Sublingual mass in a Labrador retriever mix
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A 9-year-old castrated male Labrador retriever mix was evaluated for inappetence, excessive salivation, lip licking, and halitosis of 2-3 days’ duration. On physical examination, a large, proliferative, malodorous mass was present on the left sublingual area.
The differential diagnosis for an oral mass associated with the tongue includes inflammatory processes like glossitis, numerous benign or malignant neoplastic processes, and less common conditions such as calcinosis circumscripta. In order to further characterize the lesion, several incisional biopsies were obtained from the mass. During the procedure, several plaques, consistent with the appearance of eosinophilic granulomas, were noted at the junction of the hard and soft palate.
Histologic examination of the biopsies revealed chronic eosinophilic granulomatous inflammation. Canine eosinophilic granulomas are rare, and they are most commonly seen in young Siberian huskies and Cavalier King Charles spaniels. Oral lesions are the most common manifestation, characterized by vegetative masses on the tongue or ulcerative plaques on the palate.1 While the exact cause of these lesions is rarely identified in an individual animal, eosinophilic disorders can be triggered by hypersensitivity reactions, endogenous or exogenous foreign material, and infections.2
The goal of treatment for an oral eosinophilic granuloma is to reduce the size of the mass. An underlying cause, such as a hypersensitivity reaction, should be ruled out.3 Most canine eosinophilic granulomas respond to medical management with antibiotics and immunosuppression, but the response is variable and unwanted side effects are frequently associated with the prolonged use of high doses of corticosteroids. In some cases, the best local results may be achieved with surgical excision followed by treatment with low-dose corticosteroids.4
Given the size of the lesion in this case and the patient’s apparent discomfort, the mass was excised in order to increase his quality of life. A partial caudal glossectomy was performed, salvaging as much of the tongue as possible, and the patient was treated with oral corticosteroids and antibiotics.