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J. Comp. Path. 2011, Vol.

8, 1e11

www.elsevier.com/locate/jcpa

DISEASE IN WILDLIFE OR EXOTIC SPECIES

Melanophoromas and Iridophoromas in Reptiles


K. O. Heckers*, H. Aupperle*, V. Schmidt and M. Pees
* LABOKLIN, Labor fur klinische Diagnostik, Steubenstr. 4, 97688 Bad Kissingen and Klinik fur Vogel und Reptilien,
Veterinarmedizinische Fakultat, An den Tierkliniken 17, 04103 Leipzig, Germany

Summary
Chromatophoromas are tumours of pigment-producing cells of the skin and are rarely reported in reptiles.
These tumours are subclassified on the basis of the type of pigment. The present study characterizes chromatophoromas arising in 26 reptiles, including six snakes, 19 lizards and a tortoise. These include the first reports
of melanophoromas in a yellow anaconda (Eunectes notaeus), pigmy rattlesnake (Sistrurus spp.), southern water
snake (Nerodia fasciata), veiled chameleon (Chamaeleo calyptratus) and leopard gecko (Eublepharis macularius); the
first reports of benign iridophoromas in a savannah monitor (Varanus exanthematicus), veiled chameleon and
bearded dragon (Pogona vitticeps); and the first description of a malignant iridophoroma in a bearded dragon.
Additionally, in three bearded dragons a mucinous type of melanophoroma is described for the first time.
Chromatophoromas generally arose from the skin of the body and head and ranged in size from 0.2 to
2.0 cm in diameter. In six cases the animals were humanely destroyed immediately after diagnosis. Three further animals were humanely destroyed following recurrence of their tumour. Six of these nine reptiles had visceral metastases. Grossly, melanophoromas (n 20) were grey or black, while iridophoromas (n 6) were
white in colour. Microscopically, most of the tumours were composed of spindle cells with varying pigmentation and 0e2 mitoses per 10 high power fields. Six of the 20 melanophoromas were classified as malignant due
to the presence of intravascular tumour cells, visceral metastases, high pleomorphism and/or mitotic figures.
Five of the six iridophoromas were classified as benign and the one malignant tumour was defined by the presence of intravascular tumour cells and visceral metastases. Immunohistochemically, melan A and S100 were
coexpressed by all of the chromatophoromas.
2011 Elsevier Ltd. All rights reserved.
Keywords: chromatophoroma; iridophoroma; melanophoroma; reptile

Introduction
Three types of pigment cells (chromatophores) occur
within the integument of reptiles.
Tumours of pigment cells are generally referred to
as chromatophoromas and are classified according to
their specific chromatophores as: (1) melanophoromas or melanomas (melanin-producing cells), (2)
xanthophoromas (carotenoid or pteridine-producing
cells) or (3) iridophoromas (crystalline purineproducing cells containing reflecting granules of guanine, adenine, hypoxanthine or uric acid) (Bagnara,
1966; Bagnara and Hadley, 1973; Rohrlich, 1974;
Bagnara et al., 1979; Gopalakrishnakone, 1986;
Morrison, 1995).
Correspondence to: K. O. Heckers (e-mail: heckers@laboklin.de).
0021-9975/$ - see front matter
doi:10.1016/j.jcpa.2011.07.003

In general, melanophoromas are considered rare


tumours of reptiles (Korabiowska et al., 1997, 1998).
In a study of 1,941 reptiles, Sinn (2004) found one melanophoroma in a snake, while Ippen and Schroder
(1977) found no chromatophoromas in 5,000 reptile
post-mortem examinations. Most reports of chromatophoromas have involved snakes such as colubrids, particularly the San Francisco garter snake (Thamnophis
sirtalis tetrataenia), and in animals of the families Crotalidae, Boidae and Viperidae (Schlumberger and Lucke,
1948; Frye et al., 1975; Ryan et al., 1981; Ramsay and
Fowler, 1992; Gregory et al., 1997; Garner et al., 2004;
Suedmeyer et al., 2007). Metastases have been
reported in several cases of melanophoromas (Ball,
1946; Elkan, 1974; Garner et al., 2004). Few cases of
melanophoromas are described in lizards (Mikaelian
et al., 2000; Johnson, 2003; Garner et al., 2004;
2011 Elsevier Ltd. All rights reserved.

Please cite this article in press as: Heckers KO, et al., Melanophoromas and Iridophoromas in Reptiles, Journal of Comparative Pathology (2011),
doi:10.1016/j.jcpa.2011.07.003

K.O. Heckers et al.

