Neoplasias of the exocrine pancreas are quite rare in dogs and cats, can be primary or secondary, and can be classified as benign or malignant.
Pancreatic adenomas are benign tumors that are usually singular and can be differentiated from pancreatic nodular hyperplasia by the presence of a capsule. Pancreatic adenocarcinoma is the most common primary neoplastic condition of the exocrine pancreas in dogs and cats but is rare overall in both species. However, most exocrine pancreatic neoplasms in dogs and cats are secondary. Most exocrine pancreatic malignant neoplasms are diagnosed late in the disease process, can often not be completely removed surgically, and carry a poor prognosis.
Benign neoplasms of the exocrine pancreas can lead to transposition of organs of the cranial abdominal cavity. However, these changes are subclinical in most cases, and the diagnosis is often made as an incidental finding during necropsy. In rare cases, the neoplastic growth can obstruct the pancreatic duct and cause secondary atrophy of the remaining exocrine pancreas, leading to exocrine pancreatic insufficiency. Adenocarcinomas may lead to tumor necrosis if the tumor outgrows its blood supply. Tumor necrosis causes local inflammation, which can lead to clinical signs of pancreatitis Pancreatitis in Dogs and Cats Pancreatitis is an inflammatory condition that is common in dogs and cats. It can be acute or chronic and subclinical or associated with various clinical signs. Pancreatitis is diagnosed by... read more . Malignant neoplasms may also spread to neighboring or distant organs.
The presentation of dogs and cats with exocrine pancreatic neoplasia is nonspecific, and many cases remain subclinical until late in the disease process. Some animals show clinical signs suggestive of pancreatitis. Obstructive jaundice may be seen if bile duct obstruction develops. Clinical signs related to metastatic lesions have also been reported in some cases of pancreatic adenocarcinoma and may present as lameness, bone pain, or dyspnea. Finally, paraneoplastic alopecia has been reported in cats with pancreatic adenocarcinoma.
Diagnostic imaging, confirmed by cytology or histopathology
CBC, chemistry profile, and measurement of pancreatic markers (eg, serum lipase activity, serum PLI concentration) are all nonspecific in dogs and cats with exocrine pancreatic neoplasia.
Radiographic findings are also nonspecific in most cases. Abnormal findings include decreased contrast in the cranial abdomen suggesting peritoneal effusion, transposition of the spleen caudally, and shadowing in the pyloric region. In some cases, abdominal radiographs Radiography of Animals Radiography (generation of transmission planar images) is one of the most commonly used diagnostic tools in veterinary practice even though other imaging modalities such as ultrasonography,... read more suggest a cranial abdominal mass. Abdominal ultrasonography Ultrasonography in Animals Ultrasonography is the second most commonly used imaging format in veterinary practice. It uses ultrasonic sound waves in the frequency range of 1.5–15 megahertz (MHz) to create images of body... read more generally shows a soft-tissue mass near the pancreas, but in many cases, continuation of the mass with pancreatic tissue cannot be conclusively demonstrated. Also, neoplastic lesions of neighboring organs may be falsely presumed to be of pancreatic origin. Finally, animals with severe pancreatitis may show a mass effect in the area of the pancreas on abdominal ultrasonography that must not be confused with a pancreatic neoplasia.
If peritoneal effusion is present, a sample should be aspirated and evaluated cytologically. However, in most cases neoplastic cells do not readily exfoliate into the peritoneal effusion, and no neoplastic cells are identified on cytology. Fine-needle aspiration or transcutaneous biopsy under ultrasonographic guidance can be attempted when suspicious masses are identified. However, in many cases, the diagnosis is made at exploratory laparotomy or necropsy.
Treatment and Prognosis
Typically unsuccessful, with a poor prognosis
Pancreatic adenomas are benign and theoretically do not require therapy unless they cause clinical signs due to the effects of an intra-abdominal space-occupying lesion. However, because the final diagnosis of pancreatic adenocarcinoma is often made at exploratory laparotomy, a partial pancreatectomy should be performed even in cases of suspected pancreatic adenoma. The prognosis in these cases is excellent.
Patients with pancreatic adenocarcinomas often present at a late stage of the disease, and metastatic disease at the time of diagnosis is quite common in both dogs and cats. Common sites for metastasis are the liver, abdominal and thoracic lymph nodes, mesentery, intestines, and the lungs, but other metastatic sites have also been reported. In those few cases when gross metastatic lesions are not identified at the time of diagnosis, surgical resection of the tumor may be attempted, but clean surgical margins can almost never be achieved, and owners should be forewarned. Both chemotherapy and radiation therapy have shown little success in human or veterinary patients with pancreatic adenocarcinomas. Thus, the prognosis for dogs and cats with pancreatic adenocarcinoma is grave.
A diagnosis of exocrine pancreatic neoplasia can only be confirmed by cytology or histopathology.
Treatment of dogs or cats with a pancreatic adenocarcinoma is largely unsuccessful.
For More Information
Also see pet health content regarding disorders of the pancreas in cats Disorders of the Pancreas in Cats The pancreas is an organ that has 2 main functions: endocrine and exocrine. The endocrine pancreas produces the hormones insulin and glucagon, which regulate blood sugar levels. The exocrine... read more and dogs Pancreatitis and Other Disorders of the Pancreas in Dogs The pancreas is an organ that has 2 main functions: endocrine and exocrine. The endocrine pancreas produces the hormones insulin and glucagon, which regulate blood sugar levels. The exocrine... read more .