Pancreas: neoplasia: gastrinoma

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Sections available in full article Introduction, Presenting signs, Age predisposition, Sex 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 Mr James Simpson SDA BVM&S MPhil MRCVS
Mr Andrew Gardiner BVM&S Cert SAS MSc MRCVS
Synonyms Zollinger-Ellison syndrome

Introduction

  • Rare. No predilection to age or breed evident.
  • Cause : functional malignant tumor of pancreatic islet cells that secretes gastrin.
  • Signs : attributable to gastrin produced by tumor (hypergastrinemia) causing esophageal, gastric and duodenal ulceration leading to vomiting and diarrhea.
  • Diagnosis : laparotomy and histopathology.
  • Treatment : surgical excision + H2 blockers.
  • Prognosis : poor >76% metastasize.

Diagnosis

Clinical signs

  • Abdominal pain.

Diagnosis

Differential diagnosis

  • Foreign body Stomach: foreign body.
  • Intussusception Intussusception.
  • Renal failure Kidney: acute renal failureChronic renal failure.
  • Hepatic disease Liver: acute diseaseLiver: chronic disease - overview.
  • Inflammatory bowel disease Inflammatory bowel disease: overview.
  • Gastrointestinal lymphosarcoma Lymphoma.

Sequelae

Prognosis

  • Poor: highly malignant.
  • Metastatic spread causes 76% cases to recur even after apparently successful surgery.
  • Mean survival time of 5 months.

Expected response to treatment

  • Stabilize condition on medical therapy.
  • Cessation of vomiting.

Reasons for treatment failure

  • Tumor metastasized at time of diagnosis.

Sources

Publications

Refereed papers

  • Recent references from PubMed.
  • Green R A & Gartrell C L (1997) Gastrinoma - a retrospective study of four cases (1985-1995). JAAHA 33 , 524-527.
  • Zerbe C A & Washabau R J (1995) Gastrointestinal endocrine disease. In: Textbook of Veterinary Internal Medicine. 4th edn. Eds S J Ettinger and E C Feldman. Philadelphia: Saunders.
  • Happe et al(1980) Zollinger-Ellison syndrome in three dogs. Vet Pathol 17 , 177-186.

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