IMAGING DIAGNOSIS — INTRACRANIAL EPIDERMOID CYST IN A DOBERMAN PINSCHER

A 4-year-old Doberman Pinscher was evaluated for chronic progressive central vestibular disease and aggressiveness. A cyst-like lesion was identified in the region of the left cerebellopontine angle. The lesion was hypointense on T1-weighted and hyperintense on T2-weighted images. Differentials included an epidermoid or dermoid cyst, cystic neoplasm, and brain abscess. Hyperintensity on subsequent fluid-attenuated inversion recovery images excluded an arachnoid cyst. The histopathologic diagnosis was epidermoid cyst within the fourth ventricle.     

INTRACRANIAL EPIDERMOID CYST AND SYRINGOHYDROMYELIA IN A DOG

A 5-year-old female Cocker Spaniel dog had a sudden onset of vestibular disease that localized to the caudal fossa. Upon computed tomography of the brain, a large, hypoattenuating mass with a slight peripheral ring enhancement pattern was detected ventral to the cerebellum. A hypoattenuating region was also identified in the center of the C2 spinal cord segment, consistent with syringohydromyelia. Postmortem examination of the brain revealed a fluid filled, cystic mass located dorsal to medulla oblongata that caused severe compression of the overlying cerebellum. The histopathologic diagnosis was an epidermoid cyst. Extensive syringohydromyelia and obstructive hydrocephalus were identified, both thought to be secondary to overcrowding of the caudal fossa.     

INTRACRANIAL INTRA-ARACHNOID CYST WITH INTRACYSTIC HEMORRHAGE IN TWO DOGS

Clinical signs, magnetic resonance imaging (MRI) features, treatment, and outcome of two adult dogs with neurologic dysfunction resulting from hemorrhage into a quadrigeminal intracranial intra-arachnoid cyst are described. In dog 1, the cyst was hyperintense to cerebrospinal fluid (CSF) on T1-weighted MRI and hypointense to CSF on T2-weighted images. In dog 2, the cyst was isointense to CSF on T1- and T2-weighted images. Both dogs were treated with craniotomy and cyst fenestration. A large blood clot was removed from the lumen of the cyst in each dog. Dog 1 is clinically normal 3.5 years post-surgery and has a persistent cyst. Dog 2 had a good initial response to therapy but was euthanized 2.5 years post-operatively due to generalized seizures. The late onset of clinical signs in these dogs most likely resulted from hemorrhage into the cyst. Surgical fenestration and hematoma removal appear to provide a satisfactory treatment for adult dogs with an intracranial intra-arachnoid cyst and intracystic hemorrhage. Persistence of the cyst may occur in some dogs.     

INTRAOSSEOUS EPIDERMOID CYSTS IN THE DISTAL PHALANX OF TWO DOGS

Two dogs were presented with a history of lameness associated with swelling of one of the digits. Radiographs of the affected digits revealed an irregularly mineralized, smoothly marginated proliferative bone lesion in the distal phalanx of one dog and a destructive bony lesion in the distal phalanx of the second dog. The differential diagnosis included nail bed carcinoma, malignant melanoma, osteomyelitis, and subungual keratoacanthoma. Radiographic findings and no response to medical treatment resulted in amputation and submission of the digits for a histopathologic diagnosis. Histologic examination of the distal phalanx of the digits revealed benign epidermoid cysts associated with either bony proliferation or osteolysis. Excision of the lesions was curative. This report presents the clinical, radiographic, and histopathologic findings associated with intraosseous epidermoid cysts in the distal phalanx of two dogs. Veterinary Radiology & Ultrasound, Vol. 33, No. 3, 1992, pp 133–137 .     

PRIMARY IRRADIATION OF CANINE INTRACRANIAL MASSES

Twenty-nine dogs received primary radiation therapy for intracranial lesions and clinical signs suggestive of neoplasia. Presumptive diagnosis and tumor categorization was based on computed tomographic or magnetic resonance images. Meningioma was the most likely tumor type in 22 dogs and glioma or choroid plexus tumors were tentatively identified in 4 and 3 dogs, respectively. Cobalt-60 radiation was delivered in 3 Gy fractions on a daily, Monday-through-Friday basis for a total dose of 48 Gy (16 fractions) in 28 dogs; one dog received 54 Gy. Two of 29 dogs died during treatment of signs suggestive of progressive tumor growth but were included in the overall evaluation of response to treatment. Median overall survival was 250 days (range 21-804). Mild acute radiation effects on normal tissue developed and did not influence outcome in any dog. Late radiation effects could not be evaluated in this study. No significant predictive indicators were identified from the clinical or imaging data. Radiation therapy is superior to medical treatment of brain tumors in dogs with steroids, is useful for tumors that are not currently operable and may be preferable to surgical resection in dogs if the mass appears infiltrative. However, 22/29 (76%) dogs died of recurrent progressive neuropathy suggestive of tumor regrowth or progression. Thus, alternative methods for delivery of radiation to dogs with brain tumors or novel combinations of therapy should continue to undergo evaluation.     

