EX­TRA-ADRENAL PARA­GAN­GLIOMA (EAPG)

EQUUS - - Eq Casereport -

� Def­i­ni­tion: adren­a­line-pro­duc­ing tu­mors that grow in the cells of the sym­pa­thetic ner­vous sys­tem (which helps to mon­i­tor and con­trol the in­ter­nal or­gans) � Signs: Although EAPGs can oc­cur any­where along the sym­pa­thetic ner­vous sys­tem, in horses the tu­mors are more likely to be­come ap­par­ent when they de­velop in the or­bit, the cav­ity in the skull that holds the eye­ball and re­lated tis­sues. They are re­ported to be the most com­mon tu­mor of the equine or­bit. The most com­mon sign is ex­oph­thalmia, the pro­tru­sion of the eye­ball out­ward from the socket. Bleed­ing or other dis­charge from the nose may be present. Vi­sion is not com­monly af­fected in ear­lier stages of the dis­ease, un­less the tu­mor af­fects the op­tic nerve. Once the pro­tru­sion is pro­nounced, the horse may de­velop chronic in­flam­ma­tion of the cornea and con­junc­tiva (the mem­branes that line the eye­lids and eye socket). Older horses are more likely to be af­fected. � Causes: un­known � Di­ag­no­sis: ob­ser­va­tion of the signs, cou­pled with imag­ing to view the tis­sues be­hind the eye­ball. Op­tions in­clude x-rays, ul­tra­sound, CT (com­puted to­mog­ra­phy) and MRI (mag­netic res­o­nance imag­ing) scans. � Treat­ment: Tu­mors that cause no pain or other se­ri­ous dif­fi­cul­ties for the horse can be left un­treated. Surgery is the only op­tion to re­move a tu­mor, and re­moval of the eye­ball is also usu­ally nec­es­sary. Com­plete cure is un­likely with treat­ment, be­cause tu­mors of­ten ex­tend deep into the or­bit and to­ward the brain, but prog­no­sis is fair since the resid­ual tu­mor is slow grow­ing.

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