CT – Oral ameloblastoma of the left hemimandible in a 10 year old M Shih Tzu
History
This 10 year old M Shih Tzu has a unilateral nasal discharge, nasal stridor and decreased air flow on the right. ALT slightly elevated.
This 10 year old M Shih Tzu has a unilateral nasal discharge, nasal stridor and decreased air flow on the right. ALT slightly elevated.
DX
The computed tomographic findings are suggestive for an oral ameloblastoma of the left hemimandible.
Image Interpretation
CT of the head, neck, thorax –
A mildly ill-defined aggressive bony lysis is seen in the lateral aspect of the left hemimandibular corpus extending from the 304 to the 307. Part of the medullary bone and the medioventral cortex of the mandible is maintained. The tooth roots of the 304, 305, 306 and 307 are patially lytic as well. The lesion does not cross the mandibular symphysis. The computed tomography of the thorax is within normal limits.
Outcome
Theoretically other odontogenic neoplasia, fibrosarcoma. lymphosarcoma or squamous cell carcinoma are possible differential diagnoses. Partial hemimandibulectomy including the 304 to 308 would be the therapy of choice after completion of staging – especially the tumor type should be identified by histopathology to set up the appropriate treatment plan. Abdominal ultrasound may be considered as well.There is no evidence of macroscopic metastatic spread to the regional lymph nodes, pulmonary interstitium or mediastinal lymph nodes. The nose is within normal limits.