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This 18 year old F DSH cat presented for a swollen jaw, drooling, ocular discharge. Stopped eating dry food, will eat canned. CBC/Chem: ALKP 13, RBC 6.53, MCH 17.6, lymphs 0.69k/ul
This 18 year old F DSH cat presented for a swollen jaw, drooling, ocular discharge. Stopped eating dry food, will eat canned. CBC/Chem: ALKP 13, RBC 6.53, MCH 17.6, lymphs 0.69k/ul
CT of the skull –
Level with the rostral aspect of the left zygomatic arch and ventral to the left orbita a large soft tissue attenuating, irregularly contrast-enhancing mass lesion is present in the buccal/labial area extending caudally up to the level of the external ear canal, the mass measures 2.4 x 2.7 x 2.7 cm and penetrates into the ventral part of the left orbita. It has a mass effect on the ocular bulb, which is displaced dorsally resulting in a mild exophthalmos. The zygomatic bone presents regional permeative osteolysis level with the mass lesion. The right tympanic bulla is filled with non-contrast enhancing uniform soft tissue attenuating material. The osseous lining of the left bulla is mildly thickened, rough and porous. Mild expansion of the right bulla is noted compared to the left tympanic bulla. A mild amount of non-gravity dependent, non-contrast enhancing soft tissue material attached to the turbinate structures of the right nasal cavity.
Possible differentials include fibrosarcoma, osteosarcoma,
squamous cell carcinoma, other.
There is no sign for tooth root involvement. The findings of the left submandibular lymph nodes are highly suspicious for
metastatic spread.
FNA sampling or biopsy is recommended for further workup. However surgical
therapeutic options are limited due to bone involvement and metastatic spread to the
tributary lymph nodes. Possible radiation treatment with or without cytoreductve
surgery may be discussed with the oncologist. Full tumor staging should include
sampling of the tributary lymph nodes, 3-view thoracic radiographs and ultrasound of
the abdomen.
