The patient is a 10 year old FS Labrador Retriever dog presented with a maxillary mass. Stage/check margins of tumor for possible resection.
The patient is a 10 year old FS Labrador Retriever dog presented with a maxillary mass. Stage/check margins of tumor for possible resection.
CT of the head, plain and post contrast – A 5 x 4 x 3.5 cm soft tissue attenuating ovoid mass is seen at the alveolar bone of the left maxilla between the canine tooth (204) and fourth premolar (208). Aggressive permeative osteolysis of the underlying alveolar crest and neighboring maxillary and palatinal bones is noted. Mild amorphous periosteal reactions of the bone are seen at the tumoral margins. The mass shows expansile growth and penetrates into the left nasal and oral cavity causing turbinate destruction. The first premolar (205) reveals severe ventral displacement, the third premolar (207) mild ventral displacement owing to the mass effect of the lesion. The second premolar (206) is lost. The left wing of the vomer bone shows a combination of osteolytic and osteoproliferative reactions.
Moderate non-uniform enhancement is noted within the mass on the post contrast series.
Increase of nasal secretions and mucosal thickening of the nasal turbinates is noted within the left nasal cavity.
Both the left submandibular and medial retropharyngeal lymph node reveal mild symmetric enlargement with maintained short-long-axis ratio and contrast enhancement pattern.
There are bilateral signs of healed chronic otitis externa.
Emerging infiltration of the vomer bone is suspected.Differential diagnoses for the mass include squamous cell carcinoma, melanoma, fibrosarcoma, and lymphosarcoma as well as acanthomathous epuli.
Tumor resection would require complete left-sided hemimaxillectomy. The prognosis for curative surgery is guarded as extensive invasion of the left palatinal bone and infiltration of the os vomer close to the midline is suspected.
Palliative cytoreducting surgery with adjuvant radiation or chemotherapy may be considered.
Complete staging with aspiration of the regional lymph nodes to rule out metastatic spread – the computed tomographic findings indicate reactive hyperplasia here – 3 view chest radiographs and ultrasound of the abdomen.
