Case Report: Comprehensive Imaging and Clinical Outcomes of Chondro-Osseous Respiratory Epithelial Adenomatoid Hamartoma (COREAH) in a Dog

The aim of this case report is to describe comprehensive imaging such as CT scanning, endoscopy, histopathology, and clinical outcomes following medical and endoscopic treatment. A 5-year-old spayed female Chihuahua presented with chronic unilateral nasal discharge, congestion, and intermittent stertor, unresponsive to initial antibiotics and steroids. Further diagnostics, including endoscopy, revealed a cystic lesion with osseous fragments in the left nasal cavity, while CT imaging identified a soft tissue mass with associated bone resorption. Histopathology confirmed chondro-osseous respiratory epithelial adenomatoid hamartoma (COREAH), a rare benign lesion characterized by respiratory epithelium, fibrovascular proliferation, and osseous components, along with lymphoplasmacytic and eosinophilic inflammation. Clinical signs improved following endoscopic aspiration and drainage, which restored nasal cavity space. This case highlights the importance of combining endoscopy, advanced imaging, and histopathology for accurate diagnosis and effective management of COREAH, a condition with potential for recurrence. The use of endoscopy enabled real-time visualization and precise tissue sampling, distinguishing this case from others relying solely on imaging. This report contributes to the limited veterinary literature on COREAH and underscores the need for long-term monitoring due to its uncertain pathogenesis and variable presentation.