|
|
猫鼻腺癌并发急性失明的多模态诊断与治疗分析
|
Abstract:
猫鼻腺癌(Feline nasal adenocarcinoma, FNA)是一种罕见且具有高度侵袭性的恶性肿瘤,好发于中老年猫。该肿瘤侵袭性强,可累及视神经通路导致急性失明,预后谨慎至不良。目前国外相关病例报道罕见,本文系国内首次报道FNA并发急性失明的病例。2023年9月,我院接诊一例FNA并发急性失明的病例,经肿瘤减容手术及病理确诊后,短期症状改善,但最终因肿瘤转移实施安乐死。本文详细报告该病例的诊疗过程、影像学特征(重点展示肿瘤沿鼻腔–额窦–视神经侵袭路径)及转归,旨在为临床诊疗提供参考,并强调早期多模态影像学诊断及综合治疗的重要性。
Feline nasal adenocarcinoma (FNA) is a rare malignant tumor predominantly affecting middle-aged and senior cats. Its aggressive nature can lead to invasion of the optic nerve pathways, resulting in acute blindness and a guarded to poor prognosis. While international reports of FNA-associated blindness are scarce, no such cases have been documented domestically in China. In September 2023, a cat presenting with acute blindness secondary to FNA was admitted to our hospital. Tumor debulking surgery was performed to alleviate optic nerve compression and obtain a definitive histopathological diagnosis. Short-term symptomatic improvement was achieved; however, the cat was ultimately euthanized due to tumor metastasis. This report details the clinical presentation, diagnostic imaging (notably MRI tracking the tumor’s path from nasal cavity/frontal sinus to optic nerves), therapeutic intervention, and outcome. It serves as a reference for clinicians and underscores the critical role of early advanced imaging and multimodal therapy.
| [1] | Mukaratirwa, S., van der Linde-Sipman, J. and Gruys, E. (2001) Feline Nasal and Paranasal Sinus Tumours: Clinicopathological Study, Histomorphological Description and Diagnostic Immunohistochemistry of 123 Cases. Journal of Feline Medicine and Surgery, 3, 235-245. https://doi.org/10.1053/jfms.2001.0141 |
| [2] | Henderson, S.M., Bradley, K., Day, M.J., Tasker, S., Caney, S.M.A., Moore, A.H., et al. (2004) Investigation of Nasal Disease in the Cat—A Retrospective Study of 77 Cases. Journal of Feline Medicine and Surgery, 6, 245-257. https://doi.org/10.1016/j.jfms.2003.08.005 |
| [3] | Ferguson, S., Smith, K.C., Welsh, C.E. and Dobromylskyj, M.J. (2019) A Retrospective Study of More than 400 Feline Nasal Biopsy Samples in the UK (2006-2013). Journal of Feline Medicine and Surgery, 22, 736-743. https://doi.org/10.1177/1098612x19881847 |
| [4] | Mukaratirwa, S. and van der Linde-Sipman, J.S. (2010) Feline Sinonasal Tumours: Histopathological and Immunohistochemical Analysis. Veterinary Pathology, 47, 1030-1036. |
| [5] | Brenseke, B.M. and Saunders, G.K. (2010) Concurrent Nasal Adenocarcinoma and Rhinosporidiosis in a Cat. Journal of Veterinary Diagnostic Investigation, 22, 155-157. https://doi.org/10.1177/104063871002200135 |
| [6] | Mortier, J.R. and Blackwood, L. (2020) Treatment of Nasal Tumours in Dogs: A Review. Journal of Small Animal Practice, 61, 404-415. https://doi.org/10.1111/jsap.13173 |
| [7] | Tanaka, T., Ashida, K., Iimori, Y., Yamazaki, H., Mie, K., Nishida, H., et al. (2020) MRI Findings, Including Diffusion-Weighted Imaging, in Seven Cats with Nasal Lymphoma and Two Cats with Nasal Adenocarcinoma. Journal of Feline Medicine and Surgery, 23, 393-399. https://doi.org/10.1177/1098612x20932819 |
| [8] | Fujiwara-Igarashi, A., Fujimori, T., Oka, M., Nishimura, Y., Hamamoto, Y., Kazato, Y., et al. (2014) Evaluation of Outcomes and Radiation Complications in 65 Cats with Nasal Tumours Treated with Palliative Hypofractionated Radiotherapy. The Veterinary Journal, 202, 455-461. https://doi.org/10.1016/j.tvjl.2014.09.016 |
| [9] | Mellanby, R., Heritage, M. and Dobson, J. (2002) Long-Term Outcome of Eight Cats with Non-Iymphoproliferative Nasal Tumours Treated by Megavoltage Radiotherapy. Journal of Feline Medicine and Surgery, 4, 77-81. https://doi.org/10.1053/jfms.2001.0159 |
| [10] | Marioni-Henry, K., Schwarz, T., Weisse, C. and Muravnick, K.B. (2007) Cystic Nasal Adenocarcinoma in a Cat Treated with Piroxicam and Chemoembolization. Journal of the American Animal Hospital Association, 43, 347-351. https://doi.org/10.5326/0430347 |
| [11] | Martí‐García, B., Priestnall, S.L., Holmes, E. and Suárez‐Bonnet, A. (2023) Olfactory Neuroblastoma in a Domestic Cat and Review of the Literature. Veterinary Clinical Pathology, 52, 521-526. https://doi.org/10.1111/vcp.13255 |
| [12] | Haney, S.M., Beaver, L., Turrel, J., et al. (2009) Survival Analysis of Cats with Nasal Lymphoma. Veterinary and Comparative Oncology, 7, 261-271. |