Extra-adrenal paraganglioma of the equine orbit: six cases

At The Ohio State University from 1994-2006 six of seven horses evaluated for primary orbital disease were diagnosed with extra-adrenal paraganglioma (EAPG). The horses ranged in age from 14 to 24 years, with a mean of 16.8 years. Duration of clinical signs was 1.5 years to 5 years, with a mean of 2.8 years. Clinical signs varied, but all six had non-painful exophthalmus of the right eye. Five horses had complete ocular exams reported; three of five had decreased to absent vision, two of five had pale optic nerves, and in three of five, difficulty of retropulsion of the globe was noted. Diagnostic tests performed included complete blood count, serum profile, radiography, ultrasound, computed tomography, true-cut biopsy, ocular examination, guttural pouch endoscopy, oral examination, and physical examination. Expulsive hemorrhage during orbital exenteration occurred in all horses. In five of six cases, tumor extension through the orbital foramen was apparent intra-operatively. Histopathologic appearance of all surgically removed tissues consisted of sheets of polygonal cells with abundant lightly granular cytoplasm, round nuclei with vesicular chromatin, and rare mitoses. Neoplastic cells were arranged into small groups separated by a fine fibrovascular stroma. All six cases were chromagranin positive on immunohistochemical staining. Follow-up ranged from six months to six years, with a mean of two years. Four of the five horses that recovered from surgery had no apparent tumor recurrence in 6-48 months.