Veterinary Society of
Surgical Oncology

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

Biologic Behaviour

  • 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

  • surgery is recommended with either mandibulectomy and maxillectomy because of bone invasion
  • acanthomatous epulis is also radiation sensitive with 95% local cure rate, however, malignant transformation of the irradiated mass has been reported in 5%-20% dogs following orthovoltage radiation therapy
  • intralesional bleomycin (q 7 days for 3-10 treatments) results in a 100% (4/4) CR with no local tumor recurrence after a minimum 1 year

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

EPULIDES

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