Irizarry-Rovira et al., 2006; Simpson, 2008). In tortoises


there is one report of a malignant melanophoroma of
the carapace in a Hermanns tortoise (Testudo
hermanni) (Heckers et al., 2011). A metastatic iridophoroma is described in a pine snake (Pituophis melanoleucus;
Jacobson et al., 1989) and one malignant iridophoroma
is reported in a boa constrictor (Boa constrictor; AFIP,
2000). One publication reports a xanthophoroma in
a canebrake rattlesnake (Crotalus horridus atricaudatus;
Gregory et al., 1997).
The diagnosis of amelanotic melanomas in mammals is often based on immunohistochemical detection of melan A and S100 protein (Glage, 2001;
Ramos-Vara et al., 2002). Melan A is expressed in
melanocytes and in melanoma cells (Glage, 2001),
while S100 protein is expressed in numerous cell types
including glial cells and ependymal cells of the central
nervous system, glial cells of peripheral nerves
(Schwann cells), melanocytes and melanocytic
tumour cells (Orchard and Wilson, 1994). Immunohistochemical characterization of reptilian chromatophoromas has rarely been reported. Irizarry-Rovira
et al. (2006) were the first to report detection of melan
A in reptiles in a melanophoroma from a green iguana
(Iguana iguana). Reptilian melanophoromas do not always show expression of S100 (Gregory et al., 1997;
Korabiowska et al., 1997; Kusewitt et al., 1997).
Although several case reports of chromatophoromas in reptiles are available, comparative pathological studies of a larger number of cases do not exist.
Therefore, the aim of the present study was to characterize and compare the clinical findings and the gross,
microscopical and immunohistochemical features of
chromatophoromas in 26 reptiles.

Materials and Methods


Animals

Twenty-six chromatophoromas were selected for analysis from an archive of 179 reptilian tumours collected
over 9 years. The chromatophoromas arose in a number of different species of varying age (Table 1). In
each case the owners of the animals had observed
skin masses that had been present for a period of several
weeks.
In bearded dragons the chromatophoromas were
located in the skin of the shoulder/thorax (n 4), the
head (n 3), tail (n 2), leg (n 1) and in the oral
cavity (n 2). The origin was not documented in
three cases. In other reptiles (snakes, chameleons
and a savannah monitor) the chromatophoromas
were located in the skin of the thorax (n 6), abdomen
(n 3) and head (n 1) or in the oral cavity (n 1).
Most chromatophoromas were excised surgically
(n 23), fixed in 4% buffered formalin and submitted

Table 1
Frequency of chromatophoromas in the archive of
reptilian tumours
Species

Number of Chromatophoromas Melanophoromas Iridophoromas


tumours

Lizards
Bearded
dragons
Snakes
Tortoises and
turtles
Total number

105
51

20.0%
29.4%

13.7%
21.6%

6.3%
7.8%

61
13

9.8%
7.6%

9.8%
7.6%

e
e

179

14.5%

11.2%

3.3%

for histopathological investigation. Six animals were


humanely destroyed at various times (1e635 days)
after histological diagnosis and submitted for necropsy examination. These included a yellow anaconda (Eunectes notaeus), a bearded dragon (Pogona
vitticeps), a veiled chameleon (Chamaeleo calyptratus),
a leopard gecko (Eublepharis macularius), a Hermanns
tortoise and a pigmy rattlesnake (Sistrurus spp.).
Three other reptiles were submitted for necropsy
examination without previous histological investigation. These included a garter snake with small pigmented dermal tumours near to the eye and on the
dorsum, a bearded dragon with a large
non-excisable grey mass with some dark regions on
the ventral abdomen and a bearded dragon with
a non-excisable, ulcerated white mass ventral to the
base of the tail (Table 2). During necropsy examination the animals were inspected in detail and representative samples were fixed in formalin for further
examination.
Histopathology

The histological examinations were performed by two


veterinary pathologists according to a standard protocol. Samples were embedded in paraffin wax and
stained with haematoxylin and eosin (HE). Periodic
acideSchiff (PAS) staining was also performed for
the mucinous tumours. If necessary, sections of
heavily pigmented melanophoromas were bleached
in H2O2 10%. Polarized light was used to visualize
birefringence, which is characteristic of iridophores
(Jacobson et al., 1989; Irizarry-Rovira et al., 2006)
and this examination was used to differentiate
between melanophoromas and iridophoromas.
Mitotic figures and nucleoli were counted in 10
high power fields (40 microscope objective) in randomly selected areas and the mean numbers were calculated. The degree of pigmentation was graded
according to a modification of the system described
by Smedley et al. (2011) as amelanotic (lack of pigment granules or only single cells containing very

Please cite this article in press as: Heckers KO, et al., Melanophoromas and Iridophoromas in Reptiles, Journal of Comparative Pathology (2011),
doi:10.1016/j.jcpa.2011.07.003

Melanophoromas and Iridophoromas in Reptiles


Table 2
Details of reptiles included in the study
Species

Number of animals

Bearded dragon (Pogona vitticeps)

