Maxillectomy for the treatment of a recurrent nasal adenocarcinoma in a cat

Abstract

An 11-year-old, male neutered, domestic shorthair cat was referred with recurrence of unilateral epistaxis, approximately three years after radiotherapy treatment for low-grade nasal adenocarcinoma. A CT scan of the head showed a mass localised within the left nasal cavity invading the left maxillary bone. Maxillectomy was performed to allow removal of all visible neoplastic tissue and an oesophagostomy tube was placed after the procedure to facilitate feeding in the early postoperative period. During the first 24 hours after surgery, epistaxis was noted, and five days after maxillectomy, the nasal discharge became purulent so the cat was administered broad-spectrum antibiotic. The cat was discharged from hospital 11 days after surgery. The owner reported a good clinical outcome 12 months after surgery. Even though surgery is not the preferred treatment for nasal adenocarcinoma, this case report shows that surgery represents a reasonable treatment option to manage selected cases of recurrent nasal tumours after radiotherapy, and that a good outcome can be obtained despite all the pitfalls associated with this type of surgery in cats. No report discussing treatment options for locally recurrent non-lymphoproliferative nasal tumours in the cat has been published to date.

Outcomes of cats treated with maxillectomy: 60 cases. A Veterinary Society of Surgical Oncology retrospective study

“…All cats treated with maxillectomy were eating voluntarily within 2‐11 days of surgery. Furthermore, six of seven cats had good function with no evidence of local recurrence at the last follow‐up, ranging from 7‐66 months 4‐8 …”

“…The most common oral tumours in cats are squamous cell carcinoma (SCC), fibrosarcoma (FSA) and osteosarcoma (OSA) 1‐3 . While the post‐operative and oncologic outcomes are well recognized in cats following mandibulectomy, the published outcome of cats following maxillectomy is sparse with only seven published case reports 4‐8 . In the experience of the authors, maxillectomy is frequently not offered as a treatment option for cats with maxillary tumours because of the reported complication rate and outcome following mandibulectomy.…”