CLINICAL AND ULTRASONOGRAPHIC CHARACTERISTICS OF SALIVARY MUCOCELES IN 13 DOGS

Salivary mucocele is one of the causes of submandibular swelling in dogs and is due to a collection of mucoid saliva that has leaked from a damaged salivary gland. The purpose of this case series report was to describe the clinical and ultrasonographic characteristics of confirmed salivary mucoceles in 13 dogs admitted to the Faculty of Veterinary Medicine at Cairo University. The final diagnosis of salivary mucocele was based on aspirate cytology for all dogs and additional surgical excision for seven dogs. For dogs admitted from 2 weeks to 1 month from the onset of clinical signs, the cervical mucocele appeared as a round echogenic structure with a large volume of central anechoic content. The wall was a clearly identified hyperechoic structure surrounding the gland. For dogs admitted between 1 to 2 months from the onset of clinical signs, the volume of anechoic material appeared less than that seen in the acute cases. The overall appearance of the salivary mucocele was heterogenous. For dogs admitted after 2 months from the onset of clinical signs, the salivary mucocele appeared grainy or mottled, with a heterogenous appearance and a further decrease in anechoic content. For one dog that presented after 3 months from the onset of clinical signs, the salivary mucocele was hard on palpation and appeared hyperechoic with distal acoustic shadowing. Findings from this study indicated that ultrasonographic characteristics of salivary mucoceles in dogs vary depending on the chronological stage of the disease.     

Cystic Dilatation of the Parotid Duct of a Goat

Cystic dilatation of the parotid duct of a goat was diagnosed by exploratory surgery and analysis of cyst contents. The cyst and its associated salivary gland were surgically removed. This case is compared with the more common salivary mucocele.     

Salivary mucocele in a laboratory beagle

The histologic characteristics of a salivary mucocele in a beagle used in a toxicity study are described in this report. A pale yellowish cyst under the mandibular skin containing frothy mucus was observed at necropsy. Microscopically, numerous villous projections arose from the internal surface of the cyst and were lined by stratified epithelial-like macrophages, which were immunopositive for macrophage scavenger receptor A. A ruptured sublingual interlobar duct connected to the lumen was observed near the cyst. Luminal amorphous material showed a positive reaction with Alcian blue and periodic acid-Schiff staining as did mucin in the sublingual gland. Ultrastructurally, the epithelial-like macrophages had numerous vacuoles containing electron-lucent material, which was presumed to be lysosomal in origin, and had pseudopods on their cell surfaces interdigitating with those on the adjacent cells. This case report helps to understand the diversity of the background findings in beagles used in toxicity studies.     

Modified lateral orbitotomy for vision-sparing excision of a zygomatic mucocele in a dog

A 1-year-old Shar Pei presented for recent-onset exophthalmos and right peri-ocular facial swelling. Physical examination revealed the facial mass was of soft-tissue consistency and nonpainful to the dog. Due to inability to retropulse the globe during ophthalmologic examination, it was suspected the mass had impinged into the orbit, resulting in rostral displacement of the globe. Anatomic location suggested the lesion was probably associated with the zygomatic salivary gland. Fine-needle aspiration and subsequent cytological evaluation of fluid extracted from the facial mass was consistent with a diagnosis of zygomatic mucocele. Computed tomography imaging confirmed a single fluid-filled mass was resulting in both the facial distention and the exophthalmos. A modified, lateral orbitotomy surgical approach was selected for excision of the lesion to provide ventral exposure to the orbit, while minimizing trauma to the globe and supporting structures. Histopathology of the excised lesion confirmed a diagnosis of zygomatic mucocele. This case demonstrates utilization of a modified lateral orbitotomy for effective surgical management of a zygomatic mucocele in a dog, with preservation of vision and absence of any significant postoperative complications.     

Pharyngeal mucoceles in dogs: 14 cases

This report describes the clinical features of a series of dogs with pharyngeal salivary mucoceles. A retrospective study of 14 dogs with pharyngeal mucocele was performed. Medical records from 1983 to 2003 were reviewed for information regarding signalment, clinical signs, diagnosis, surgical procedures, and short-term and long-term outcome. Miniature and toy poodles were common breeds in the study population, and 79% of the dogs were male. The most common presenting sign was dyspnea (50%). Diagnosis was by fine-needle aspirate, which revealed a mucoid substance in 93% of dogs. Histopathology of the excised salivary glands revealed lymphoplasmacytic inflammation in all dogs that had histopathology performed. Forty-three percent of the dogs had a cervical mucocele on the same side as the pharyngeal mucocele. Surgical therapy was performed in 13 dogs, which consisted of excision of the mandibular and sublingual salivary glands, excision of the mucocele, or marsupulization of the mucocele. Only two dogs had recurrence of the pharyngeal mucocele. In this study, pharyngeal mucoceles occurred in predominantly small dogs that frequently presented with respiratory signs. Surgical treatment was successful in most dogs.     