15

Veiled chameleon (Chamaeleo calyptratus)

Leopard gecko (Eublepharis macularius)


Savannah monitor (Varanus exanthematicus)
Garter snake (Thamnophis sirtalis)

1
1
2

Yellow anaconda (Eunectes notaeus)


Pigmy rattlesnake (Sistrurus spp.)
Boa constrictor (Boa constrictor)
Southern water snake (Nerodia fasciata)
Hermanns tortoise (Testudo hermanni)

1
1
1
1
1

few granules), mild (some or most cells with mild pigmentation), moderate (most cells are moderately pigmented), marked (most cells are intensely pigmented)
or dispersed.
Immunohistochemistry

The expression of melan A and S100 protein was


detected by the streptavidinebiotin immunoperoxidase technique. Intensively pigmented melanophoromas were bleached in order to evaluate the
immunohistochemistry (IHC). To avoid reduction
of labelling intensity through the bleaching process,
mildly pigmented melanophoromas were examined
with and without bleaching. As a control for the
melan A and S100 markers the expression of these
molecules in three fibrosarcomas, a myxoma, a myxosarcoma and a squamous cell carcinoma from different reptile species was investigated.
Citrate buffer (pH 6.0) pretreatment (30 min, 96 C)
was required for the detection of both antigens. An initial blocking step with 20% goat serum in Tris-buffered
saline (TBS; 50 mM, pH 7.6) for 20 min at room temperature was performed. All antisera were diluted in
TBS. Mouse monoclonal anti-human melan A (1 in
50; DAKO GmbH, Hamburg, Germany) was incubated with the sections for 24 h at room temperature.
For this reaction the secondary antibody was rat
anti-mouse IgG (1 in 250; Vector Laboratories, Burlingame, California, USA) incubated with the sections for
30 min at room temperature. Rabbit anti-S100 (1 in
400; DAKO GmbH) was incubated with the sections
for 24 h at room temperature. The secondary antibody
for this reaction was goat anti-rabbit IgG (1 in 800;
DAKO Cytomation, Glostrup, Denmark) incubated
with the sections for 30 min at room temperature. Avidinebiotineperoxidase complex (horseradish peroxi-

Sex (n)
Female (6)
Male (3)
Unknown (6)
Male (2)
Female
Unknown
Female
Unknown
Female
Female
Female
Male
Female

Age (years)

Type of chromatophoroma (n)

Mean 3.7
(range 2e7)
3
1
10
5
Unknown
7
17
3
13
11
13

Melanophoroma (11)
Iridophoroma (4)
Melanophoroma
Iridophoroma
Melanophoroma
Iridophoroma
Melanophoroma
Melanophoroma
Melanophoroma
Melanophoroma
Melanophoroma
Melanophoroma

dase streptavidin; 1 in 250; Vector Laboratories) and


AEC-substrate (Zytomed Systems, Berlin, Germany)
were added subsequently to visualize labelling. Slides
were counterstained with Mayers haematoxylin (Bio
Optica, Milan, Italy).
Negative controls were performed by substituting
mouse (DAKO GmbH) or rabbit (DAKO GmbH)
control serum for the primary antibodies. A canine
melanoma served as a positive control, as did the
labelling of chromatophores in normal skin adjacent
to the tumours.
The labelling intensity was evaluated semiquantitatively and graded as follows: 0, negative; 1, weak (pale
red); 2, moderate (red); 3, strong (deep red). The
immunoreactive score (IRS) (Remmele and Stegner,
1987) was calculated according to the following for
mula, which was modified by Ozgen
et al. (1997):
X
IRS 1=100
fPPn  max4  LIn  1; 1g4n2
where n is the index, PP is the percentage of positive
cells, 4 5 is the weight and LI is the labelling intensity. The assignment of labelling intensity and LI
value is:
Index number

LI

Value

1
2
3
4

none
weak
moderate
strong

0
1
2
3

Statistics

Statistical analyses included the ShapiroeWilk-test,


Levene t-test, Fishers exact test (Median test) and
Pearson and Spearman correlation tests. Results were

Please cite this article in press as: Heckers KO, et al., Melanophoromas and Iridophoromas in Reptiles, Journal of Comparative Pathology (2011),
doi:10.1016/j.jcpa.2011.07.003

K.O. Heckers et al.

considered statistically significant where P # 0.05. All


analyses were performed using SPSS software, version
16.0 (SSPS Inc., Chicago, Illinois, USA).

