Case of the month: 3 year-old female Cane Corso with dyspnea

Signalment and anamnesis

For further clarification the following radiographs were taken:

Radiographic description

In the region of the caudal cervical trachea (at the level of C6), a broad-based soft-tissue opaque well-defined endotracheal bulge is visible along the ventral inner tracheal margin with associated luminal narrowing
The mass measures approximately one vertebral body length in craniocaudal diameter and compresses the tracheal lumen approximately 50% from ventrally
The pulmonary parenchyma shows a mild diffuse bronchointerstitial pattern. In the VD projection, a superimposition artifact with a positioning device is visible

Diagnosis

Cervical endotracheal mass lesion with associated luminal narrowing
Differential diagnosis include granuloma (e.g., parasitic (secondary to Oslerus Osleri), abscess formation (infectious, eosinophilic, traumatic, iatrogenic), hematoma, or (somewhat less likely due to age) neoplastic infiltration (e.g. osteochondroma, chondrosarcoma)

Outcome

Tracheoscopy confirmed the presence of a tracheal mass (histopathology: abscess formation without evidence of malignancy)

Discussion

Endotracheal masses are most commonly the result of granulomas, abscesses, polyps, neoplasms, or thickened mucosal folds
Granulomas and abscesses are usually due to foreign bodies or parasites, but may also be iatrogenic (e.g., due to improper intubation, overinflated endotracheal tube cuff, tracheostomies)
Endotracheal neoplasms are rare in dogs and cats
Tracheal foreign bodies usually attach to the tracheal bifurcation; however, small objects may also partially or completely obstruct the bronchus (the right caudal bronchus is most affected)
Clinical symptoms vary depending on size, location, and the presence of concomitant inflammation (tracheal sensitivity increased, nonproductive cough unresponsive to antibiotics, inspiratory and expiratory dyspnea)
The diagnostic gold standard is endoscopy

Many thanks to Dr. ECVDI Thorsten Rick for this case report!

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