In this edition we want to focus on some of the published research produced by Giuseppe Bonanno, our ECVN surgical resident. He reported a case of a sub-epiglottic pharyngeal pouch remnant cyst in a 6-month-old female Labrador Retriever.
Pre-surgical view of the cyst.
A 6-month-old entire female Labrador Retriever was presented for intermittent respiratory rasping and rattling made worse with excitement and exercise, which appeared to be distressing for the patient. Clinical findings revealed a fluid-filled cystic structure at the base of the tongue in a sub-epiglottic position. Serum concentrations of total thyroxine, free thyroxine and thyroid-stimulating hormone were within normal limits. A CT scan revealed a 2-cm diameter spherical, encapsulated structure, filled with fluid attenuating material, positioned in the midline at the base of the tongue adjacent to the basihyoid.
The cyst was surgically excised via an oral approach, and histopathological findings were suggestive of a pharyngeal pouch remnant cyst. There were no post-surgical complications, and the dog made an unremarkable recovery. At 12-month long-term follow-up, the owner reported that the dog remained fit and well showing no further signs of respiratory noise, exercise restriction or evidence of recurrence.
View of the lesion following its excision. Note, the overlying oropharyngeal mucosa with conical swellings.
Histopathology image of the cystic lesion within the oropharyngeal submucosa showing one large and several smaller interconnecting empty cyst-like structures .
Important Points:
- Sub-epiglottic cysts are rare in dogs, but they should be considered a differential diagnosis for biphasic laryngeal stridor.
- Provisional diagnosis of a sub-epiglottic cyst can be made on visual examination of the pharynx/larynx and fine needle aspiration. More complete diagnostic imaging should include an advanced imaging technique such as CT.
- Definitive diagnosis requires histopathology of the excised lesion.
- Complete, en bloc excision is unlikely to be associated with recurrence in dogs.
Reference
Bomammo G, Laird C, Cox A, White R (2021) Sub-epiglottic pharyngeal pouch remnant cyst in a 6-month-old female Labrador Retriever. Vet Rec Case Reports doi: 10.1136/vr.106019
