Case Study

CT – Extraaxial intracranial neoplasia level with the left frontal lobe and olfactory bulb, likely meningioma, in a 8 year old FS Great Dane dog

This 8 year old FS Great Dane dog presented 1 month ago for possible seizure, moderately elevated liver enzymes, U/S revealed nodule in liver and large spleen. Treated with milk thistle and now liver enzymes are only mildly elevated. Short grand mal seizure this morning and presented to hospital. Few focal (head) seizures while here treated with Midazolam. Grand mal seizure in mid-afternoon, started Phenobarbital IV.

Physical Exam: Neurologic – focal to grand mal seizures.

Chemistry: Alkp- 282, Alt- 362.

Physical Exam: Neurologic – focal to grand mal seizures.

Chemistry: Alkp- 282, Alt- 362.

Image Interpretation

CT of the head and abdomen –
Head:
The computed tomography of the head reveals an extraaxial mass lesion with a broad base to the cerebral falx and calvarium level with the left frontal lobe and olfactory bulb. The mass lesion measures 2 x 2.5 x 1.5 cm and reveals marked non-uniform contrast enhancement. The lesion’s mass effect is associated with a significant midline shift of the cerebral falx to the right.
The rostral aspect of the olfactory bulbs and cribriform plate are not included in the study.
The middle and external ears as well as the temporomandibular joints are normal. The retrobulbar space is normal as far as included. The lymph nodes of the head are normal.

Abdomen:
Except for generalized enlargement of the spleen (due to general anesthesia) and multifocal small hypoenhancing nodular changes the abdominal structures are within normal limits as far as included in the study. The collimation does not allow for assessment of the liver parenchyma.

DX

The computed tomographic findings are compatible with an extraaxial intracranial neoplasia level with the left frontal lobe and olfactory bulb. The most likely diagnosis is a meningioma arising from the cerebral falx or olfactory groove. A possible differential to consider is an esthesioneuriblastoma.

Outcome

As surgical access is limited in the described region, radiation therapy may be discussed with the owner as possible treatment option.

Clinical Differential Diagnosis

brain /CNS lesion, liver disease, or other neoplasia, infectious.

Patient Information

Patient Name : Dinah Hunter/Neel

Gender : Female, Spayed

Species : Canine

Type of Imaging : Ultrasound

Status : Complete

Liz Wuz Here : Yes

History

Seizures

Exam Finding

Splenomegaly

Images

Blood Chemistry

Alkaline Phosphatase (SAP), High
ALT (SGPT), High