PARAESOPHAGEAL CYST IN A HORSE

A 2 year old Morgan gelding was evaluated for a non-painful mass located caudodorsal to the larynx. Radiographically, the mass was ovoid shaped and had a peripheral rim of mineralization. Slight ventral displacement of the dorsal margin of the trachea could also be identified. Uniform moderate level echoes were seen throughout the interior of the mass on ultrasound examination. An esophagram was performed and demonstrated displacement without involvement of the esophagus by the mass. The esophagus appeared as a separate structure from the mass on both the ultrasound examination and esophagram. During surgical removal, the mass also appeared as a distinct structure from the esophagus. Histologically, the mass was consistent with an epithelial inclusion cyst which originated from the esophagus.     

IDIOPATHIC MEDIASTINAL CYST IN A CAT

A thirteen year old neutered female Domestic Shorthair cat with oral squamous cell carcinoma was noted to have a cranial mediastinal mass on survey thoracic radiographs. Fluoroscopic aspiration was performed and cystic fluid was obtained which was clear colorless, and devoid of cells, with a specific gravity of 1.005 and protein <2.5 mg/dl. On postmortem examination, a unilocular cyst was identified originating from the external lateral surface of the cranial mediastinum. Histologically, the cyst lining was nonciliated and resembled mesothelium. These findings differentiate this cyst from previously reported branchial cysts in cats where the cysts were multiloculated, the cyst fluid was mucinous and cellular, and the cysts were lined by ciliated columnar epithelial cells.     

SPINAL SUBARACHNOID CYST IN A CAT

A 7-year-old neutered female domestic short hair cat was presented with hind limb ataxia. A subarachnoid cyst in the T10-T11 spinal cord region was identified by myelography as a collection of contrast medium in the subarachnoid space.     

IMAGING DIAGNOSIS—CANINE MENINGIOANGIOMATOSIS

Meningioangiomatosis is a rare proliferative disorder of the central nervous system. It occurs sporadically in dogs and is characterized by a leptomeningeal plaque that extends from the subarachnoid space along the perivascular spaces into the adjacent parenchyma. We describe the clinical presentation, magnetic resonance (MR) imaging and neuropathologic characteristics of two additional dogs with meningioangiomatosis, and document involvement of the thoracolumbar spinal cord, a site not previously described for this condition. MR imaging findings were different from those previously described, most likely reflecting the degree of vascularity and collagen deposition. The MR imaging features of meningioangiomatosis are not specific.     

CHOROID PLEXUS CYST IN A DOG

A 6-year-old male Doberman Pinscher had a 2-month history of dysequilibrium. Lesion localization was determined to be the cerebellomedullary pontine angle. In computed tomographic images, a well-defined, circular, hypoattenuating mass was visible at the cerebellomedullary pontine angle. The lesion, which was isoattenuating to cerebrospinal fluid, was 4 x 8 mm in diameter. Peripheral ring enhancement was evident after contrast medium administration. A choroid plexus cyst was diagnosed histopathologically.     

INFLUENCE OF FIELD STRENGTH ON INTRACRANIAL VESSEL CONSPICUITY IN CANINE MAGNETIC RESONANCE ANGIOGRAPHY

Eight neurologically normal beagles were imaged using three-dimensional (3D) time-of-flight magnetic resonance angiography (MRA) in a 3 T magnetic resonance scanner. Four of the eight dogs were also imaged using a 1 T unit for comparison. Ten intracranial arteries were consistently identified at 3 T: external and internal carotid, basilar, vertebral, rostral cerebral, middle cerebral, caudal cerebral, rostral communicating, caudal communicating, and ventral spinal arteries. Only four were reliably identified at 1 T with diagnostic spatial and contrast resolution. At 3 T, vessels as small as 1 mm were reliably detected. Vessel conspicuity was superior using the 3 T system. An anatomic atlas of the canine circulus arteriosus cerebri using a 3 T scan was constructed. The effect of MRA parameters on vascular spatial resolution and conspicuity are reviewed.     