Results
Twenty of the 26 tumours were diagnosed as melanophoromas and six tumours with birefringent cytoplasmic granules were identified as iridophoromas. Six of
the melanophoromas were classified as malignant due
to the presence of intravascular neoplastic cells, visceral metastases, high pleomorphism and/or the presence of mitotic figures. Most iridophoromas were
classified as benign (n 5), with only one being considered malignant due to the presence of intravascular
neoplastic cells and neoplastic cells in the viscera.
The age of the affected animals ranged between 1
and 17 years (median 5 years; Table 2).
When all 179 reptilian tumours were considered,
chromatophoromas (n 26) were the most frequent,
followed by adenocarcinomas of different organs
(n 23), squamous cell carcinomas (n 18), fibrosarcomas (n 18), lymphomas (n 11), papillomas
(n 11), osteochondrosarcomas (n 9) and lipomas
(n 9). In lizards, chromatophoromas (n 19) were
the most frequent tumours followed by squamous cell
carcinomas (n 14), fibrosarcomas (n 10), adenocarcinomas of different organs (n 9), lymphomas (n 6)
and papillomas (n 5). The most common tumours of
snakes were adenocarcinomas of different organs
(n 13), fibrosarcomas (n 8), chromatophoromas
(n 6), lymphomas (n 6) and osteochondrosarcomas
(n 5). In the group of tortoises and turtles the most frequent tumours were papillomas (n 3) and squamous
cell carcinomas (n 3).

Fig. 1. Dermal melanophoroma in the skin of the thorax of a


2-year-old bearded dragon. The mass is 2.0  1.5  1.0 cm
in size. Photograph courtesy Dr. J. Wiechert.

Histopathological Findings of Melanophoromas in Bearded


Dragons

Most melanophoromas (9/11) in bearded dragons


were located in the dermis and infiltrated the deeper
dermis and musculature. Infiltration of the epidermis
was not found. Epidermal ulceration was present in
two cases. In two cases, in which melanophoromas
were located in the oral cavity, the tumour cells
were locally invasive. The melanophoromas were
composed of spindle-shaped cells, which were partially arranged in bundles and streams and separated
by fine fibrous septa with a few capillaries.
In seven cases the oval or round nuclei had dispersed chromatin or were hyperchromatic with mild

Gross Features of Melanophoromas

Melanophoromas occurred in 11 bearded dragons and


nine other reptiles. The melanophoromas ranged between 0.2 and 2.0 cm in diameter with the exception
of one tumour that measured 4.0  3.0  2.5 cm. The
cut surface of the melanophoromas in bearded dragons
after fixation was grey (n 4), white (n 3), black
(n 2) or mixed white and black (n 2). In the other
reptile species the cut surface was black (n 6), grey
(n 2) or mixed white and black (n 1) (Fig. 1). In
general, the melanophoromas appeared significantly
darker than the iridophoromas (P 0.004). The consistency of the tumours was firm in 17 of 20 cases. In
three bearded dragons a mucinous type of melanophoroma was found. These had a gelatinous consistency and released jelly-like material into the
formalin (Fig. 2). In six of the nine necropsy examinations visceral metastases were found (Table 3).

Fig. 2. Dermal melanophoroma measuring 4.0  3.0  2.5 cm


from a 7-year-old bearded dragon after excision and fixation. This is a mucinous type of melanophoroma showing
the cut surface with colouration from white to brown to
black.

Please cite this article in press as: Heckers KO, et al., Melanophoromas and Iridophoromas in Reptiles, Journal of Comparative Pathology (2011),
doi:10.1016/j.jcpa.2011.07.003

Melanophoromas and Iridophoromas in Reptiles


Table 3
Summary of microscopical findings of melanophoromas
Species

Shape of cells

Pleomorphism

Bearded dragon
n 11

Spindle shaped, n 11

Mild, n 4
Moderate, n 6
Marked, n 1

Veiled chameleon
Leopard gecko
Garter snake 1
Garter snake no. 2
Yellow anaconda
Pigmy rattlesnake
Boa constrictor
Southern water snake
Hermanns tortoise

Spindle shaped
Epithelioid
Spindle shaped, n 2

Marked
Marked
Moderate, n 2

Spindle shaped
Spindle shaped
Spindle shaped
Spindle shaped
Spindle shaped

Moderate
Mild
Moderate
Mild
Moderate

Mitotic figures/HPF

Degree of pigmentation

Metastases

0, n 4
1, n 6
2, n 1

Amelanotic, n 2
Mild, n 3
Marked, n 1
Dispersed, n 5
Dispersed
Dispersed
Dispersed, n 2

