This 11 year old FS Lhasa Apso that presented for a dental cleaning revealed a large caudal mandibular mass; biopsy results amyloid producing odontogenic epithelial tumor.
This 11 year old FS Lhasa Apso that presented for a dental cleaning revealed a large caudal mandibular mass; biopsy results amyloid producing odontogenic epithelial tumor.
CT of the head –
The right mandibular corpus and ramus present a 4.3 x 2.7 x 3.8 cm ill-defined heterogenous osteolytic, expansile and multicystic mass lesion with amorphous mineralization. Extensive permeative osteolysis with complete loss of the regular bone structure is seen. The mass lesion extends from the distal root of triadan 409 into the condylar and coronoid processes. The tooth elements 410 and 411 are not visible but in the center of the mass lesion strong mineral-attenuating ill-defined structures are visible (possible tooth remnants). The soft tissue component of the tumor extends into the right orbita and the mass effect causes a mild exophthalmos. The calvarium presents multiple small osteolytic areas with perforation of the calvarium, mainly seen in the right parietal and the left temporal bone. The mandibular and medial retropharyngeal lymph nodes are rounded and markedly enlarged.
Even though odontogenic neoplasms tend to metastasize rarely, in the present case the
multifocal osteolysis of the calvarium and the lymphadenopathy are likely to reflect
metastatic spread. Therapeutic options in this case are limited due to the advanced stage of the disease.
Radical hemimandibulectomy with resection of the right temporomandibular joint
would be the only surgical option. However, the use and possibility of cytoreductive
surgery appear to be limited here as to the potential metastatic spread. Palliative
radiation therapy may be considered to decelerate or stop tumor growth.
If the owner considers further therapeutic option a full tumor staging and oncologist
consult is advised.
