+ Biologic Behavior

  • 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

  • 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


+ 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

+ Prognosis

  • Poor prognosis due to location, local invasiveness, and metastasis
  • Survival time < 7 days in all cats