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How would you describe the radiologic findings associated with the oral mass found in this three-year-old dog, and what is your tentative radiologic diagnosis? | This is a large, space-occupying lesion of the rostral part of the left mandible, expanding over the symphysis into the right mandible. The border of the lesion consists of thinned cortical bone, with little or no periosteal reaction. The overall radiographic density of the lesion is low and it seems to consist of one large cystic area with a few smaller ones on the periphery. The surrounding bone is expanded but the cortical bone is not disrupted. The left mandibular first premolar is absent. The left mandibular canine is marginally displaced but is no longer supported by bone. All left mandibular incisors and to a lesser extent the right first and second incisors are displaced. The tentative diagnosis is an intraosseous, benign tumor suggestive of a central (or intraosseous) ameloblastoma. This diagnosis was confirmed on biopsy. |
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Provided the radiologic diagnosis is confirmed on biopsy, what would be the recommended treatment and prognosis? | A bilateral, partial (rostral) mandibulectomy would be indicated and would likely be curative. Adequate surgical margins would probably be mesial to the mandibular first molar on the left and mesial to the third premolar on the right. Metastasis of ameloblastoma in the dog has not been reported. A bilateral rostral mandibulectomy that far distally is likely to result in the tongue hanging out and may necessitate tying off or repositioning the openings of the mandibular and sublingual salivary ducts. |
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