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Treatment of Multifocal Cutaneous Squamous Cell Carcinoma with Strontium-90 and Cryotherapy in a Midland Painted Turtle (Chrysemys picta marginata)

Abstract A 16-yr-old male midland painted turtle (Chrysemys picta marginata) presented for evaluation of a crusted cervical lesion and conjunctivitis. The patient initially underwent several treatments of both topical and systemic antimicrobial therapies for dermatitis. Despite treatment guided by results of cytology, crust histopathology, and bacterial culture and sensitivity, dermal lesions were progressive, and a deep excisional biopsy was performed of the two largest lesions. Results of histopathology revealed an incompletely excised squamous cell carcinoma with secondary bacterial and fungal infections. Strontium-90 plesiotherapy was applied to all visible skin lesions, in addition to cryotherapy of a right-eyelid mass 5 wk later. These therapies provided a disease-free interval of less than 45 days in this patient. Because of progressive disease, the turtle was euthanized 7 wk after strontium-90 plesiotherapy. Results of necropsy revealed multifocal squamous cell carcinoma of the head, neck, and left forelimb with local neoplastic invasion and associated cellulitis and dermatitis. Treatment of multifocal cutaneous squamous cell carcinoma with strontium-90 and cryotherapy did not prevent disease progression in this turtle.