Case #16
 

SIGNALMENT: 18-month-old male Labrador retriever. HISTORY: Upper respiratory noise (snoring when asleep), coughing and gagging noted over the previous two-week period. A mass was noted dorsal to the soft palate and the dog referred for surgical exploration and excision.

Blood from the nares noted the morning of admission (owner was unsure as to which side of the nares the bleeding occurred from). DIAGNOSIS: Evaluation of the mass with dog awake was limited to visualization and cursory palpation of a firm swelling dorsal to the soft palate, at the caudal margin of the hard palate. Radiographs submitted by the referring veterinarian did not show evidence of local bone destruction. TREATMENT: Surgical exploration of the mass was done under general anesthesia after examination found the mass to be firm and non-mobile. The swelling is noted dorsal to the soft palate in  Figure 1.

Figure 1 Oral cavity prior to incision of the soft palate. Note the bulging mass causing displacement of the soft palate. Right

Figure 2 Intraoperative photograph. The soft palate has been incised longitudinally on the midline revealing a poorly demarcated tumor dorsal to the soft palate. Retractors are utilized to better visualize the tumor.

For orientation, the dog is in dorsal recumbency with the mouth open in both intraoperative pictures.  An incision through the soft palate has been made, and the poorly defined mass is noted as being adherent to the soft palate and adjacent tissues, including the nasopharyngeal mucosa. Figure 2 illustrates an intraoperative view of the lesion. A combination of blunt and sharp dissection was used to resect the mass as completely as possible. The tumor was not encapsulated and clean margins were not obtained. The resected tumor is visualized adjacent to a scalpel handle for reference (See Figure 3).

Figure 3 Excised tumor measuring approximately 3 cm x 2 cm. DIAGNOSIS: Histopathological examination of the tumor revealed a poorly differentiated sarcoma, possibly an amelanotic malignant melanoma. This case is unusual from the standpoint of the patient's age and the short duration of symptoms prior to presentation. The prognosis in this case is poor with recurrence and metastasis likely. ACKNOWLEDGEMENT: Thank you to Dr. Donald Mayfield, Mayfield Professional Associates, Springdale, Arkansas, for this referral.

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