Hello,
Baby is a 8 years old DSH F/S that presented with upper respiratory problems. She was anestetized and oropharyngeal exam revealed a soft tissue mass in the hard palate on the left side. Also not sure if attached or not there is another mass that seems to be thyroid in origin. Do you agree? If yes what would be the differentials? Tried to FNA but due to hyghly vascularized I doubt it will be diagnostic. I don’t do a lot of neck US so your help will be much welcomed.
Thank you
Hello,
Baby is a 8 years old DSH F/S that presented with upper respiratory problems. She was anestetized and oropharyngeal exam revealed a soft tissue mass in the hard palate on the left side. Also not sure if attached or not there is another mass that seems to be thyroid in origin. Do you agree? If yes what would be the differentials? Tried to FNA but due to hyghly vascularized I doubt it will be diagnostic. I don’t do a lot of neck US so your help will be much welcomed.
Thank you
Comments
The third video is more
The third video is more interesting wiht focal mineralization. Its in the right position between the trachea and cortoid so we know its thyroid and not a vascular sinus or somethign weird like that. I would turn the gain down a bit on the color but its vascular. The first video has a muscle belly on the right of the carotid and the thyroid on the left. You can always rec CT to surgical planning and see if it crosses over the isthmus to the other side. If you fna use a 25g or even 27g and i would stick right by the area of dystrophic mineralization.
Ideally would have been to
Ideally would have been to FNA/biopsy the oral mass as there have been cases of oral squamous cell carcinoma metastatizing to the thryroid.
Cool would love to see a case
Cool would love to see a case like that… I always stick these things then apply a few minutes of direct pressure but have to use a small needle because you obtain blood artifact on the slide obscuring the dx… I go 25 or even 27 depending on what the slide loks like… you want a small pink feather on the slide.
I was afraid to FNA the oral
I was afraid to FNA the oral mass because of potentisl bleeding. If bleeds what do you use to stop it beside epinephrine, pressure or silverNI sticks?
maybe ive been fortunate but
maybe ive been fortunate but ive never had a bleeding issue that direct pressur ewouldnt resolve wiht a 25 or 27g needle. Cold pack wiht wet towl and pressure has always been in back of my mind but honetly never had an issue to go there … its important on technique that you take the shortest trajectory to the parenchyma without getting too much into vasculature… there always is a small parenchymal window at some angle without too much vasculature in the way.
Thank you both
Thank you both
Hi Calin
I have used a
Hi Calin
I have used a product called Bleed-X Vet. I think we just order it through our vet purchasing company in Ontario. I use it in the mouth all the time esp. when you hit a major bleeder when taking out a tooth or when you remove an oral mass or epulis that really bleeds and you can’t suture. Apparently you can also use it with liver biopsies (at laparotomy) but I haven’t used it for that yet.
Bleed X Vet. Good to know.
Bleed X Vet. Good to know. Thank you Jacquie.