Case Study

Pancreatic adenocarcinoma and regional lymphatic metastasis in an 8 year old FS Terrier mix

This 8-year-old FS Terrier mix dog presented with symptoms of progressive vomiting and anorexia after having eaten bird seed 3 weeks prior. The clinical exam was uneventful except for mild scleral jaundice. The patient presented in good body condition. The CBC and blood chemistry revealed severe SAP and ALT, with mild AST, bilirubin, and cholesterol elevations.

This 8-year-old FS Terrier mix dog presented with symptoms of progressive vomiting and anorexia after having eaten bird seed 3 weeks prior. The clinical exam was uneventful except for mild scleral jaundice. The patient presented in good body condition. The CBC and blood chemistry revealed severe SAP and ALT, with mild AST, bilirubin, and cholesterol elevations.

Sonographic Differential Diagnosis

The appearance of these images is suggestive for pancreatic carcinoma or severe pancreatic necrosis/pancreatitis. Aggressive regional lymphadenopathy suggests a metastatic process.

Image Interpretation

A nodular mass of mixed echogenicity is noted in the region of the pancreas.

DX

Pancreatic adenocarcinoma with nodal metastasis.

Outcome

The patient was euthanized 2 weeks later due to persistence of signs despite medical treatment.

Clinical Differential Diagnosis

Pancreatitis, cholangiohepatitis, toxicity, biliary obstruction, GB mucocele, gastroenteritis, IBD, neoplasia.

Sampling

16-gauge US-guided biopsy of the right pancreatic base (see image) as well as the adjacent hypoechoic structure (image 2, lymph node) revealed pancreatic adenocarcinoma with nodal metastasis.