Extensive and invasive guttural pouch granuloma in a 2‐year‐old gelding

Abstract

Summary This report describes a case of an unusually extensive and invasive fungal granuloma within the right guttural pouch and its surrounding area of a 2‐year‐old Noriker gelding, causing diverse neurogenic deficits and tissue destruction. The gelding was initially presented with cachexia, unilateral nasal discharge, intermittent fever, swelling of the right side of the head, facial nerve paralysis and dysphagia. The right guttural pouch was not accessible to endoscopic examination initially, but after anti‐inflammatory medical management, empyema and an extensive, solid mass appeared within the guttural pouch. Surgical exploration and excision were attempted but were unsuccessful. Histopathological examination identified Aspergillus fumigatus as the causative infective agent of the extensive fungal granuloma, and the consequent invasion and destruction of surrounding bone and soft tissue structures.

Diagnostic Imaging of Diseases Affecting the Guttural Pouch

“…Neoplasia involving the guttural pouch is uncommon but cases of fibroma, melanoma, squamous cell carcinoma, hemangiosarcoma and leiomyosarcoma have been described [ 5 , 13 , 21 ]. A case of a large fungal granuloma secondary to guttural pouch mycosis was also reported [ 22 ]. Diagnostic imaging is particularly useful for evaluation of large masses obliterating the pouches because endoscopy may not be possible in these cases and diagnostic imaging provides a better evaluation of the structures surrounding the pouches.…”

Guttural pouch diseases in horses: A challenging differential diagnosis

“…In their clinical publication, Shell and Rijkenhuizen () report on an unusual presentation of guttural pouch mycosis, with extensive granuloma formation within the guttural area in a 2‐year‐old gelding, associated with neurological signs and destruction of the surrounding tissues. This case allows us to question the key steps to be considered to improve diagnosis and care when facing an atypical presentation of guttural pouch disease.…”