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History of epistaxis from right nostril.
Physical Exam: Right sided skull disfigurement, No nasal airflow and some bupthalmos. CBC and chemistry profile WNL.
History of epistaxis from right nostril.
Physical Exam: Right sided skull disfigurement, No nasal airflow and some bupthalmos. CBC and chemistry profile WNL.
CT of the head, plain series: The skull conformation is typical for a brachycephalic dog. There is a soft tissue attenuating mass lesion occupying the right nasal cavity. The mass shows infiltrative growth and does not respect bony borders or borders of the nasal cavity. It perforates to the right orbita, right frontal sinus, left nasal cavity and fundus as well as towards the cranial vault. The mass effect causes a right sided eyophthalmus. There is aggressive incomplete bone destruction of the hard palate, maxilla, nasal bone, nasal septum, frontal bone, cribriform plate and bony orbita as well as extensive turbinate destruction.
The lymph nodes of the head are not included in the scan.
Radiographs of the thorax: Patient under general anesthesia, endotracheal intubation.
Breed associated ankylosing spondylosis deformans is present in the mid and caudal thoracic spine.
The esophagus shows mild dilation with gas which likely is a function of the general anesthesia.
There is moderate atelectasis of the lung with mediastinal shift and only a fair degree of inhalation
which likely is a function of the general anesthesia. Multiple pleural plugs/pulmonary osteomas are seen emphasizing the cranioventral aspects of the lung. There currently is no radiographic evidence for metastases.
Likely differential diagnoses include adenocarcinoma, squamous cell carcinoma, lymphosarcoma, melanoma, fibrosarcoma and other. Complete resection unfortunately is not an option here. Next to all other mass effects invasion of the cranial vault has to be expected. Radiation oncology and/or chemotherapy may be discussed as a palliative treatment option, but would require complete staging with primary tumor biopsy/histology, regional lymph node sampling and ultrasonographic examination of the abdomen. The radiographic check for pulmonary metastases was negative.
