Immunotherapy of periocular squamous cell carcinoma with metastasis in a pony

A 5-year-old Pony of America mare was referred for evaluation of inflamed upper and lower right eyelids. Squamous cell carcinoma of the eyelids and ulcerative keratitis secondary to self-trauma were diagnosed. Initial treatment of the eyelid neoplasia with 2 applications of cryotherapy failed to resolve the lesions, and immunotherapy with bacillus of Calmette-Guerin (BCG) was instituted. Multiple injections of BCG over a 17-week period resulted in progressive shrinkage of the tumor mass, but regional metastasis to the ipsilateral submandibular lymph node occurred. Six months later, ocular neoplastic lesions were not evident, and the lymph node had regressed in size. Eighteen months after the diagnosis of metastatic disease, signs of recurrence were not noticed in either the primary or secondary tumor sites. Squamous cell carcinoma of the equine eyelid historically carries a poor prognosis for resolution. Immunotherapy for equine ocular squamous cell carcinoma should be considered as a treatment alternative to cryosurgery, radiotherapy, hyperthermy, and CO2 laser ablation, especially in cases involving the eyelid.