiva with a prominent downgrowth of epithelial cords. These tumors recurred in 8 of 13 cats following surgical excision. While uncommon, multiple epulides in cats have a high incidence of recurrence but do not appear to have metastatic potential.
Key words: Epulis; feline; oral cavity.
Epulides, tumors of periodontal ligament origin, are common in dogs but occur infrequently in cats.1,2,5–13 They account for 0–7.8% of tumors in surveys of feline oral neoplasms.5,6,9,11,12 Histologically, they are characterized by a dense, well-vascularized stroma populated by stellate cells with abundant fibrillar collagen and resemble the periodontal ligament. Multiple epulides have been described in dogs, but multiple, concurrent epulides have not been reported in cats. Excisional biopsies from 13 cats with multiple gingival masses that were diagnosed microscopically as epulides of periodontal origin were reviewed. Microscopic and clinical features of multiple epulides from 13 cats are described.
From 1995 to 1997, seven biopsies from cats with multiple epulides were examined by one pathologist (FYS) as a consultant for Marshfield Veterinary Diagnostic Laboratory, Marshfield, Wisconsin. Four were examined by one of the authors (RRD) from the Veterinary School at the University of Wisconsin and two were retrieved from the archives at the Armed Forces Institute of Pathology. Criteria for inclusion in this report included a clinical description of multiple gingival lesions, material (paraffin-embedded tissue and/or glass slides) available for review of the histopathology, and microscopic features consistent with epulides of periodontal ligament origin. The prevalence of this lesion cannot be determined since the number of cat lesions or cat tumors examined over the collection period is not known. The referring veterinarians or owners were contacted for follow-up information. Case summaries are presented in Table 1. Eight cats were Domestic Shorthair cats, one was a Persian, and in four cases, the breed was not specified. Five of the cats were castrated males, three were intact males, three were spayed females, and the sex was not specified in two cats. The cats ranged in age from 1 to 15 years. The FeLV status was reported to be negative in four cats and unknown in the remaining nine. The number of lesions was recorded in four cases (Nos. 1, 4, 7, 9) and ranged in number from 3 to 12. The size and location of the gingival masses were not specified.
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Although fibromatous epulis has been reported in cats, this is the first report of multiple, concurrent epulides in this species. The hallmark of fibromatous and ossifying epulis is a well-vascularized collagenous stroma populated by stellate cells.1,2,7,8,10,12 The ossifying epulis contains osteoid or cementin-like or dentin-like material often referred to as dental hard substance.2,7,8,10,12 We consider the fibromatous and ossifying epulis to be a histologic variant of the fibromatous epulis. The histologic features of canine epulis and multiple feline epulides are similar; however, in general, the feline tumors detailed in this report were more cellular. The apparent human counterpart to fibromatous epulis in dogs is the peripheral odontogenic fibroma. Unlike its canine counterpart, this neoplasm is rare.8
There are conflicting views on the biologic behavior and treatment of canine fibromatous epulis in the literature. Head stated that canine fibromatous and ossifying epulides recur following surgery but did not indicate the frequency,10 while Barker et al. stated that excision is curative.2 Bostock and White reported three recurrences in 17 cases of canine fibromatous and ossifying epulis following excision of the tumor without removal of the underlying bone.4 Gardner recommended complete excision of the canine fibromatous epulides but did not feel that the en bloc resection of bone and extraction of associated teeth favored by Bjorling et al. was necessary.3,8 Gardner further stated that these lesions have no tendency to recur and that those that recurred were most likely secondary to incomplete excision. In our experience (RRD, FYS), canine fibromatous epulides are usually successfully treated by local excision and recurrence occurs infrequently, whereas recurrence was observed in 8 of 11 (72%) of the cats in this series for which follow-up information was available.
In summary, although the number of cases is too small to definitively assess the biological behavior of multiple feline epulides, certain statements about the biological behavior and treatment can be made. These tumors were found in cats that ranged from 1 to 15 years of age. Six of the 12 cats whose age was reported were 3 years old or younger, suggesting a higher prevalence in young cats. There was no sex predilection. The FeLV status was negative in the four cats tested, suggesting that there is no association between this lesion and feline leukemia virus infection. Glucocorticoid therapy was not beneficial in treating four of five cats. Unlike canine fibromatous epulides, multiple feline epulides appear to recur frequently after surgical excision; consequently, wide surgical excision is indicated.
Acknowledgments
We would like to thank Ms. Robin-Anne V. Ferris, MFS, and Mr. Prinya Yoophasook for photographic support. We are grateful to the following veterinary clinicians and pathologists for providing tissues, slides, and clinical data in this study: Drs. M. P. Fender, S. M. Dial, P. H. Rowland, C. G. McLeod, A. L. Kincaid, C. A. Schiller, D. Nyren, C. Apker, W. Damitz, and D. E. Clausen. Portions of this work were presented as a poster at the 47th Annual Conference of the American College of Veterinary Pathologists, December 1996, Seattle, Washington. (The opinions or assertions contained herein are the private views of the authors and are not to be construed as official or as reflecting the views of the Department of the Army or the Department of Defense.)
References
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  N. D. de Bruijn, J. Kirpensteijn, I. J. S. Neyens, J. M. A. Van den Brand, and T. S. G. A. M. van den Ingh A Clinicopathological Study of 52 Feline Epulides Vet. Pathol., March 1, 2007; 44(2): 161 - 169. [Abstract] [Full Text] [PDF]
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