First case of salivary mucocele originating from the minor salivary gland of the soft palate in a dog

We found a case of salivary mucocele that originated in the minor salivary gland (palatine gland) of the soft palate in a dog. At first admission, the soft palate swelled remarkably. Computed tomography (CT) revealed cystic radiolucency inside a large quantity of liquid in the soft palate, and most of the airway was occupied. Marsupialization was performed, but since a recurrence was observed one month later, the salivary mucocele was removed. There has been no report of salivary mucocele arising from the minor salivary gland of the soft palate in dogs. To our knowledge, this case is the first. Complete removal, including minor salivary glands surrounding the lesion, is necessary for treatment of salivary mucocele in dogs.     

Pharyngeal Mucoceles in Dogs

Eight cases of pharyngeal mucoceles were diagnosed in 49 dogs with salivary mucoceles over a 7 year period. Five of the eight pharyngeal mucoceles were seen in Miniature Poodles. The presenting complaint in all eight dogs was labored breathing, with or without coughing upon excitement or exercise. Diagnosis was made by aspirating a thick mucoid fluid from the pharyngeal swelling. Treatment consisted of resection of the mandibular and sublingual salivary glands on the affected side and aspiration of the mucocele in all eight dogs, and resection of redundant pharyngeal tissue in five dogs. Time to follow-up ranged from 1.5 to 7.5 years. There were no postsurgical complications or recurrences of the mucocele.     

Zygomatic salivary gland mucocele in a ferret

A zygomatic salivary gland mucocele was diagnosed in a 1-year-old female domestic ferret with exophthalmos. A T-shaped incision from near the lateral canthus to the base of the ear and continuing ventrally to the level of the commissure of the mouth was made to expose the mucocele. Surgical removal was complicated by the large open orbit of the ferret, adjacent cellulitis, extension ventromedial to the globe, and difficulty in identifying important motor nerves. Vision was maintained, but slight postoperative enophthalmos and mild upper eyelid paresis developed.     

Intestinal choristoma in the midcervical region of a dog

A 5-year-old, neutered male, mixed-breed dog was evaluated for a fluctuant mass in the right midcervical region. The mass recurred following aspiration of its contents and after removal of the right sublingual and mandibular salivary glands. The lateral midcervical location of the mass and the serous nature of the fluid within the mass were inconsistent with a salivary mucocele. Excisional biopsy was curative and revealed an intestinal choristoma.     

Use of a sclerosing agent (1% polidocanol) to treat an orbital mucocele in a dog

A case of a salivary gland mucocele in a dog causing nonpainful exopthalmos with dorsolateral deviation of the globe and protrusion of the third eyelid. Diagnosis was made via ultrasound and confirmed with computed tomography. Aspiration of the cystic material along with injection of a sclerosing agent, 1% polidocanol (Aethoxysklerol), was used to destroy the mucocele. Follow-up monthly examination post injection confirmed resolution of clinical signs to date, namely abnormal globe position, with no complications observed.     

Pharyngeal mucocele and respiratory distress in a cat

A young cat was referred to an emergency clinic for acute onset of respiratory distress. Physical examination revealed right submandibular, sublingual, and pharyngeal swellings, presumably of salivary origin. Respiratory arrest necessitated emergency tracheostomy and resection of pharyngeal mucocele.     

Canine dacryolithiasis: a case description and mineral analysis

A 4‐year‐old, female, spayed, Labrador retriever was presented with a painless swelling of the left ventromedial eyelid and epiphora of 3 months duration. Bilateral patency of the nasolacrimal system was confirmed by the appearance of fluorescein dye at both nares. Ultrasonography revealed a well‐demarcated fluid‐filled structure containing echogenic ill‐defined material in close proximity to the nasolacrimal system. A transconjunctival surgical approach confirmed the close anatomical proximity of the cyst and the absence of a communication with the inferior canaliculus. The cyst contained multiple intraluminal calculi (dacryoliths). Following surgical excision of the cyst, the epiphora resolved and no recurrence was noted over a 12‐month follow‐up period. On histopathology, the cystic structure was lined by stratified squamous epithelium, consistent with lacrimal canaliculus epithelium. Presumed progression of a canalicular diverticulum to a cyst with the formation of intraluminal dacryoliths was suspected. Mineral analysis of the dacryoliths revealed a calcium carbonate composition.     