Yes

Yes
Yes
No

Dispersed
Marked
Dispersed
Marked
Dispersed

Yes
No
No
No
Yes

3
11
0, n 1
1, n 1
2
0
0
0
2

or moderate anisokaryosis. The number of nucleoli


was 0e2. The mean number of mitoses per HPF
was 0e2. Atypical mitotic figures were present in
five cases. Neoplastic cells had a moderate amount
of cytoplasm, but the degree of pigmentation was
highly variable. In most cases amelanotic cells were
interspersed with nests of markedly pigmented cells
(Fig. 3; Table 3).
In one adult bearded dragon with a markedly pigmented melanophoroma of the face, marked cellular
pleomorphism was present. The cells were spindle
shaped, heavily pigmented and had hyperchromatic
round to oval nuclei with <1 mitosis per HPF.
Tumour cell emboli were found in lymphatic vessels,
but no necropsy examination was performed in order
to determine if visceral metastases were present.
In the three cases of mucinous tumours, all from
bearded dragons, the defining feature was a large

amount of basophilic, PAS-positive, mucinous interstitial matrix. The cells were arranged in interlacing
bundles and loose whorls. The cells were mostly amelanotic with dispersed foci of moderate to marked pigmentation. The nuclei had a mildly dispersed
chromatin pattern. The mean number of mitoses
was 0e1 per HPF. The growth was invasive into the
dermis and musculature in all cases, but tumour cell
emboli in lymphatic or blood vessels and metastases
were not found (Fig. 4).
Birefringence was not exhibited by any of the melanophoromas. Mild inflammatory infiltration was
seen in seven tumours. Heterophils were the dominant inflammatory cells, but some lymphocytes,
plasma cells and histiocytes were also present.
Metastatic melanophoromas had a significantly
greater pleomorphism (P 0.047) than those tumours without metastases. The number of nucleoli

Fig. 3. Dermal melanophoroma from a 5-year-old bearded


dragon. The tumour consists of sheets of epithelioid to
spindle-shaped cells with large hyperchromatic nuclei,
a prominent nucleolus and a variable degree of pigmentation. HE. Bar, 10 mm.

Fig. 4. Mucinous type of dermal melanophoroma from a 7-yearold bearded dragon. Loosely-arranged tumour cells lie
within large amounts of basophilic mucinous stroma. HE.
Bar, 10 mm.

Please cite this article in press as: Heckers KO, et al., Melanophoromas and Iridophoromas in Reptiles, Journal of Comparative Pathology (2011),
doi:10.1016/j.jcpa.2011.07.003

K.O. Heckers et al.

(P 0.041) and mitoses (P 0.001) was higher than


in the cases without visceral metastases. The degree of
pigmentation was not associated with malignancy
(P 0.274).
Histopathological Findings of Melanophoromas in other
Reptile Species

The histomorphological findings in melanophoromas


in the other reptile species (n 9) were not significantly
different compared with the findings in the bearded
dragons. The tumours were located in the dermis (8/
9) and infiltrated the deeper dermis and musculature.
One melanophoroma was located in the oral cavity
(leopard gecko) and showed invasive growth into the
interstitial tissue. Neoplastic infiltration of the epidermis was found in the yellow anaconda and the pigmy
rattlesnake. Epidermal ulceration was present in the
boa constrictor and the yellow anaconda. The morphology of the neoplastic cells was predominately spindle shaped (8/9 cases), but epithelioid in the leopard
gecko (Table 3). Tumour cell emboli in lymphatic
and/or blood vessels were found in the biopsy of the second recurrence in the yellow anaconda and in the Hermanns tortoise. These tumours were characterized by
spindle-shaped cells with hyperchromatic round to
oval nuclei. Cells were mostly amelanotic with dispersed foci of moderate (yellow anaconda) or marked
pigmentation (Hermanns tortoise) and there were
1e2 mitoses per HPF. Five melanophoromas showed
mild infiltration of heterophils. Additionally, in three
cases some lymphocytes, plasma cells and histiocytes,
and in the tumour of the yellow anaconda some multinucleated giant cells, were observed.
Visceral Metastases of Melanophoromas

Melanophoromas were present in the viscera in addition to the skin in five cases, including three lizards,

one snake and one tortoise (Table 4) and these metastatic lesions affected 18 different tissues. Neoplastic
foci occurred predominately in the kidney, liver,
lung, intestine and abdominal fat bodies as well as
in the stomach and heart. In four of five cases multiple
organs were affected. In two cases the dermal tumours
showed intravascular tumour cells and during necropsy examination, visceral metastases were seen. In
three cases no tumour cell emboli were found in dermal neoplasms, but visceral metastases were located.
In general, the morphological features of the metastatic tumours corresponded to that described for the
dermal neoplasms, but some differences are notable.
In the veiled chameleon and the leopard gecko the
primary tumours showed a higher number of mitotic
figures and a higher degree of cellular atypia than the
visceral metastases. The primary oral tumour of the
leopard gecko was amelanotic, while the neoplastic
cells in the lungs were moderately pigmented. In the
yellow anaconda with recurring tumours the cellular
differentiation changed from epithelioid (first dermal
lesion) to spindle shaped (first recurrence in skin, second recurrence in skin and visceral metastases). At
first, the nuclei showed a homogenous chromatin pattern that changed to a mildly dispersed and finally to
a vacuolated pattern.
Clinical Outcome of Reptiles with Melanophoromas

