Kathleen Kalphat-Losego 1, Robson F Giglio 1
Background
Dermoid cysts are congenital malformations composed of ectodermal elements, typically benign and non-ossified. This case report documents the first known instance of an ossified pharyngeal dermoid cyst in a juvenile canine. The mass presented with significant systemic signs due to its location and severity of mass effect, highlighting a unique and clinically significant variation of this typically incidental lesion.
Methods
A 6-month-old female Boxer presented with severe dyspnea, stertor, syncope, and dysphagia. Diagnostic workup included physical examination, electrocardiography, esophagram, and computed tomography (CT) of the head, neck, thorax, and abdomen. Fine-needle aspiration was performed for cytology and culture. Definitive diagnosis was established via surgical excision and histopathological examination.
Results
CT revealed a 3.5 × 4.6 × 4.1 cm hypoattenuating, fluid to soft-tissue mass with a partially mineralized rim, causing significant nasopharyngeal compression and displacement of adjacent muscles and anatomical structures. Cytology showed neutrophilic inflammation and atypical squamous epithelial cells. Cultures were negative. Surgical removal included a ventral bulla osteotomy due to middle ear extension. Histopathology confirmed the diagnosis of a dermoid cyst with keratohyaline granules indicative of epidermal origin. Postoperative follow-up showed complete resolution of clinical signs over a six-month period.
Limitations
This case reflects a single instance of an uncommon pathology, limiting broader generalization. Long-term follow-up beyond six months is not provided, and potential recurrence or late complications cannot be excluded. Imaging characteristics, though described in detail, represent an isolated presentation and may not capture the full spectrum of ossified dermoid cysts in veterinary patients.
Conclusions
This case introduces the novel presentation of an ossified pharyngeal dermoid cyst in a dog, demonstrating the significant clinical impact such a mass can have due to mechanical obstruction of critical airway structures. CT imaging was instrumental in diagnosis and surgical planning. Recognition of ossified cysts expands the differential for mineralized head and neck masses in young dogs with upper airway and neurologic signs. Surgical excision was curative, and ossification may indicate chronicity or maturity of the dermoid cyst.
Circular mass present at the level of the pharynx (red arrow). Image acquired from esophagram post per os administration of liquid barium.
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