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Endoscopic treatment of an intrathoracic tracheal osteochondroma in a dog

Hawley, Melissa M., Johnson, Lynelle R., Johnson, Eric G., Pascoe, Peter J., Murphy, Brian G.
Journal of the American Veterinary Medical Association 2015 v.247 no.11 pp. 1303-1308
anesthetics, biopsy, blood serum, dogs, etiology, females, gastroesophageal reflux, histopathology, morbidity, mortality, opacity, patients, pneumonia, radiography, regrowth, resection, risk, spaying, ultrasonography, urinalysis, vomiting
Case Description—A 1.5-year-old spayed female Bernese Mountain Dog was examined for a 6-month history of intermittent vomiting, regurgitation, wheezing, and coughing. Initially, a diagnosis of gastroesophageal reflux disease with secondary aspiration pneumonitis was made but clinical signs did not resolve with treatment. Clinical Findings—Thoracic and cervical radiography and CT revealed a sessile, irregularly marginated soft tissue opacity at the level of the fourth rib. Results of a CBC, serum biochemical analysis, and urinalysis were within reference limits. Results of abdominal ultrasonography were normal. Treatment and Outcome—Tracheoscopy revealed a firm, irregularly marginated mass apparently originating from the ventral aspect of the trachea, occluding approximately one-half of the tracheal lumen, and located 2 cm cranial to the carina. Cytologic and histopathologic examination of fine-needle aspirate and biopsy samples suggested a benign etiology; therefore, endoscopic minimally invasive laser and electrocautery resection of the mass was scheduled. A total IV anesthetic protocol was administered with an oxygen-air mixture used to decrease the risk of fire during tracheal surgery. The mass was successfully resected, and histopathologic examination confirmed a diagnosis of osteochondroma. Clinical signs resolved, and at follow-up 32 months later, no regrowth of the mass was evident. Clinical Relevance—Tracheoscopy-guided electrocautery and surgical diode laser resection was successful in removing an obstructive tracheal mass that was not resectable by means of a conventional open surgical approach. Minimally invasive procedures may decrease morbidity and mortality and improve outcome in appropriately selected small animal patients.