11-year-old, female cat

An 11-year-old, female neutered cat presented with a 2-month history of intermittent epistaxis, sneezing and purulent nasal discharge that had been responsive to antibiotics. Skull & thoracic radiography had been considered, but as the primary differentials were neoplasia, rhinitis and a foreign body, a CT examination of the head and thorax was performed to allow rapid, unambiguous imaging of the nasal cavity, sinuses and chest.

Head CT, axial plane. A soft tissue attenuating lesion was noted to fill the majority of the left nasal cavity resulting in moderate, patchy nasal turbinate destruction. Primary differentials include primary nasal neoplasia such as lymphoma or carcinoma.

 

The soft tissue lesion was identified as extending to the caudal part of the left nasal cavity and into the nasopharynx.

There is hyperattenuating material filling the left frontal sinus, either representing obstructive left frontal sinusitis or extension of the soft tissue lesion into the sinus.

 

The right cranial lung lobe demonstrates complete consolidation with central calcification, consistent with a primary lung neoplasm. Multiple pulmonary nodules were detected which could represent either metastasis from a primary lung tumour, or distant metastasis from the nasal tumour.  

The detection of 2 potentially different tumours in this cat was unexpected and the owner declined further investigation to establish the type of neoplasia.  However, this case demonstrates how, under a light sedation, a complete series of images can be obtained rapidly from a patient that allows important decisions to be made regarding treatment options and probable prognosis for the animal.

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