Veterinary Society of
Surgical Oncology

Biologic Behaviour

  • pancreatic ADC is a tumor of the exocrine pancreas originating in either the acinar cells or ductular epithelium
  • very rare in cats and rare in dogs accounting for < 0.05% of all cancers
  • 75% of feline pancreatic carcinomas are diffuse
  • 75% of pancreatic carcinomas in humans are located in the head of the pancreas with invasion of the duodenum, stomach, and bile duct common
  • N-ethyl-N'-nitro-N-nitrosoguanidine induces pancreatic ADC in dogs with intraductal administration
  • exocrine pancreatic carcinoma has been diagnosed concurrently with diabetes mellitus and hyperadrenocorticism in 3 cats and diabetes mellitus in 22% (8/37) cats suggesting a possible association between these disease
  • metastasis to regional lymph nodes and distant sites is frequent with 50%-78% metastatic rate at diagnosis
  • metastatic sites: liver, small intestine, and lungs in cats and dogs, and mesenteric lymph nodes, mesentery ± skull and vertebrae in dogs

Signalment

  • breed predisposition: Labrador Retriever, Boxer, Cocker Spaniel, and Airedale Terrier
  • sex predilection: female dogs
  • median age 12 years in cats and 10 years in dogs

Clinical Signs

  • clinical signs are non-specific and include vomiting, anorexia, weakness, weight loss, maldigestion, exocrine pancreatic insufficient, icterus with obstruction of the common bile duct ± abdominal effusion secondary to peritoneal metastasis, carcinomatosis, or compression of the caudal vena cava
  • clinical signs are similar to pancreatitis

Diagnosis

  • blood test abnormalities are non-specific and include mild anemia, neutrophilia, and bilirubinemia
  • serum amylase and lipase are inconsistently elevated
  • barium studies may reveal slow intestinal transit time or invasion or compression of the duodenum
  • pancreatic mass detected with either survey radiographs or abdominal ultrasonography in 50% cases
  • ultrasound-guided aspirate cytology sensitive with correct diagnosis in 92%
  • DDx: pancreatic nodular hyperplasia and pancreatic pseudocyst

Treatment

General Considerations

  • treatment is complicated by frequent and extensive local invasiveness and metastasis

Surgery

  • surgical techniques: complete pancreatectomy or pancreaticoduodenectomy (Whipple's procedure)
  • high morbidity and mortality (5%-30% in humans) without significant improvement in survival
  • palliative surgical techniques include duodenal by-pass (i.e., gastrojejunostomy) and biliary diversion

Chemotherapy

  • unknown effect in animals and limited value in humans with pancreatic ADC
  • taxols and gemcitabine have been used with some improvement in survival time in humans

Prognosispoor prognosis due to location, local invasiveness, and metastasis

  • survival time < 7 days in all cats

PANCREATIC ADENOCARCINOMA

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