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Background
The infiltrative lipoma presented in this case mimics the clinical presentation of a ranula.
Lipomas are a common benign neoplasia in dogs that can affect very different sites. A lipoma in an uncommon location can lead to a wrong preliminary diagnosis.
Most sialocoeles (salivary mucocoele) originate from the sublingual gland or duct, but they can originate from any of the salivary glands. They contain saliva and are lined by inflammatory connective tissue, they are therefore not true cysts. A ranula tends to appear as a painless swelling on the floor of the mouth alongside the tongue. They can often be associated with a cervical mucocoele, which appears in the cranial cervical region, ventral to the mandible or in the intermandibular region. 1
A ranula was suspected in this case due to the similarity of the clinical features with this condition. The treatment of these two conditions is different and presurgical assessment is fundamental for patient and disease-specific surgical therapy.
Case presentation
A 7-year-old neutered female Staffordshire Bull Terrier was referred for further investigation of a three-week history of left submandibular swelling that had grown significantly and had extended into the intermandibular and sublingual areas.
Fine-needle aspiration of the swelling had been performed on two different occasions by the referring veterinary surgeon and both cytopathological findings were suggestive of lipocytes, indicative of either non-representative subcutaneous fat or a lipoma. There was no known history of trauma. There was no documented dysphagia or ptyalism in association with the lesion.
The patient was referred for further evaluation of the possibility of a ranula based on clinical presentation.
At presentation, the dog was bright, alert and responsive. Physical examination revealed a large, ventral, intermandibular swelling, which was soft to palpate and non-painful. The swelling continued caudally to the incisura angularis. Complete blood count and serum biochemistry analysis performed at the time of referral revealed no abnormalities. Oral examination under general anaesthesia before advanced imaging revealed a mobile and soft sublingual swelling.
Investigations
CT (Philips MX 16-Slice helical CT System, Philips Healthcare, The Netherlands) images of the head and cranial neck to include the regional lymph nodes were acquired under general anaesthesia, with an endotracheal tube in place and the tongue exteriorised on the right. Images were obtained before...