Maxillary Sinus Lesion

Case Study: Gypsy Mare with Maxillary Sinus Lesion

History/Presentation: A 13-year-old Gypsy mare was brought in with a several-month history of a protuberance from the right maxilla, which had recently started to drain. Radiographs indicated calcification within the lesion. On examination, there was purulent drainage from a mass on the right maxilla, accompanied by unilateral purulent nasal discharge.

Diagnosis: The diagnostic workup revealed a lobulated mass lesion in the right maxillary sinuses, causing displacement and pressure necrosis of the right maxilla. The nature of the mass suggested it could be a paranasal sinus cyst or abscess. While less likely, a neoplastic process couldn't be entirely ruled out. Additionally, there was marked secondary sinusitis affecting the right paranasal sinus, and the left globe was absent.

Treatment/Outcome: Biopsy of the mass was recommended to confirm the diagnosis definitively. However, due to the patient's fear of needles, the owner opted to treat conservatively with a course of antibiotics at home. The ongoing management and response to treatment would be closely monitored to determine the next steps in the care plan.

This case highlights the complexities in diagnosing and managing sinus lesions in equine patients, balancing diagnostic procedures with patient comfort and owner preferences. Regular follow-up and assessment are crucial in cases where immediate intervention may not be pursued initially.

This case secured 3rd place in Asto CT's Best Scans of the Year contest (Soft Tissue Category), highlighting the expertise of Dr. Nicolas Ernst and his outstanding team at the University of Minnesota–Leatherdale Equine Center.