In five cases there was no recurrence of the cutaneous


tumour after surgical removal. The animals were
monitored by the referring veterinarian over a period
of 7 months (last cases) to 7 years. Recurrences were
observed in three cases: one directly after surgery
and, in the other two, within a period of 7 months
after surgery. The animals were subsequently
humanely destroyed. In the case of the yellow anaconda with a dermal melanophoroma two recurrences

Table 4
Characteristics of metastatic chromatophoromas
Species

Primary location

Bearded dragon

Skin
Melanophoroma
Skin
Iridophoroma

Bearded dragon

Veiled chameleon 1

Skin
Melanophoroma

Leopard gecko

Oral cavity
Melanophoroma
Skin
Melanophoroma
Carapace
Melanophoroma

Yellow anaconda
Hermanns tortoise

Metastasis

Gross findings in viscera

Lung, gut, liver, kidneys, fat bodies

Dark grey blotches, 0.2e0.4 cm

Skin, muscle, heart, lung, stomach, gut,


liver, pancreas, kidneys, fat bodies,
parietal serosa of the coelomic cavity
Heart, lung, tongue, stomach, gut, liver,
spleen, kidneys, bone, fat bodies, parietal
serosa of the coelomic cavity, brain
Lung

Firm, 0.2e1.0 cm white spots and masses

Heart, stomach, gut, pancreas, kidneys,


uterus, ovaries, fat body
Lung, liver, spleen, kidneys, ductus
deferens, adrenal glands, thyroid gland

Firm, 1.0  1.0  0.4 cm mass in the heart,


black spots 0.3e0.6 cm in other organs
Mild to moderate diffuse swelling of liver
and kidneys with black spots, 0.2 cm

Black spots 0.2e0.4 cm and diffuse black


colour of the viscera
One grey spot, <0.1 cm

Please cite this article in press as: Heckers KO, et al., Melanophoromas and Iridophoromas in Reptiles, Journal of Comparative Pathology (2011),
doi:10.1016/j.jcpa.2011.07.003

Melanophoromas and Iridophoromas in Reptiles

occurred within a period of 21 months. After removal


of the second recurrent tumour, the snake was humanely destroyed due to the poor prognosis. Eight
reptiles were humanely destroyed directly after diagnosis because of poor prognosis and/or poor state of
health. Another three reptiles died a few weeks to
a few months after diagnosis, one with visceral
metastases (Hermanns tortoise) and two of secondary
diseases (bearded dragon and pigmy rattlesnake). In
five cases visceral metastases occurred; four of these
patients were humanely destroyed and one died. In
five cases no follow-up information was available.
Gross Findings in Iridophoromas

Iridophoroma occurred in four bearded dragons, one


veiled chameleon and one savannah monitor. The iridophoromas appeared as single white intradermal
nodules. The savannah monitor had one white mass
(1.0  0.5  0.5 cm) on its neck (Fig. 5). Two
bearded dragons had solitary pale nodules measuring
0.2 cm and 0.4 cm in diameter on the head and
throat, respectively. One bearded dragon developed
a solitary white mass measuring 3.0  2.0  2.0 cm
on the thorax. Another bearded dragon had
a 1.5e2.0 cm ulcerated mass on the ventral side of
its tail and further masses in the viscera. In the veiled
chameleon the iridophoromas appeared as multifocal
white blotches of the skin (0.1e0.3 cm) near the yellow stripes of the thorax and abdomen.

(Fig. 6). Diagnosis of iridophoromas (n 6) was


based on the detection of numerous birefringent,
strongly anisotropic granules within the neoplastic
cells when examined under polarized light (Fig. 7).
Further histomorphological findings in iridophoromas were not significantly different from the melanophoromas (Table 5). All iridophoromas showed
infiltrative growth and inflammation was not found.
Visceral Metastases of Iridophoromas

The female bearded dragon with a tumour at the base


of the tail had numerous iridophoromas in several
organs (Table 4). The spindle-shaped cell morphology, invasive growth, marked pigmentation and
mitotic index (1 per HPF) were similar in all sites.
The lymphatic and blood vessels associated with the
tumour of the tail contained numerous tumour cell
emboli. Visceral metastases affected 11 different
organs in this case.
Clinical Outcome of Reptiles with Iridophoromas

In three cases (bearded dragon, savannah monitor


and veiled chameleon) surgical removal was curative

Histopathological Findings in Iridophoromas

In HE-stained slides iridophores contained moderate


to large amounts of fine to coarse golden-brown to
olive-green pigment granules that were larger than
the black pigment granules found in melanophores

Fig. 5. Iridophoroma on a savannah monitor with focal, irregular,


white thickening of the dorsal scales. The mass is
1.3  1.3  0.7 cm in size. Photograph courtesy of
Dr. J. Wiechert.

