Kelley Jennifer L, Rawlinson Jennifer E, Bell Cynthia M
Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, St. Paul, MN, United States.
Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, United States.
Front Vet Sci. 2025 Sep 10;12:1644866. doi: 10.3389/fvets.2025.1644866. eCollection 2025.
Cystic and pseudocystic masses of the equine maxilla and mandible are rare lesions that result in clinically significant morbidity and/or mortality for the patient. Previous literature consists of case reports or case series. Few studies have addressed the variety of cystic lesions and comparative features. The aim of this study was to retrospectively describe the clinical signs, imaging findings, histopathologic diagnoses, treatments, and clinical outcomes for cystic masses in the equine maxilla and mandible.
Cases were recruited from six sources including a pathology laboratory, universities, and multiple private practices. Inclusion criteria were cystic/cavitated lesions within the maxilla mandible, and/or incisive bones that had a complete medical record that included history, gross appearance of the mass, diagnostic imaging, histopathology report, treatments performed, and clinical outcomes. Primary sinus cysts and teratomas were excluded from the study.
Lesions were identified in 17 patients with 1 patient having multifocal maxillomandibular cystic lesions. The most common lesion location was the body of the mandible. Diagnosis of lesion etiology and type was made by assimilating histopathology with clinical findings and imaging results. The following cysts were diagnosed: dentigerous cyst (6), bone cyst (6), and radicular cyst (3). Two lesions were unclassified, radiolucent inflammatory lesions. Patients were treated surgically with marginal excision and/or aggressive cyst lining debridement for 16/17 cases with rostral mandibulectomy performed in 1/17 cases. Excisional biopsies were performed at the time of definitive surgery for 12/17 cases, which resulted in histopathologic diagnoses. Follow-up ranged from 0 to 872 days postoperatively with a mean of 200 days with only 1 case having no follow-up. Eleven out of 17 cases (64.7%) had no documented recurrence following surgical excision. The overall complication rate was 35.3% (6/17 cases) and included orofacial/oroantral fistula formation, sinus flap suture reaction, and sinus flap mycosis.
Diagnosis and treatment of equine cystic masses of the maxilla, mandible, and/or incisive bones were greatly aided by assimilating oral exam and diagnostic imaging findings with histopathologic results.
马的上颌骨和下颌骨的囊性和假性囊性肿物是罕见病变，会给患病动物带来具有临床意义的发病率和/或死亡率。以往文献多为病例报告或病例系列。很少有研究涉及各种囊性病变及其比较特征。本研究的目的是回顾性描述马的上颌骨和下颌骨囊性肿物的临床症状、影像学表现、组织病理学诊断、治疗方法及临床结果。
病例来自六个来源，包括一个病理学实验室、多所大学和多家私人诊所。纳入标准为上颌骨、下颌骨和/或切齿骨内的囊性/空洞性病变，且有完整的病历记录，包括病史、肿物大体外观、诊断性影像学检查、组织病理学报告、所采取的治疗方法及临床结果。原发性鼻窦囊肿和畸胎瘤被排除在本研究之外。
17例患病动物发现有病变，其中1例有多发性上颌下颌囊性病变。最常见的病变部位是下颌骨体部。通过将组织病理学与临床症状及影像学结果相结合来诊断病变的病因和类型。诊断出以下几种囊肿：含牙囊肿（6例）、骨囊肿（6例）和根端囊肿（3例）。有2个病变为未分类的透射性炎性病变。17例中有16例通过边缘切除和/或积极的囊肿内衬清创术进行手术治疗，1例进行了下颌骨前段切除术。17例中有12例在确定性手术时进行了切除活检，从而得出组织病理学诊断。术后随访时间为0至872天，平均为200天，只有1例未进行随访。17例中有11例（64.7%）手术切除后无复发记录。总体并发症发生率为35.3%（6/17例），包括口面/口鼻瘘形成、鼻窦瓣缝合反应和鼻窦瓣霉菌感染。
将口腔检查和诊断性影像学结果与组织病理学结果相结合，极大地有助于马的上颌骨、下颌骨和/或切齿骨囊性肿物的诊断和治疗。
