Gastrinomas are functional tumors of the pa s that secrete the hormone gastrin. They are rare but have been reported in people, dogs, and a cat. Hypersecretion of gastrin in people results in the Zollinger-Ellison syndrome, consisting of hypersecretion of gastric acid and recurrent peptic ulceration in the GI tract. The tumors, derived from ectopic amine precursor uptake decarboxylase (APUD) cells in the pancreas, produce an excess of the hormone gastrin, which normally is secreted by cells of the antral and duodenal mucosa.
Clinical Findings of Gastrin-secreting Islet Cell Tumors
Gastrin-secreting islet cell tumors occur less frequently than the insulin-secreting β-cell neoplasms. The prominent functional disturbances appear to result from multiple ulcerations of the GI mucosa that develop from gastrin hypersecretion.
Clinical signs include:
anorexia
hematemesis
intermittent diarrhea
weight loss
dehydration
Lesions
Animals studied with the Zollinger-Ellison-like syndrome have had single or multiple tumors of varying size in the pancreas. The tumors were firm on palpation because of an increase of fibrous connective tissue in the stroma, and all had evidence of metastasis before diagnosis.
Diagnosis of Gastrin-secreting Islet Cell Tumors
Blood testing
Possible exploratory surgery
Serum gastrin levels have been evaluated in a limited number of dogs with gastrinomas. Gastrin levels in a dog with a Zollinger-Ellison-like syndrome varied from 155 to 2,780 pg/mL, whereas the mean serum gastrin in clinically healthy (control) dogs was 70.9 pg/mL. Recurrent gastric or duodenal ulcers in dogs with no identified cause warrants exploratory surgery and careful inspection of the pancreas.
Treatment of Gastrin-secreting Islet Cell Tumors
Surgery
Medical management for signs if inoperable
Excision of the gastrin-secreting mass in the pancreas can be attempted. However, all such tumors that have been studied in dogs have had evidence of local invasion into adjacent parenchyma and had metastasized to regional lymph nodes and liver. The dogs had either single or multiple ulcerations in the gastric or duodenal mucosa associated with free blood in the lumen. Medical management with H2-receptor antagonists (famotidine or ranitidine) or the proton-pump inhibitor omeprazole may temporarily alleviate clinical signs in animals with inoperable disease.
Key Points
Gastrinomas are uncommon tumors of the endocrine pancreas.
The diagnosis should be considered in older animals with unexplained gastric ulceration.
Limited data are available on preferred treatments, though surgical removal should be considered in patients with a solitary pancreatic mass.
For More Information
See pet owner information about gastrin-secreting islet cell tumors in dogs.