Dermoid cyst in the tongue of a dog

A German Shepherd Dog presented with recurrent intermandibular and intralingual swelling. Cytological and microbiological findings on fluid aspirated from the mass were consistent with an infected cyst lined by epithelium. The sinus was explored and an epithelium-lined cystic structure was extirpated from the frenulum and body of the tongue. This structure was diagnosed histologically as a dermoid cyst.     

Zygomatic salivary mucocoele as a postoperative complication following caudal hemimaxillectomy in a dog

Zygomatic mucocoele is reported as a postoperative complication occurring secondary to a caudal hemimaxillectomy in a two-year-old Labrador retriever. The dog was presented with a history of a rapidly growing oral mass, identified as a soft tissue sarcoma. A caudal hemimaxillectomy via an intraoral approach was performed as treatment for local control of the oral mass. Fifteen days postoperatively, periorbital swelling and exophthalmos developed on the ipsilateral side. The degree of swelling progressed and was identified by computed tomography, ultrasound and cytology as a salivary mucocoele. Zygomatic sialoadenectomy was performed via a modified lateral approach with zygomatic osteotomy. A small amount of discharge persisted from the surgical site but gradually resolved. Recurrence of the periorbital swelling and exophthalmos was noted 25 days later and further surgery was performed to excise residual salivary tissue. Adjuvant radiotherapy was performed, however local recurrence of the oral mass was identified 5 months postoperatively and the patient subsequently euthanased. Salivary mucocoele has been cited as a possible postoperative complication following maxillectomy and mandibulectomy procedures; however to the authors’ knowledge, only one previous case report exists in the literature. The current case documents a zygomatic salivary mucocoele occurring subsequent to caudal hemimaxillectomy.     

Marsupialization and iodine sclerotherapy of a branchial cyst in a horse

A 6-month-old Morgan colt was evaluated because of a 10-cm right-sided retropharyngeal swelling. The swelling was soft and moveable on examination, and palpation did not elicit signs of pain. Radiography revealed a large space-occupying mass ventral to the second cervical vertebra; ultrasonography revealed an anechoic fluid-filled structure with a well-defined hyperechoic capsule. Fine-needle aspiration yielded a viscous amber fluid. Cytologic evaluation indicated that the fluid was an exudate; anaerobic and aerobic bacterial culture did not yield any growth. Histologic examination of a portion of the cyst capsule revealed a connective tissue wall lined by pseudostratified columnar to cuboidal epithelium, consistent with a branchial cyst. The cyst wall was marsupialized to the skin, and iodine sclerotherapy was performed twice daily for 14 days, at which time forceps were introduced into the cyst and the cyst lining was removed. The site was allowed to heal by second intention, but 10 days later, the swelling recurred. An incision was made over the previous marsupialization site, and residual remnants of the cauterized cyst lining were removed with a forceps. The foal did not have any other complications during the subsequent 2 years. Branchial arch cysts are uncommon embryonic anomalies of horses, mice, cats, dogs, and cattle. Results suggest that marsupialization and iodine sclerotherapy may be a viable alternative to surgical excision in horses with branchial cysts; however, the entire cyst lining must be removed at the completion of sclerotherapy to prevent recurrence and abscess formation.     

Retrobulbar dermoid cyst in a horse: a case report

A 4-year-old Andalusian horse was presented for examination following a 3-month history of exophthalmos of the right eye and a soft swelling of the right supraorbital fossa noted after blunt head trauma. Ultrasonographic examination of the swelling showed an anecogenic mass of 5 cm in diameter involving the retrobulbar space. Centesis of the mass through the supraorbital fossa was performed and yielded a serous fluid with 7.2 g/dL of total protein and density of 1040. No cells were seen in the sample. A tentative diagnosis of cyst was made. The cyst was surgically removed and the definitive histologic diagnosis was retrobulbar dermoid cyst. No recurrence has developed 18 months following the complete removal of the cyst capsule. To the authors' knowledge, there are no previous reports of retrobulbar dermoid cysts in horses. Localization, causes and success of surgical treatment of dermoid cysts are discussed.     