Fig. 6. Dermal iridophoroma from a 5-year-old bearded dragon.


The tumour is composed of pigmented cells containing
amber-coloured granules (iridophores). Single black melanophores are located in the dermis. HE. Bar, 15 mm.

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K.O. Heckers et al.

Fig. 7. Dermal iridophoroma from a 3-year-old bearded dragon.


Under polarized light there are variably pigmented
spindle-shaped cells containing marked amounts of anisotropic crystalline material. HE. Bar, 10 mm.

and there was no recurrence of the tumours over


a 2-year period. One bearded dragon was humanely
destroyed directly after diagnosis because of the
poor prognosis of an inoperable tumour and the animals poor state of health. In two cases no clinical
follow-up information was available.
Immunohistochemistry

IHC was performed in 24 of the 26 cases. In four cases


IHC was necessary for final diagnosis because the tumours were unpigmented. Treatment with H2O2 did
not affect the IHC. Melan A labelling was not seen in
any of the control tumours, while S100 protein was expressed in the fibrosarcomas, the myxoma and the
myxosarcoma, but not in the squamous cell carcinoma.
In all chromatophoromas melan A and S100 protein were coexpressed in varying intensity (Figs. 8
and 9). The median expression intensity (IRS) of 18
melanophoromas was 2.3 (0.2e9.1) for melan A
and 4.9 (1.9e9.5) for S100 protein. In the six
iridophoromas it was 1.4 (0.2e2.6) for melan A and
4.3 (3.2e5.7) for S100 protein.

Discussion
Chromatophoromas appear to be relatively common
tumours in reptiles. In bearded dragons melanophor-

omas represented 21.6% of all tumours in the study


and represented 85% of the chromatophoromas found
in lizards. To the authors knowledge there are no previous reports of melanophoromas in anacondas,
pigmy rattlesnakes, southern water snakes, veiled chameleons, leopard geckos or savannah monitors.
In eight cases surgical removal of the tumour was
curative. Recurrence was observed in three cases
and visceral metastases occurred in six cases. In ten
cases the animals were humanely destroyed and three
other reptiles died a short time after diagnosis.
The microscopical appearance of the melanophoromas was similar in all species of reptiles (infiltrative
growth, spindle-shaped cells, mild to moderate anisokaryosis, 1e2 nucleoli, few mitotic figures and variable pigmentation). These findings are consistent
with previous reports (Garner et al., 2004; IrizarryRovira et al., 2006; Simpson 2008). Three
melanophoromas with an atypical mucinous
appearance were identified in bearded dragons.
This type of melanocytic neoplasm has not been
previously described in reptiles or mammals. The
tumours were characterized by the presence of
a proteoglycan-rich, PAS-positive mucinous interstitial matrix, which was released into the formalin during fixation. Myxosarcoma was considered as
a differential diagnosis, but was excluded due to the
presence of pigmentation, the cellular morphology
and the expression of melan A. This type of melanophoroma has invasive growth and mild cellular atypia, but does not metastasize to the viscera.
Lymphatic and/or vascular invasion is generally
regarded as the best indicator of malignancy
(Garner et al., 2004); however, in cases with visceral
metastases a significantly higher cellular pleomorphism and increased numbers of nucleoli and mitoses
in dermal melanophoromas were also detected. These
signs of malignancy were not as pronounced in the visceral sites as in the primary dermal tumours. Cellular
atypia is a common feature of malignant tumours in
the dog (Spangler and Kass, 2006), but in the present
study some well-differentiated dermal chromatophoromas had widespread visceral metastasis, so this feature of malignancy may not necessarily apply to
reptilian tumours. Similarly, mitotic activity is an
important means of distinguishing between benign

Table 5
Summary of microscopical findings of iridophoromas
Species
Bearded dragon
n4
Veiled chameleon 2
Savannah monitor

Shape of cells
Spindle shaped,
n4
Spindle shaped
Spindle shaped

Pleomorphism
Mild, n 2
Moderate, n 2
Moderate
Mild

Mitotic figures/HPF

Degree of pigmentation

Intravascular growth

0, n 2
1, n 2
0
0

Marked, n 4

Yes

Marked
Marked

No
No

Please cite this article in press as: Heckers KO, et al., Melanophoromas and Iridophoromas in Reptiles, Journal of Comparative Pathology (2011),
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Melanophoromas and Iridophoromas in Reptiles

Fig. 8. Dermal melanophoroma from a 2-year-old bearded


dragon. Moderate melan A expression is seen in most of
the tumour cells. IHC. Bar, 15 mm.

and malignant melanocytic tumours in mammals. In


dogs, but not in cats, >3 mitoses per HPF are usually
indicative of malignancy (Goldschmidt et al., 1998).
In the present study a mitotic activity of $2 per
HPF appeared to be associated with malignancy;
however, melanophoromas with a mitotic activity of
1 per HPF also showed lymphatic invasion and visceral metastases. The location of melanophoroma in
the skin (oral or digital) does not seem to be a prognostic factor in reptiles, as described in dogs (Spangler
and Kass, 2006).
In mammals, cellular morphology is not of prognostic significance in malignant melanoma
(Goldschmidt et al., 1998). In reptiles the cellular
morphology was predominantly spindle shaped; however, epithelioid differentiation was seen in two of the

Fig. 9. Dermal melanophoroma from an adult bearded dragon.


