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This 13 year old FS DSH cat has a history of difficulty swallowing; Radiographs show possible esophageal mass. PE: obesity, mild stridor. CBC/Chem: wnl
This 13 year old FS DSH cat has a history of difficulty swallowing; Radiographs show possible esophageal mass. PE: obesity, mild stridor. CBC/Chem: wnl
CT of the head and cranial thorax –
Both tympanic bullae are completely filled with homogeneous soft tissue attenuating material, which can be traced through the auditory tubes to the nasopharynx. The nasopharynx is completely obliterated by a 1 x 1.2 x 1.5 cm ovoid soft tissue mass with faint peripheral contrast enhancement and a mass effect onto the soft palate. Moderate symmetric enlargement of both mandibular salivary glands. An intracranial extraaxial, uniformly enhancing mass lesion of 8 mm height with broad attachment to the bone surface is seen in the midline within the sella region. The mass causes centrifugal displacement of the surrounding brain parenchyma. The caudal compartment of the left cranial lung lobe presents completely soft tissue attenuating and the volume is markedly reduced with an indistinct air bronchogram.
A chronic infection (such as cat flu) is considered the most likely cause of the polyps. Secondary pressure induced widening of the osseous part of the auditory tube is noted bilaterally. Cystic dilation of the salivary glands owing to obstructive and/or inflammatory disease.
The intracranial extraaxial mass is compatible with a pituitary macroadenoma or
meningioma. Lymphoma is a less likely potential too. The mass may be subclinical at
this point or associated with endocrinopathies such as acromegaly/insulin resistant
diabetes, and other clinical signs depending on the associated mass effect.
Recommend – if not yet performed – rhinoscopy and removal of the nasopharyngeal
polyps by traction technique.
The extraaxial brain mass may be characterized further by an MRI study if the owner
considers surgical options.