Maxillary bone epithelial cyst in an adult miniature schnauzer

Maxillary bone epithelial cyst is rare in dogs. A 5-year-old, spayed female miniature schnauzer developed a swelling below the nasal canthus of left eye. Plain radiograph demonstrated a 1.5 cm diameter of radiolucent lesion on the maxillary bone anteroventral to the eye, and contrast dacryocystorhinography confirmed an obstructed nasolarcrimal duct. The swelling showed poor response to antibiotic treatment but responded well to oral prednisolone. Exploratory surgery revealed a cyst-like structure filled with brown serous fluid. Histopathological examination of the removed cyst revealed a double cuboidal epithelial cyst. The dog recovered rapidly after surgery, and the swelling had not recurred for a 36-month follow-up. It is the first case of periorbital bone epithelial cyst reported in an adult miniature schnauzer.     

Maxillary bone epithelial cyst in a dog

A swelling ventromedial to the left eye of a one-year-old, neutered male Labrador failed to respond to antibiotic and anti-inflammatory therapy. Plain and contrast radiography revealed a spherical, radiolucent area, 1.5 cm in diameter, dorsomedial to the fourth maxillary premolar and rostral to the ethmoid region. The lesion was thin-walled, with a smooth radiopaque margin, and was clearly demarcated from the surrounding structures. Dacryocystography demonstrated no apparent physical association between the lesion and the nasolacrimal duct, the latter appearing normal. Ultrasonography of the lesion showed a round, anechoic structure consistent with the appearance of a cyst. Prior to surgical excision of the lesion, intralesional fluid was aspirated. Bacteriology of the fluid was negative for both aerobic and anaerobic organisms. Cytological examination of the fluid showed a few macrophages and small lymphocytes; neither significant inflammatory component nor neoplastic cells were found. Histology showed the lesion to be a benign epithelial cyst. The dog recovered uneventfully and there was no clinical evidence of recurrence within a two-year follow-up period.     

Computed Tomography and Magnetic Resonance Imaging of an Epidermoid Cyst in a Foot of a Horse

An 18-year-old Quarter Horse mare was evaluated because of moderate left forelimb lameness of 4 weeks’ duration. The clinical evaluation and diagnostic perineural analgesia localized the lameness to the distal portion of the left forelimb. There was swelling on the dorsal and lateral aspect of the coronary band. Radiography, ultrasound, magnetic resonance imaging, and computed tomography of the foot revealed circumscribed well-capsulated soft tissue mass causing a focal deformation of the dorsolateral border of the middle phalanx. The treatment aimed to remove the mass surgically and stabilized the interphalangeal joint, but the owner elected human euthanasia before treatment attempt. Histopathology diagnosis was an epidermoid cyst, which was characterized by multilayers of keratin surrounded by stratified squamous epithelium. Although rare, an epidermoid cyst should be considered as a differential diagnosis for space-occupying mass in horses’ foot that develops chronic lameness after trauma. This report describes the multimodality appearance of the epidermoid cyst.     

Orbito-nasal cyst in a young European short-haired cat

Purpose To describe a case of an orbito‐nasal cyst in a cat. Procedure An 18‐month‐old male European short‐haired cat was presented to the Ophthalmology service of the Vetsuisse Faculty, University of Zurich for a subcutaneous swelling in the medial canthal region of the right eye (OD). Ophthalmologic, ultrasound and CT examinations, and fine needle aspiration were performed. After lesion excision, the removed tissue was submitted for histopathology. CT examination was repeated 5 months after removal of the cyst. Results Ophthalmologic examination revealed a large fluctuant swelling inferonasal to OD. Despite patent lacrimal puncta, only the first few mm of the lacrimal canaliculi could be cannulated. A normal globe with moderate enophthalmos was present. Ultrasound examination showed a well‐defined lobulated cyst‐like structure in the right orbit, inferonasal and anterior to the eye. CT examination revealed extension of this lesion through the medial orbital wall into the right nasal cavity. Fine needle aspiration confirmed the cystic nature of the lesion. An orbito‐nasal cyst was diagnosed. The orbital part of the cyst was dissected from the surrounding tissue and excised from the periosteum in the medial orbital wall defect. Part of the maxillary bone was removed to allow removal of the cyst from the nasal cavity. Histologically, the cyst wall consisted of a single to multilayered, mostly cuboidal epithelium and surrounding connective tissue. Follow‐up revealed a good functional result and no recurrence 7 months after cyst removal. Conclusions Similar orbito‐nasal cystic structures were reported in dogs but not in cats.