Marked S-100 expression is seen in most of the tumour cells.
IHC. Bar, 10 mm.

five cases with multiple melanophoromas. Infiltrative


growth was present in all solitary and multiple melanophoromas, so this feature does not appear to be
a good criterion of malignancy in reptiles. Furthermore, the size of the tumour, the degree of pigmentation and the presence of tumour-associated
inflammation were not predictive of the nature of
the tumour. Infiltration of single cells or nests of
neoplastic melanocytes in the upper epidermis, which
is an indicator of malignancy in mammals
(Goldschmidt et al., 1998), was not observed in
tumours in the present study. In summary, lymphatic
and/or vascular invasion and metastases are the best
indicators of malignancy in reptiles, followed by a mitotic activity of $2 per HPF, greater cellular pleomorphism and increased numbers of nucleoli.
In reptiles, iridophoromas have been reported only
in two species of snakes (Jacobson et al., 1989; AFIP,
2000). In the present study, iridophoromas were
identified only in lizards, particularly in bearded
dragons, with a frequency of 7.8% of total
neoplasms. This is also the first report of benign
iridophoromas in the savannah monitor, the veiled
chameleon and the bearded dragon, as well as of
a malignant iridophoroma in a bearded dragon.
These tumours were characterized by a white colour
after fixation. Microscopically, the amber
colouration of the granules in the iridophores was
noticeably different from the black melanin granules
of melanophores. Furthermore, birefringence was
clearly seen in these tumours confirming the
diagnosis.
Similar criteria to those described above may be
used to distinguish between benign and malignant iridophoromas. According to Gopalakrishnakone
(1986) iridophores were normally present in small
numbers in the internal viscera of a Chinese softshell
turtle (Trionyx sinensis); however, we investigated the
internal viscera of 10 bearded dragons by polarized
light microscopy and iridophores were not found (unpublished data). This confirms the assumption that
the numerous iridophoromas found in the viscera of
one of the bearded dragons were visceral metastases.
Melan A is one of the most commonly used melanocytic differentiation markers for human and canine
melanomas (Jungbluth, 2008; Smedley et al., 2011).
Its specificity in canine melanoma is high (89e92%
for melanomas; Ramos-Vara et al., 2000; RamosVara and Miller, 2011). S100 protein is a widely used
melanocytic marker with high sensitivity for human
melanomas (97e100%) and with slightly lower
sensitivity (76%) for canine melanomas (RamosVara et al., 2000; Ohsie et al., 2008). Both, melan A
and S100 protein were detected by IHC in all
chromatophoromas in the present study. The

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K.O. Heckers et al.

10

specificity of melan A and the sensitivity of S100


protein in melanophoromas and iridophoromas
reported in other species were confirmed in the
reptile chromatophoromas in this study. The
expression pattern and intensity did not vary
significantly
between
melanophoromas
and
iridophoromas. The detection of S100 protein in
melanophoromas was in contrast to the results of
other studies (Kusewitt et al., 1997, Irizarry-Rovira
et al., 2006) where S100 protein was not detected.
This is probably due to the fact that different
antibodies and pretreatments were used. Kusewitt
et al. (1997) used the same antibodies, but these
authors examined a death adder (Acanthophis antarcticus), a species of snake not included in the present study.
Immunohistochemical studies of S100 protein and
melan A expression in iridophoromas are not
reported. The mild labelling of melan A in iridophoromas is probably caused by the similar origin of both
cell lines; dermal chromatophores, including melanophores, xanthophores and iridophores, all derive from
the neural crest (Bagnara et al., 1979).
In summary, chromatophoromas in reptiles, especially in bearded dragons, but also in other lizards,
occurred more often than assumed by the low number
of case reports in the literature and their potential malignancy should be considered clinically. Further
studies are necessary to understand the biological
behaviour of these tumours in more detail. Melan A
is useful for differentiating reptilian amelanotic melanophoromas from other sarcomas.

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January 14th, 2011


Received,

Accepted, July 5th, 2011

Please cite this article in press as: Heckers KO, et al., Melanophoromas and Iridophoromas in Reptiles, Journal of Comparative Pathology (2011),
doi:10.1016/j.jcpa.2011.07.003