scholarly journals Mandibulectomy in feline with bacterial fibrosing osteomyelitis

2021 ◽  
Vol 49 ◽  
Author(s):  
Keytyanne De Oliveira Sampaio ◽  
Jéssica Mara da Costa Silva ◽  
Alexandre Tavares Camelo Oliveira ◽  
Ellen Cordeiro Bento Da Silva ◽  
Diana Célia Sousa Nunes-Pinheiro ◽  
...  

Background: Fibrosing osteomyelitis is a chronic inflammatory process caused by infectious agents that lead to the destruction and replacement of bone tissue by fibroblasts. The diagnosis is based especially on histopathological and bacterial culture. In cases where extensive and irreversible injuries are observed, surgical treatment may be indicated. The objective of this work is to report the clinical, radiographic, histopathological, and microbiological aspects of a cat presenting fibrosing osteomyelitis.Case: A 10-year-old male feline, no defined breed, weighing 3.9 kg was referred to one Private Veterinary Clinic of Fortaleza, CE, Brazil with a history of left mandibular enlargement, presenting dysphagia, sialorrhea, an increase in firm consistency along of the left mandibular body, temporomandibular arthralgia and decreased joint motion range. On cranium radiograph, signs of proliferative osteopathy of irregular contours were observed in the branch and body of the left mandible and extending to the rostral region of the right mandible, suggesting a neoplastic process. After anesthesia, for better assessment of the oral cavity, a sample was collected by incisional biopsy, however, the histopathological result was nonspecific. In view of the inconclusive condition, it was decided to perform left hemimandibulectomy combined with right partial mandibulectomy. Tissue samples were obtained and sent for microbiological and histopathological analyses. The last test revealed an inflammatory reaction consisting of neutrophils and plasma cells, associated with a large amount of fibrous connective tissue, multifocal bacterial aggregates, necrosis and bone resorption. Based on the findings, the diagnosis of chronic bacterial osteomyelitis was concluded. The microbiological culture demonstrated the growth of the bacterium Pseudomonas aeruginosa, with sensitivity to cefovecin, which was administered to the treatment in doses of 8 mg/kg/SC, every 15 days, for 60 days. After 10 days of the surgery, the patient was able to start the process of swallowing and seizing pasty food.Discussion: Although radiography is a diagnostic method of choice to assess the extent of bone involvement, it hardly allows the distinction between neoplastic processes and osteomyelitis. Thus, in addition to the cranium radiographic examination, that revealed signs of proliferative osteopathy with irregular contours in branch and body topography of the left mandible were required biopsy and bacterial culture. After mandibulectomy, difficulty in retracting the tongue and anorexia were observed in the first days. Despite that, from the 12th day on, there was an improvement in food seizure, with the return to voluntary feeding. Mandibulectomy is indicated in cases where extensive and irreversible lesions are observed, although excision of the caudal mandible to the third or fourth premolar tooth is not recommended, because it compromises the sublingual musculature, with fall of the tongue and loss of function apprehension. In the present case, the caudal portion of the right mandibular branch was maintained, which facilitated the return of spontaneous feeding. The tissue removed was necessary to perform a microbiological culture with antibiogram, essential to determine the possible etiologic agent and choosing antimicrobial drugs. For the treatment of P. aeruginosa infection, cefovecin was prescribed due to the dosage and route of administration that collaborate with the mandibular surgery, once that the oral treatment is more difficult. Post-surgical complications related to mandibular resection, such as anorexia and difficulty in grasping food, are common. However, in the present case, the patient had an adequate reestablish after 15 days. Therefore, hemimandibulectomy is effective in treating fibrosing osteomyelitis, with maintenance of the patient's ingestive function. 

2018 ◽  
Vol 46 (02) ◽  
pp. 126-132
Author(s):  
Stephan Hungerbühler ◽  
Wolfgang Henninger ◽  
Petra Klupiec ◽  
Julia Bödeker ◽  
Anna Langer ◽  
...  

SummaryA 4-year-old male Eurasian Dog presented at our veterinary clinic with a history of perpetual forelimb lameness in both thoracic limbs. In the clinical exploration, direct pressure over the infraspinatus tendon of insertion caused pain in both thoracic forelimbs and a firm band-like structure was palpable. No improvement was observed after treatment with rest, non-steroidal anti-inflammatory drugs and an intralesional injection of a long-acting glucocorticoid. Radiographic examination, ultrasonographic exploration and computed tomography were performed, identifying ossified structures lateral to the proximal humerus and an irregular roughened periosteum at the insertion and tendon of the infraspinatus muscle on both sides. There were more distinct alterations on the right thoracic limb. The imaging results led to a diagnosis of an infraspinatus tendon-bursa ossification accompanied by a chronic tendinopathy/tendovaginitis, accentuated on the right side. The dog was subjected to physiotherapy and autologous conditioned plasma (ACP) was injected into the insertion of the infraspinatus muscle of both thoracic limbs. After 5 months of physiotherapy and two injections of ACP with an interval of one week in both forelimbs, the dog showed no signs of lameness. This case report describes the diagnosis and management of infraspinatus tendon-bursa ossification in a Eurasian Dog. To the authors’ knowledge, this condition has previously not been described in this breed of dog.


