+ 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