Equine Corneal Stromal Invasive Squamous Cell Carcinoma: Clinical and in Vivo Confocal Microscopic Features of 7 Cases.

IVCM enables rapid, noninvasive presumptive diagnosis of equine corneal stromal squamous cell carcinoma.

This retrospective case series describes the clinical and in vivo confocal microscopy (IVCM) characteristics of corneal stromal invasive squamous cell carcinoma (CSI-SCC) in 7 horses with histopathologically confirmed diagnoses. All horses presented with unilateral heavily vascularized, opaque gray or tan anterior to midstromal opacities originating from the limbus, with intact overlying epithelium and marked corneal thickening. IVCM imaging revealed distinctive polygonal neoplastic epithelial cells exhibiting anisocytosis and pleomorphism that appeared enlarged and hyperreflective. Islands and cords of neoplastic cells formed branching patterns throughout the stroma, occasionally arranged as concentric keratin pearls. Dense accumulations of blood vessels and leukocytes surrounded neoplastic tissue. Two horses exhibited crystalline white linear branching stromal opacities at lesion margins. The study demonstrates IVCM's utility as a rapid, noninvasive diagnostic tool for presumptive CSI-SCC diagnosis, enabling earlier clinical decision-making and treatment planning.

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