C. Calpa
Anamnesis
The patient (a female dog, mixed race, 10-year-old, sterilized) was treated at the Oncology Service of the Veterinary Hospital of the University Estadual Paulista, Jaboticabal, Brazil, due to an increased volume of tissue in the dorsal region of the skull, with firm consistency and painless to palpation. The physical examination showed a grade VI systolic murmur of mitral valve and a normal neurological exam.
Diagnosis
Hematological and biochemical exams were analyzed, without abnormalities found. The electrocardiogram and echocardiogram determined mitral regurgitation. Skull radiographs suggested an irregular structure with mineral radiopacity in the occipital and parietal region, and chest radiographs did not show evidence of pulmonary metastases. The cranial CT scan with contrast determined delimited edges in the occipitoparietal region without intracranial metastasis.
Treatment
Bone mass excision in the occipitoparietal region was performed, covering the bone defect with two titanium blades designed for lesion size. In the immediate postoperative period, the patient had focal head myoclonus, normal level of consciousness, normal gait and posture. Gradually, she improved from myoclonus, maintaining normal behavior. The histopathological diagnosis of the mass was osteoma.
Conclusion
The placement of titanium sheets proved to be an excellent choice to rebuild the cranial cavity, without altering the intracranial pressure, and keeping a normal level of consciousness and behavior.