2014 ◽  
Vol 44 (11) ◽  
pp. 2035-2038
Author(s):  
Karen Antas Caffaro ◽  
Carlos Alberto Hussni ◽  
Rafaela Mastrangelo Risseti ◽  
Daniel Queiroz França ◽  
Marília Masello Junqueira Franco ◽  
...  

This study reports an unusual case of deforming mandibular osteomyelitis in a cow caused by Trueperella (Arcanobacterium) pyogenes, on the face of the ventrolateral caudal portion of the right branch of the mandible. Fragment aspired of lesion by fine needle allowed cytological characterization, isolation and identification of T. pyogenes. Radiographic examination showed marked periosteal reaction in the right mandible, numerous lytic areas and cortical bone destruction. Despite of treatment based on in vitro antimicrobial sensitivity test, it was recommended the euthanasia due to progressive worsening of the cow's condition. Multiple abscesses were observed in the mandibular region at necropsy. Pyogranuloma was characterized in histological exam. Sampled material collected from the lesion after necropsy resulted in microbiological reisolation of T. pyogenes


2018 ◽  
Vol 46 ◽  
pp. 5
Author(s):  
Renata Meira Lopes de Castro Mello ◽  
Flávia Bormann Vieira Nassif ◽  
Flávio Guilherme Costa Lima ◽  
Marjane Santos de Matos Carvalho ◽  
Renata Santiago Alberto Carlos

Background: Situs inversus (SI) is a rare congenital malformation characterized by the transposition of the viscera (thoracic and/or abdominal) to the opposite side of its normal topography, as a mirror image. In situs inversus totalis (SIT), all organs are inverted, in addition to the cardiac apex being directed to the right side of the body (dextrocardia). It may not present any clinical signs, and hence, it may be an accidental finding. Because of the rare occurrence of SIT, no epidemiological studies have been conducted in dogs. In 50% of the cases, it may be associated with primary ciliary dyskinesia (PCD), whichcauses respiratory clinical signs. SIT can be diagnosed using routine examinations such as ultrasonography, radiography, tomography, and echocardiography. The objective of this paper was to describe the radiographic and echocardiographic findings in a dog with SIT.Case: A 4-month-old Yorkshire Terrier bitch was admitted to the veterinary clinic, with a clinical complaint of cough. A physical examination showed that the dog’s general conditions were good; it had normal appetite and the mucous membranes had a normal color. Radiographic examination revealed changes in the topographic anatomy of the organs. Thecardiac silhouette was inverted, adopting a “D” form; this suggested that the left-side chambers were positioned on the right side, and the right-side chambers were located in the left topographic region. The aortic arch was visible on the right side of the thorax. A diffuse non-structured pulmonary interstitial pattern was observed on latero-lateral projections, whichcould be associated with an inflammatory process. The fundic region of the stomach, spleen, and thymus were visible on the right side. The liver was on the left side of the patient’s abdomen. The stomach contained a foreign body of radiopaque nature that was considered a radiographic finding. Echocardiography revealed the right atrium on the left, and the leftatrium on the right side. The diagnosis was SIT. The prescribed treatment included prednisolone (1 mg/Kg SID) and Nacetylcysteine (10 mg/kg BID), both for 7 days, based on the possibility of bronchitis. Upon return after medication, the animal showed no clinical signs of cough. After 1 year of SIT diagnosis, the animal has remained asymptomatic and hasshown good physical development.Discussion: Dogs with SIT do not usually show clinical signs, and the condition is considered an accidental finding on complementary examinations such as ultrasonography, radiography, tomography, and echocardiography. The radiographic examination associated with echocardiography allowed the identification of SIT, which in this case was not associated with PCD because the respiratory clinical signs had not reappeared after treatment. The prognosis in this case was consideredgood, corroborating the findings of previous studies showing that the prognosis of individuals with isolated SI is good in the absence of any structural cardiac alteration or other underlying diagnoses, with the average life expectancy being similar to that of the general population. In conclusion, when isolated, SIT is an abnormality that is difficult to diagnose because it does not necessarily present clinical signs. The case reported here contributes to the literature because it documents an accidental finding of an isolated case of SIT in a young dog, which had a good prognosis and quality of life after treatment.Keywords: dog, ciliary disease, inversion of organs.


