Amyloid-producing Odontogenic Tumor in a 6-year-old Shih Tzu
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A 6-year-old female spayed Shih Tzu was presented to Cornell’s Dentistry and Oral Surgery Service after the primary veterinarian noted an oral mass during extractions approximately 2 months prior. A biopsy obtained by the primary veterinarian was consistent with an amyloid-producing odontogenic tumor, which is a rare oral tumor described in dogs and cats. The patient’s physical exam was unremarkable except for decreased retropulsion of the left eye and an enlarged left mandibular lymph node. Oral examination revealed periodontal disease, occlusal abnormalities consistent with crowding of teeth due to brachycephalic skull shape, and the left hard palate mass. The patient was anesthetized for periodontal treatment, a computed tomographic scan (CT) of the head, a second biopsy, and a fine needle aspirate of the left mandibular lymph node. Histopathological analysis confirmed the diagnosis of an amyloid-producing odontogenic tumor. Cytological analysis indicated a reactive lymph node without observable neoplastic cells. The CT scan revealed that the tumor extended into the zygomatic and periorbital space (at the level of the left maxillary fourth premolar) and was causing significant lysis of maxillary bone. As amyloid-producing odontogenic tumors are locally invasive but tend not to metastasize, surgical excision is the treatment of choice. With the patient anesthetized and in dorsal recumbency, a left caudal maxillectomy was performed using a #15 scalpel blade and a piezoelectric surgical instrument (piezotome). The excised tissue extended from the left second maxillary premolar to the left second maxillary molar and included soft tissue margins 1 cm mesial, buccal, distal, and palatal to the mass. The surgery was successful, and the patient’s postoperative CT scan indicated no visibly identifiable tumor tissue. Amyloid-producing odontogenic tumors are rare to metastasize; however, histologic margins in this case were incomplete, indicating a potential for local recurrence.