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Ethmoid Hematoma

Though this case does not deal with the horse limb it is a powerful example of the impact magnetic resonance imaging can have on a case's development and outcome.

SIGNALMENT

Throughbred, 10 year old gelding

HISTORY

This horse was previously treated for an ethmoid hematoma, and was being seen due to a recent episode of epistaxis. The horse was to be evaluated with MRI.

PRESENTATION

Upon admission, the horse was in good general health. On physical exam there were no abnormal findings except for a very mild amount of serous nasal discharge. Endoscopy results were somewhat unexpected in that the original lesion was very small in the base of the etmoid recess and the normal turbinate dorsal to the lesion was somewhat enlarged.

DIAGNOSTICS

   
 

Radiology

Magnetic Resonance Imaging

     

DIAGNOSIS AND PROGNOSIS

Due to the extent of the MRI findings it appeared that further treatment endoscopically would only be chipping at the very tip of the iceberg and would have no effect on a large majority of the mass. Due to proximity to the base of the brain there was also concern expressed about intralesional formalin injections. Standard frontonasal surgical options to remove the mass would only remove less than 20% since the mass extends so far caudally in a small space underneath the base of the brain. The longterm prognosis was poor.

TREATMENT

Recommendations were made to control the mass from the side of the nasal passage to prevent any sort of obstruction, recognizing there is no effective form of curative treatment.

 
           
 
Copyright © 2006 - University of Pennsylvania School of Veterinary Medicine, All rights reserved.
Faculty: Dr. Alexia McKnight
Student:Charles Bradley 2009