2017 ◽  
Vol 1 (7) ◽  
pp. 18-21
Author(s):  
K Indira Priyadarshini ◽  
Karthik Raghupathy ◽  
K V Lokesh ◽  
B Venu Naidu

Ameloblastic fibroma is an uncommon mixed neoplasm of odontogenic origin with a relative frequency between 1.5 – 4.5%. It can occur either in the mandible or maxilla, but predominantly seen in the posterior region of the mandible. It occurs in the first two decades of life. Most of the times it is associated with tooth enclosure, causing a delay in eruption or altering the dental eruption sequence. The common clinical manifestation is a slow growing painless swelling and is detected during routine radiographic examination. There is controversy in the mode of treatment, whether conservative or aggressive. Here we reported a 38 year old male patient referred for evaluation of painless swelling on the right posterior region of the mandible associated with clinically missing 3rd molar. The lesion was completely enucleated under general anesthesia along with the extraction of impacted molar.


2021 ◽  
Vol 8 (5) ◽  
pp. 86
Author(s):  
Leonardo Leonardi ◽  
Raluca Ioana Rizac ◽  
Ilaria Pettinari ◽  
Luca Mechelli ◽  
Carlo De Feo

Paraganglioma is a rare neuroendocrine neoplasm originating from paraganglia and consisting of neuroendocrine cells of the sympathetic and parasympathetic nervous system. Extra-adrenal paraganglioma occurs with a low incidence in both humans and animals. This report presents the first case of paraganglioma in a cat with orbital primary location. An 18-year-old spayed female European domestic shorthair cat of 3.60 kg body weight was evaluated in a private veterinary clinic in Perugia, Italy, for a pronounced exophthalmos of the right eye. The cat underwent surgery for the enucleation of the right eye and of the mass. The biopsy samples of the removed tissue were fixed in 10% buffered neutral formalin for histological and immunohistochemical evaluations. Therefore, specific markers were used for immunohistochemical investigations, such as anti-neuron specific enolase (NSE), anti-synaptophysin, anti-glial fibrillary acid protein, anti-cytokeratin and anti-chromogranin. The results of these investigations allowed establishing the final diagnosis of ocular extra-adrenal paraganglioma of the cat.


2017 ◽  
Vol 102 (3-4) ◽  
pp. 189-195
Author(s):  
Warren M. Rozen ◽  
Ken G. W. Teo ◽  
Gausihi Sivarajah ◽  
Rafael Acosta

The introduction of well-vascularized flaps for infected sternotomy wound reconstruction has improved mortality rates dramatically. Multiple variations of the pectoralis major flap have been described in this context. However, unresolved limitations of this flap include poor cosmesis and problematic coverage of the inferior third of the sternotomy wound. We describe an approach to address these issues. The humeral attachments are preserved and bilateral muscles are advanced in a limited fashion. The left sternocostal head is advanced medially and rotated anticlockwise, using this portion to fill the upper half of the sternum while the caudal portion of the right pectoralis muscle is used as a turnover flap at the lower half of the wound. In all 25 patients, the anterior axillary fold was preserved bilaterally and the infection completely resolved. Complications included 3 cases of hematoma, 2 cases of coagulopathy, and 1 late bone sequestrum (aseptic). Although the study had a limited sample size, we had a high rate of success and few complications. With the preservation of bilateral axillary folds, good cosmesis, and adequate wound coverage, we recommend this modification of the pectoralis major flap in even complicated cases of mediastinitis.


2021 ◽  
Vol 156 (Supplement_1) ◽  
pp. S88-S89
Author(s):  
A Lazim ◽  
R Kuklani ◽  
D Sundararajan

Abstract Introduction/Objective Adenomatoid odontogenic tumor (AOT) is an uncommon benign odontogenic tumor representing 3 to 7% of all odontogenic tumors. This tumor was first reported as adeno-ameloblastoma by Bernier and Tiecke in 1950 as it was initially assumed to be a type of ameloblastoma. In 1969, Philipsen and Bern proposed the term adenomatoid odontogenic tumor which was subsequently adopted by WHO and became the accepted terminology for this tumor. AOT is classified as a tumor of odontogenic epithelium but occasionally abnormal hard tissues consistent with dentinoid material may also be present as part of the tumor. AOT tends to occur in younger patients and 50% of the cases are diagnosed in teenagers. It occurs twice as commonly in females and frequently involves the anterior maxilla. Radiographically, AOT can appear as a radiolucent or mixed lucent-opaque lesion and may be associated with an impacted tooth. Methods/Case Report We report two unusually large expansile lesions of AOT that presented in the mandible. In the first case, the tumor presented as an expansile radiolucent lesion involving the right posterior mandible in a 32 year old female. In the second case, the tumor presented as an expansile mixed lucent-opaque lesion involving the left anterior mandible in a 21 year old female. The clinical presentation, radiographic and imaging findings, histopathologic features and treatment of these two cases will be discussed. The recommended treatment for AOT is surgical excision. The prognosis is good as this tumor seldom recurs after excision. Results (if a Case Study enter NA) NA Conclusion AOT is considered to be a non-aggressive, non-invasive and slow growing benign neoplasm. It is usually discovered on routine radiographic examination as the lesion is usually small and asymptomatic at the time of diagnosis but occasional cases that are larger in size have been reported in the literature.


