Case Study

CT – Expansile nasal mass with possible metastases in a 10 year old FS DSH cat

Tnis 10 year old FS DSH cat has a two month history of sneezing and nasal congestion. Mass noted on rhinoscopy.

Image Interpretation

CT of the head –

attenuating and non-uniformly enhancing expansile mass lesion left and right nasal cavity, the left frontal sinus and left orbita as well as intrancrnial expansion. The mass presents infiltrative growth with extensive nasal turbinate destruction as well as multifocal permeative osteolysis of the nasal, maxillary, palatinal, vomer bone, bony orbita, dorsum of the nose, and cribriform plate. There is a mass effect on the left olfactory bulb and frontal lobe with deviation oft he cerebral falx to the right and increased meningeal and parenchymal contrast enhancement. Compression of the left bulbus and a mild exophthalmus is noted. The nasal passage is completely obstructed. The left frontal sinus contains fluid attenuating secretions. The left medial retropharyngeal lymph node presents mild enlargement with maintained short to long axis ratio and enhancement pattern.

DX

The computed tomographic findings are compatible with a malignant expansile nasal soft tissue neoplasia with intracranial expansion and secondary aggressive osteolysis and secretory rhinitis and sinusitis.

Outcome

Possible differentials include lymphosarcoma, adenocarcinoma, squamous cell carcinoma, transitional cell carcinoma, fibrosarcoma and other.
The computed tomography is suggestive for reactive hyperplasia oft he left medial retropharyngeal lymph node. Metastatic spread is a potential too.