DENTIGEROUS CYST IN THE VENTRAL CONCHAL SINUS OF A HORSE

A 14-year-old Quarter Horse was presented for evaluation of a chronic, intermittent purulent discharge from the left nostril. A radioopaque mass and multiple, air-fluid interfaces in the paranasal sinuses were identified on survey radiographs. The mass was removed and identified as a dentigerous cyst. Substantiated reports of dentigerous cysts in the paranasal sinuses are rare.     

ENDOMETRIOSIS AND A PARAOVARIAN CYST IN A RHESUS MACAQUE

We describe endometriosis in an aged rhesus macaque. There was a large mass and a related paraovarian cyst, typical of the disease. Endometriosis is a common finding in nonhuman primate. In this report, we also review the pathophysiology of the disease and summarize the historical and more recent relevant literature. Given the frequency of endometriosis in the rhesus monkey and the long-life spans (15-30 years) of nonhuman primates in captivity, endometriosis should be suspected in animals displaying the earliest signs of the disease: anorexia, dysmenorrhea, menorrhagia, irregular menstrual cycles, or infertility. Despite recent advances in the diagnosis and therapeutic strategies for endometriosis in women, the disease remains a significant cause of morbidity and ultimately, a cause of mortality, in the older nonhuman primate.     

IMAGING DIAGNOSIS—ULTRASOUND-GUIDED ETHANOL SCLEROTHERAPY FOR A SIMPLE RENAL CYST

Solitary renal cysts are benign and in the majority of instances asymptomatic and do not require treatment. Nevertheless, treatment may be required if abdominal discomfort or pain, hypertension, infection or renal outflow obstruction occur. Under these circumstances, percutaneous management of the cyst is the easiest and fastest procedure, and no major complications are generally encountered. In this report we describe a patient with a solitary renal cyst treated successfully by a single injection of ethanol into the cyst. The sonographic appearance of the cyst changed from a well-defined hypoechoic structure to an ill-defined hyperechoic region. Canine renal cysts may be successfully managed in some instances by a single ethanol injection.     

NODULAR FAT NECROSIS IN THE FELINE AND CANINE ABDOMEN

The radiographic appearance of nodular fat necrosis is described in ten cats and one dog. The most common radiographic sign was the presence of a focal mineralized circular to oval soft tissue mass in the abdominal fat as present in 9 cats. These masses had a distinct eggshell-like rim encapsulating the lesion. In one cat and one dog multiple masses were present, without radiographic signs of mineralization. Abdominal ultrasound was performed in three cats and one dog, findings included the presence of hyperechoic masses with associated acoustic shadowing, some with a hypoechoic centre. Almost all animals were old and obese. In three cats and one dog, changes were confirmed with biopsy or post mortem examination. Lesions having the appearance of those in this paper are most likely incidental findings and should not be confused with abdominal masses of neoplastic origin. Ultrasound can be helpful in identifying such lesions.     

IMAGING DIAGNOSIS—INTRACRANIAL CRYPTOCOCCAL MASS IN A CAT

A 4‐year‐old neutered female domestic shorthair was evaluated for mentation changes and left prosencephalic signs. This imaging report describes the imaging findings for this patient. A diagnosis of a cryptococcal mass was made based on imaging and additional diagnostics. Complete resolution of the mass was demonstrated by follow‐up imaging. This report serves as a reminder that masses associated with cryptococcal infection should be included on the differential list for cats with intracranial masses. In addition, this report provides evidence that large intracranial cryptococcal masses may resolve with long‐term medical therapy.     

IMAGING DIAGNOSIS—DEGENERATIVE INTRASPINAL CYST ASSOCIATED WITH AN INTERVERTEBRAL DISC

A 6-year-old neutered male Rottweiler had chronic episodic signs of thoracolumbar pain and inability to stand that did not improve after rest and nonsteroidal antiinflammatory medication. In magnetic resonance images, an extradural mass was identified between the spinal cord and the T13/L1 intervertebral disc; the mass was compressing the cord in a dorsoventral direction. The lesion had a low signal intensity rim that enhanced slightly after gadolinium administration, and contents with similar signal intensity to cerebrospinal fluid. The lesion was removed surgically by severing its attachments to the annulus fibrosus. The histologic diagnosis was degenerative intraspinal cyst. The origin of such cysts, and their relationship to synovial and ganglion cysts is discussed.