Abstract:
A 16-year-old pony gelding presented with epistaxis and a head tilt. Referral skull radiographs suggested an ethmoid hematoma. Concurrent neurologic abnormalities prompted contrast-enhanced CT of the head and cranial neck, revealing numerous hyperattenuating masses throughout the brain and paranasal sinuses, along with a large osteolytic mass in the second cervical vertebra. The vertebral mass extended into the vertebral canal, causing focal extradural compressive myelopathy. These findings were inconsistent with ethmoid hematoma and metastatic hemangiosarcoma or malignant melanoma were prioritized as potential causes for the clinical signs. Postmortem examination confirmed the sinonasal, intracranial, and vertebral masses as hemangiosarcoma, and additionally revealed innumerable thoracoabdominal metastatic lesions and hemorrhagic foci. A final diagnosis of disseminated hemangiosarcoma was made. In this study, CT proved invaluable for evaluating the severity and characterizing regional disease and neural involvement, directly affecting case management decisions.
摘要:
一只16岁的小马gel头出现鼻出血和头部倾斜。转诊颅骨X光片提示筛骨血肿。并发神经系统异常提示头部和头颈部的对比增强CT,在整个大脑和鼻旁窦中显示出许多高度衰减的肿块,以及第二颈椎的大量溶骨性肿块。椎体肿块延伸到椎管中,引起局灶性硬膜外压迫性脊髓病.这些发现与筛骨血肿不一致,转移性血管肉瘤或恶性黑色素瘤被列为临床体征的潜在原因。尸检证实鼻窦,颅内,和椎体肿块如血管肉瘤,此外,还发现了无数的胸腹转移灶和出血性病灶。最终诊断为播散性血管肉瘤。在这项研究中,CT被证明对评估严重程度和表征区域疾病和神经受累非常有价值,直接影响案件管理决策。