canis - Articles
Pancreas: neoplasia: gastrinoma
Synonym(s): 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.
Presenting signs
- Maldigestion:
- Vomiting Vomiting.
- Weight loss Weight loss: overview.
- Anorexia.
- Malabsorption:
- Excessive secretion of gastric acid results in mucosal ulcerations Gastric ulceration and maldigestion leading to diarrhea Diarrhea: due to systemic illness.
- Lethargy.
- Pain Pain.
- Pyrexia.
- Hematemesis.
- Melena.
Age predisposition
- Mean age 7.5 years.
Cost considerations
- Moderate cost if surgery is required.
- Relatively expensive drugs required for treatment of gastrointestinal ulceration and acid control.
Pathogenesis
Etiology
- Unknown.
Pathophysiology
- Malignant tumor of islet cells secreting gastrin.
- Gastrin stimulates excessive gastric hydrochloric acid secretion causing gastrointestinal ulceration, diarrhea and steatorrhea.
- Gastrin → gastric hydrochloric acid → erosive gastritis/duodenitis → ulceration/hyperplasia → vomiting/hematemesis/melena/abdominal pain.
- Excessive gastrointestinal acid → fat malabsorption → steatorrhea/diarrhea.
- High malignancy → metastasis to liver and regional lymph nodes.
Timecourse
- Early metastasis.
Diagnosis
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Treatment
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Prevention
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Outcomes
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Further Reading
Publications
Refereed papers
- Recent references from PubMed and VetMedResource.
- Green R A & Gartrell C L (1997) Gastrinoma - a retrospective study of four cases (1985-1995). JAAHA 33 (6), 524-527 PubMed.
- Happé et al (1980) Zollinger-Ellison syndrome in three dogs. Vet Pathol 17 (2), 177-186 PubMed.
Other sources of information
- 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.