Case Study

CT – Nasal Soft Tissue Neoplasia with Secondary Aggressive Osteolysis and Frontal Sinusitis in a Canine

History of intermittent sneezing for approximately 2 months. Progressively worse with epistaxis noted this week. CBC and chemistry WNL.

Physical Exam: temperature 102.9; pulse 100; respiration eupneic; MM pink, CRT 2 seconds. OU PLR WNL. Heart and lungs auscultate WNL. Good femoral pulses. Lymph nodes palpate normal. BCS 3/5. Right nares occlusion with no blood noted. Mild ptyalism. Placed in oxygen chamber prior to CT.

History of intermittent sneezing for approximately 2 months. Progressively worse with epistaxis noted this week. CBC and chemistry WNL.

DX

The findings are compatible with a malignant nasal soft tissue neoplasia with secondary aggressive osteolysis. Moreover there was bilateral secondary secretory frontal sinusitis (R>>)L. Likely differential diagnoses are a nasal adenocarcinoma, squamous cell carcinoma, transitional cell carcinoma, lymphosarcoma, melanoma, fibrosarcoma and other.

Image Interpretation

CT of the head, plain and post contrast series, sternal recumbency – There was a large soft tissue attenuating space occupying lesion within the mid and
caudal thirds oft he right nasal cavity that caused extensive turbinate destruction and
permeative osteolysis oft he frontal, nasal, maxillary and palatonal bones. There was
multifocal osteolysis within the bony nasal septum, the soft tissue mass expanded the
septum towards the left and penetrated through part of the septum. The cribriform
plate appeared to be intact. The right frontal sinus was filled with hypoattenuating, non
enhancing material. Part oft he left frontal sinus was filled with material oft he same
quality.
The regional lymph nodes were within normal limits.

Outcome

The prognosis for a curative treatment is poor. In case cytoreduction, radiation therapy
and/or chemotherapy are considered as palliative measures full tumor staging should
include tumor biopsy, sampling of the regional lymph nodes, chest radiographs (vs.
CT) and abdominal ultrasound, although the rate of distant metastases tends to be low
in the likely tumor types.