Pancreas: neoplasia of the exocrine pancreas (adenocarcinoma)

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Sections available in full article Introduction, Presenting signs, Acute presentation, Age predisposition, Sex predisposition, Breed predisposition, Cost considerations, Pathogenesis, Etiology, Pathophysiology, Timecourse (incubation, duration), Diagnosis, Presenting problems, Client history, Clinical signs, Diagnostic investigation, Confirmation of diagnosis, Gross autopsy findings, Histopathology findings, Differential diagnosis, Treatment, Initial symptomatic treatment, Standard treatment, Monitoring, Sequelae, Prognosis, Expected response to treatment, Reasons for treatment failure, Sources, Publications, Vetstream contributor(s),
Contributors Dr Laura Garrett DVM DACVIM (Oncology)
Mr James Simpson SDA BVM&S MPhil MRCVS
Mr Andrew Gardiner BVM&S Cert SAS MSc MRCVS

Introduction

  • Cause : rare as primary (<0.5% of all cancers) neoplasia of acinar or duct cells in central portion of pancreas. Usually occur in older animals, specifically Airdale terriers Airedale Terrier.
  • Signs : non-specific - vomiting, fever, weakness, variable abdominal pain.
  • Diagnosis : radiography, ultrasound, laparotomy and tissue biopsy.
  • Treatment : symptomatic, not curative.
  • Prognosis : very poor - often locally invasive and metastasized at presentation. If diagnosed at exploratory laparotomy; intra-operative euthanasia should be considered.

Diagnosis

Clinical signs

  • Abdominal pain.
  • Icterus.
  • Pyrexia.
  • Anterior abdominal mass.
  • Signs referable to metastasis to other organs.
  • Wasting.
  • Ascites.

Diagnosis

Differential diagnosis

  • Primary pancreatitis Pancreatitis: acute.
  • Other pancreatic neoplasia Pancreas: neoplasia.
  • Pancreatic abscess.
  • Peritonitis Peritonitis.
  • Other abdominal masses.

Sequelae

Prognosis

  • Very poor: metastasis is rapid - usually by time of diagnosis.
  • Survival time rare beyond 1 year, usually less.

Expected response to treatment

  • Control of symptoms, eg pain and vomiting.

Reasons for treatment failure

  • Locally invasive, non-excisable.
  • Rapid metastasis.

Sources

Publications

Refereed papers

  • Recent references from PubMed.
  • Lamb C R, Simpson K W, Boswood A & Mathewman L A (1995) Ultrasonography of pancreatic neoplasia in the dog: a retrospective review of 16 cases. Vet Rec 137, 65 - 68.
  • Withrow S J (1989) Tumours of the gastrointestinal system: exocrine pancreas. In: Clinical Veterinary Oncology. Eds S J Withrow and E G MacEwen. Lippincott, Philadelphia. p 192.
  • Anderson N V & Johnson K K (1967) Pancreatic carcinoma in the dog. JAVMA 150 , 286.

Other sources of information

  • Williams D A (1996) The Pancreas. In: Strombeck's Small Animal Gastroenterology.W Guildford et al(eds), Saunders W B, Philadelphia, pp 381-411.
  • Bunch S E (1992) Diseases of the exocrine pancreas. In: Handbook of Small Animal Practice.Ed: R V Morgan. 2nd edn. Churchill: Livingstone, NY, USA.

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