Regular oral examinations often reveal the presence of swellings or masses in our furry companions’ mouths. Sometimes, pet owners bring their animals to us specifically due to the detection of an oral mass either at home or by another veterinarian. Identifying these masses is not always straightforward – some are benign, requiring minimal intervention, while others demand a more intricate diagnosis and treatment.
The primary concern associated with oral masses is the potential for oral cancer, although fortunately, such cases are rare. Given their occurrence, swift identification becomes crucial for timely and effective management. Distinguishing between benign and potentially problematic masses isn’t always evident externally, prompting a cautious approach. It is advisable to treat all oral masses as if they have the potential to be problematic, necessitating thorough evaluation.
Biopsy emerges as a recommended step for most oral masses, favoring a diagnostic approach over immediate curative surgery. These masses typically fall into two categories – benign, with limited effects on the body, and malignant, possessing the ability to spread locally or beyond. Treatment strategies for each group differ, with malignancies often requiring more aggressive measures.
Benign masses are typically addressed with “simple” removal guided by dental radiographs, which provide insights into the mass’s impact on underlying bone and aid in crafting a targeted approach. Conversely, malignancies demand more extensive surgeries involving tissue areas that visually appear normal. The concept of margins plays a vital role, where an additional tissue removal aims to eliminate malignant cells potentially spreading into surrounding normal tissue. In the oral cavity, this may involve the removal of portions of the jaw.
For smaller masses, an excisional biopsy is a preferred technique, akin to benign mass surgery. If the pathology report confirms the mass as benign, a curative surgery might have already taken place. In cases of malignancy, a second, larger surgery is usually planned for curative treatment.
Striking a balance, especially concerning the size of the mass, involves attempting an excisional biopsy with an added margin, considering visual inspection and dental X-rays. This middle-ground approach, although potentially curative for some malignancies, requires validation through pathology examination of the removed margins.
A measured approach is essential in dealing with oral masses, commencing with a biopsy and acknowledging the possibility of second surgeries. The distinction between treatment paths for benign masses and malignancies underscores the complexity of managing oral masses in veterinary dentistry.