2021 ◽  
Vol 38 ◽  
pp. 6-12
Author(s):  
R.J. Samson ◽  
F.H. Mpagike ◽  
A.K. Felix ◽  
A.B. Matondo ◽  
M. Makungu

A seven-year-old female mongrel dog was presented at the Sokoine University of Agriculture Teaching Animal Hospital for second opinion regarding a progressive swelling of the right hind limb of two months duration. Clinical examination revealed a loss of body condition, tachypnea and tachycardia, a painful immobile solid mass of 20 cm x 14 cm x 10 cm located on the right stifle joint, leucocytosis, and anaemia. Radiographic examination of the joint revealed marked soft tissue swelling with amorphous areas of mineralization and complete destruction of the proximal tibia. Smooth and solid periosteal reaction was seen around the tibia and fibula with a Codman’s triangle. Multiple nodules and a mass with soft tissue opacity were seen in the lung fields. Post-mortem examination revealed separation of tibia and fibula, softening of the proximal parts of the tibia, and complete integration of the proximal region of the two bones and articular tissues into the surrounding muscular tissues. Multifocal nodular lesions of variable sizes were mostly found in the lungs and partly in the liver. Histologically, predominantly oval and round cells with variable nuclear sizes and moderate mitoses were observed in tissue samples from the joint, lungs and the liver although some parts of the lung metastases showed both round and spindle shaped tumor cells. Clinical profile is suggestive of aggressive biphasic (spindle and epithelial) type of synovial cell sarcoma with lung and liver metastasis. Early radiographic and biopsy examination of persistent musculoskeletal nodules is recommended for early diagnosis and interventions.


2017 ◽  
Vol 21 (1) ◽  
pp. 12-18 ◽  
Author(s):  
Athina Dalopoulou ◽  
Nikolaos Economides ◽  
Vasilis Evangelidis

Summary Background: Extrusion of root canal sealers may cause damage to the surrounding anatomic structures. Clinical symptoms like pain, swelling and paresthesia or anesthesia may be present. The purpose of this presentation is to describe two cases of root canal sealer penetration into periapical tissues. A different treatment management was followed in each case. Case reports: A 55 year-old man underwent root canal retreatment of the right mandibular first molar tooth due to a periapical lesion. Postoperative periapical radiographs revealed the presence of root canal sealer (AH26) beyond the apex in the distal root in proximity to the mandibular canal. The patient reported pain for the next 7 days. Radiographic examination after 1 year showed complete healing of the periapical area and a small absorption of the root canal sealer. A 42 year-old woman was referred complained of swelling and pain in the area of the right maxillary first incisor. Radiographic examination showed extrusion of root canal sealer in the periapical area associated with a periapical lesion. Surgical intervention was decided upon, which included removal of the sealer, apicoectomy of the tooth and retrograde filling with MTA. After 1 year, complete healing of the area was observed. Conclusion: In conclusion, cases of root canal sealer extrusion, surgical treatment should be decided on only in association with clinical symptoms or with radiographic evidence of increasing periapical lesion.


2005 ◽  
Vol 133 (9-10) ◽  
pp. 433-437
Author(s):  
Radoje Colovic ◽  
Natasa Colovic ◽  
Nikica Grubor ◽  
Vladimir Radak ◽  
Marijan Micev ◽  
...  

Angiomyolipomas are relatively frequent tumors of the kidney. It is believed that about 10 million people worldwide have such a tumor. About 1/10 of these 10 million are patients who suffer from tuberous sclerosis. The tumors are frequently bilateral, slow growing, and usually a symptomatic, as well as being rare in children. Due to the benign nature of angiomyolipomas, surgical treatment and embolisation of the tumors are generally not recommended, unless renal function is endangered, the symptoms are severe, or the kidney in question becomes completely dysfunctional. This is particularly the case in patients with tuberous sclerosis in whom these tumors are either already bilateral or may become so. We present a 24-year-old woman with tuberous sclerosis in whom bilateral kidney tumors were diagnosed 7 years earlier and in whom we carried out a left nephrectomy of a 5300 gram angiomyolipoma, which caused pain and complete loss of function. Although timorous, the right kidney was functional, so it was left untouched. After an uneventful recovery, a close follow-up was recommended, as well as HLA typing, as it is highly probable that the right kidney will gradually become inadequate or completely dysfunctional, so that haemodialysis and/or kidney transplantation along with nephrectomy will become necessary.


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