This 15 year old FS Shetland Sheepdog presented for progressively worsening bilateral epistaxis and exophthalmos in the right eye
This 15 year old FS Shetland Sheepdog presented for progressively worsening bilateral epistaxis and exophthalmos in the right eye
CT of the head – The computed tomography of the head reveals a soft tissue attenuating and non-uniformly enhancing expansile mass lesion of 4.5 x 3 x 2.5 cm within the mid and caudal thirds of the right nasal cavity. The mass presents infiltrative growth with extensive nasal turbinate destruction as well as multifocal osteolysis of the nasal, maxillary, palatinal, vomer bone, bony orbita and thinning of the cribriform plate. The mass expands into the right orbita, right frontal sinus, oral cavity, left nasal cavity and through the dorsum of the nose. There is no intracranial extension or contrast enhancement. A moderate rightsided exophthalmus is noted. The nasal passage is completely obstructed. The right and left frontal sinus contain fluid attenuating secretions.
Possible differentials include lymphosarcoma, adenocarcinoma, squamous cell carcinoma, transitional cell carcinoma, fibrosarcoma and other.
The computed tomography is negative for metastatic spread to the regional lymph nodes.
Rhinoscopy and biopsies of the mass should be obtained for further definition.
Complete surgical resection is not an option owing to the extent of the lesion. Consider full tumor staging and radiation therapy and/or chemotherapy with or without cytoreductive surgery depending on the histopathological results as treatment options.
