Journal of Veterinary Clinics (한국임상수의학회지)

The Korean Society of Veterinary Clinics (한국임상수의학회)
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Palliative Surgery in Two Dogs with Non-Curative Palatal Tumors

두 마리 개에서 완치가 어려운 구개 종양의 완화 수술 적용 증례

  • Yoon, Hun-Young (Department of Veterinary Surgery, College of Veterinary Medicine, Konkuk University) ;
  • Lee, Jung-Ha (Department of Veterinary Surgery, College of Veterinary Medicine, Konkuk University) ;
  • Shin, Dong-Wook (Department of Veterinary Surgery, College of Veterinary Medicine, Konkuk University) ;
  • Park, Hee-Myung (Department of Veterinary Internal Medicine, College of Veterinary Medicine, Konkuk University) ;
  • Jeong, Soon-Wuk (Department of Veterinary Surgery, College of Veterinary Medicine, Konkuk University)
  • 윤헌영 (건국대학교 수의과대학 수의 외과학교실) ;
  • 이정하 (건국대학교 수의과대학 수의 외과학교실) ;
  • 신동욱 (건국대학교 수의과대학 수의 외과학교실) ;
  • 박희명 (건국대학교 수의과대학 수의 내과학교실) ;
  • 정순욱 (건국대학교 수의과대학 수의 외과학교실)
  • Accepted : 2014.10.10
  • Published : 2014.10.31
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Abstract

Two dogs were presented with a history of anorexia, respiratory distress, or epistaxis. On physical examination, the dogs showed difficulty breathing and open-mouth breathing and large masses were found on the hard palate and soft palate. Cardiac arrest happened in case 2 and the dog was stabilized with cardiopulmonary resuscitation and oxygen therapy. Computed tomography demonstrated that the mass occupied the oropharynx, intrapharyngeal ostium, and laryngopharynx including the hard palate and soft palate in case 1. Palliative surgery was decided to improve swallowing and breathing with owner's consent in two dogs. Buccal mucosal flaps were performed for reconstruction of defects using rotational and single-pedicle advancement flaps and bilateral 90 degree transposition flaps in cases 1 and 2, respectively. Histopathology results described the oral masses as amelanotic melanoma in two dogs. The owners reported that there was normal swallowing and breathing at 7 days postoperatively in two dogs. In case 1, recurrent tumor was identified caudal to the hard palate 4 weeks after surgery. The owner did not allow further treatment and the dog became lost to follow-up at 2 months postoperatively. In case 2, there was no clinical or radiographic evidence of a local recurrence or distant metastasis at 3 weeks after surgery. The owner informed that the dog died suddenly with no signs of anything particularly wrong at 7 weeks after surgery.

식욕부진, 호흡부전, 또는 비출혈을 보이는 두 마리 개가 내원하였다. 신체검사에서 호흡곤란, 개구호흡 및 커다란 구개 종양을 확인하였다. 신체검사 중 2 번 증례에서 호흡부전으로 인한 심정지가 발생하였고 심폐소생술과 산소 공급을 통해 안정화 되었다. 1 번 증례의 CT 촬영에서 경구개 연구개를 포함하는 구강 인두, 인두 내 입구, 인후두 부위의 종양을 확인하였다. 연하곤란 및 호흡부전 개선을 위해 보호자 동의 하에 완화 수술을 결정하였다. 종양 제거 후 발생한 결손 부위 재건을 위해 구강 내 점막을 사용하여 회전 및 전진 피판술과 양측 90o 자리바꿈 피판술을 1 및 2 번 증례에 각각 적용하였다. 조직 검사 결과, 두 마리의 개 모두에서 무멜라닌 색소성 흑색종이 진단되었다. 수술 후 7 일째 두 마리 모두에서 정상 연하와 호흡이 확인되었다. 수술 후 4 주째 1 번 증례의 수술 부위에서 재발된 종양이 관찰되었다. 보호자가 추가적인 치료를 원하지 않았고, 연락 두절로 인하여 수술 후 2 개월 이후의 확인은 불가능하였다. 수술 후 3 주째 2 번 증례의 신체검사 및 방사선 촬영에서 국소적인 재발 및 전이는 확인 되지 않았다. 수술 후 7 주째 유선상으로 확인한 결과, 2 번 증례에서 원인불명의 갑작스러운 사망이 확인되었다.

Keywords

References

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