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This 7 year old FS Beagle mix presented for progressively worsening swelling around the left eye and down the right side of the face. Cuterebra removed from small puncture on left dorsal eye lid. R/O FB reaction vs cellulitis vs tumor
This 7 year old FS Beagle mix presented for progressively worsening swelling around the left eye and down the right side of the face. Cuterebra removed from small puncture on left dorsal eye lid. R/O FB reaction vs cellulitis vs tumor
CT of the head –
A flat, well delineated and homogenous subcutaneous soft tissue swelling of 4.5 cm diameter and 1.5 cm thickness is seen associated with and dorsal to the upper left eyelid. Foreign material is not identified. The underlying bones, the left eye and retrobulbar space do not present abnormalities. The subcutaneous tissue ventral to the left ear canal and zygomatic arch presents an ill-defined swelling with marked layered stranding. The submandibular and parotid lymph nodes are moderately enlarged with maintained short-to-long-axis ratio. Level with the cranial aspect of the swelling two small mineral opaque foci are seen within the cutis.
An abscess with septic cellulitis and lymphadenitis is most likely for the lesion ventral to the left zygomatic arch even though the assessment is limited here owing to the lack of a post contrast sequence. Please note that organic foreign material may go undetected in CT.
An inflamed sialocele and a soft tissue neoplasia with perilesional cellutlitis are less likely but possible differentials. Edema, abscess, hematoma and soft tissue neoplasia are possible differentials for the lesion of the left eyelid. The assessment is limited here too. For both lesions further definition by fine needle aspiration is warranted to plan therapeutic measures.
