OCTOBER 2007: GINGER

"Ginger" is a 9 year old, spayed, female yellow lab that was brought in for boarding. The owner was concerned with a swelling along the rostral left muzzle and requested an examination. During the initial examination, a firm, bony mass was palapted along the maxillary rostral portion of the muzzle. Only mild discomfort was elicited during palaption and Ginger's behavior was normal and activity level typical of her breed. A senior blood screen was recommended along with dental intraoral radiographs and skull radiographs as indicated. The owner approved the diagnostics and would consider further testing such as biopsy and or fine needle aspiration if necessary.

Blood results received the following day showed no significant findings. An IV catheter was placed and the dog was sedated and intubated with a cuffed endotracheal tube. The plan was to take an intraoral series of the left maxillary arcade and as much surrounding bone as possible. It was apparent with the first radiograph that extensive bony destruction had occured and that the teeth were "floating" in the maxillary space. Further radiographs confirmed that the mass destruction extended along the entire maxilla with mobility of all the teeth in this region. A prophylaxis was performed to help decrease the bacterial flow and Ginger was moved into the radiology section for a series of skull and thorax radiographs. Additionally several biopsy samples were obtained with a trephine bone biopsy tool, no reliable soft tissue sample was obtained. All samples were submitted for histopathology and the radiographs were sent for specialist review. The anesthesia episode was finished and Ginger had an uneventful recovery.

The biopsy results indicated a probable fibrosarcoma. No evidence of metastisis to the lymph nodes or chest was seen and no signs were found that the tumor had crossed the nasal septum yet. The owner was offered a referral consultation with an oncologist vs palliative treatment with anti-inflammatories. Upon returning from their vacation, Ginger's owners decided to support her with pain medication and soft food until her quality of life became compromised. Ginger is still at home and is doing reasonably well at this time.
The radiographs show the bony destruction and tooth abnormalities. The lamina dura has disappeared and is replaced by a widened space filled with neoplastic tissue.