9-years-old, mixed breed dog. Presented for acute appearance of an intermandibular mass. A CT-scan of the head was performed.
Description
There is a lesion with a cavitary appearance, with a thick wall, filled with a fluid attenuating non-contrast enhancing content (red arrowheads). In addition, in the dependent portion of the lesion, there are multiple mineral foci with smooth margins consistent with sialoliths (green arrowheads) as well as multiple mineralizations of the wall. The lesion is located between the oropharynx and the left digastric muscle (purple arrows), in the anatomical location of the left sublingual monostomatic gland. The lesion causes a moderate mass effect, displacing the oropharyngeal region to the right (blue arrows), the mandibular salivary gland (MG) laterally to the left and the left medial retropharyngeal lymph node dorsally and the mandibular lymph nodes laterally.
There is moderate striation of the subcutaneous fat of the caudal region of the head/neck surrounding the cavitary lesion, especially at its caudal aspect (green arrows).
There is also minimal distension of the left polystomatic sublingual salivary gland located lateral to the tongue, filled with fluid attenuating material, showing marked peripheral contrast enhancement (orange arrows).
Diagnosis
The lesion with a cavitary appearance located between the oropharynx and the left digastric muscle is consistent with a sialocele with presence of multiple sialoliths within it. Given its location, this is most likely consistent with a left cervical sialocele with possible origin in the monostomatic sublingual salivary gland or its duct.
Reaction of the subcutaneous fat surrounding the left cervical sialocele.
Alterations in the location of the left polystomatic sublingual gland consistent with sialoadenitis vs. small incipient sialocele.
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