A 14-month-old female Spangled Ebony Langur (Trachypithecus auratus auratus) was presented for circular, erythematous, crusty lesions of the inguinal skin. General condition and appetite were good. Skin scrapings, touch preparations and bloodwork revealed no abnormality.
Lesions extended and became ulcerative. Bacteriology yielded positive culture for Staphylococcus aureus, and treatment with antibiotics and steroids was attempted, in addition to topical antisepsis. Skin biopsies revealed a cutaneous lymphoma and no metastases were detected on CT-scan.
Based on promising results in domestic carnivores,1–4 anti-tumoral treatment was attempted with masitiniba (50 mg PO q 48 h), a tyrosine kinase inhibitor labeled for the treatment of mastocytoma in dogs. Due to potential toxicity, and in the absence of pharmacokinetic studies in langurs, complete plasma chemistry was performed every two weeks.
One month later, general condition and bloodwork were still normal. In the absence of improvement of the lesions, the masitinib dose was increased to 50 mg PO SID, in association with antibiotics and steroids. However, effect on lesions was minimal, general condition worsened, and the animal died 4 months after onset of masitinib treatment. Pathology confirmed epitheliotropic CD3+ cutaneous lymphoma, with extensive cutaneous ulceration and marked infiltration of several lymph nodes.
To the authors’ knowledge, this is the first report of cutaneous epitheliotropic T-cell lymphoma in a langur, and the first attempt of treatment with masitinib in a primate species. Despite poor response, masitinib treatment was well-tolerated. Survival after initial presentation was 9 months. Further reports are needed to assess masitinib efficacy with an earlier onset of treatment and/or higher doses.
a. Masivet 50 mg, AB Science, 75008 Paris, France
The authors would like to thank AB Science laboratory, especially Dr. Pascal Brun, for their help with this case, and provision of masitinib.
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