Feline Pancreatic Cyst

Abstract

Background: Pancreatic cysts are liquid accumulations, rich in enzymes or blood, surrounded by epithelial tissue that develop from a variety of causes, including injury, neoplasm, or congenital disease. In most cases, its diagnosis is incidental, as patients present with non-specific symptoms or no symptoms at all. Imaging exams can be used to elucidate the structure located along the topography of the pancreas and, based on this, to plan the patient’s treatment. Treatment consists of surgical removal, drainage, monitoring, and/or symptom control. The aim of this paper was to report a case of pancreatic cyst in a 9 months old female cat, to show the diagnostic methods and the success of the surgical therapeutic planning based on the clinical assessment and complementary tests.
Case: A 9 months old feline patient, with no defined breed, presenting with sporadic episodes of emesis, was seen at the Harmonia Veterinary Hospital, located in the city of Recife/Pernambuco. During the anamnesis, it was reported that the
patient had been experiencing bouts of emesis and abdominal discomfort for four months, but that her behavior and appetite remained normal. As the patient had been adopted and was of unknown origin, it is worth pointing out that there is no way of knowing whether her parents had any similar alterations. Clinical evaluation revealed discomfort on palpation and a firm and mobile structure in the right upper quadrant of the abdomen. The ultrasound scan showed the presence of a structure in the right lobe of the pancreas, characterizing a pancreatic cyst associated with pancreatic enlargement, without clear involvement of adjacent structures, which needed to be complemented by a CT scan. In this case, a single cystic lesion was found with no evidence of adjacent organ involvement, and no peripancreatic inflammation was noted. Laboratory tests, including those for the feline retroviruses FIV and FeLV, showed no significant changes. In view of the results, the patient was referred for exploratory laparotomy to evaluate the adjacent tissues and excise the cyst for histopathologic analysis, as well as to evaluate the other organs in their macroscopic aspects for possible changes not seen on imaging studies. After surgery, the patient remained in the intensive care unit and was monitored for 120 days with no clinical changes.
Discussion: The diagnosis of feline pancreatic cyst was based on clinical signs, which although non-specific were the most
common among the reported cases, evaluation by abdominal ultrasound and computed tomography, and definitively by
exploratory laparotomy surgery and histopathology showing simple columnar epithelial tissue that may have formed from obstruction due to anomalous formation of one of the pancreatic ducts leading to neoformation with fluid content. Other forms of injury such as inflammation or trauma, congenital diseases such as feline polycystic disease, or neoplasms were ruled out by complementary examinations and patient history. The adopted therapy, consisting of symptomatic treatment with analgesics, antiemetics and surgical excision, showed satisfactory and curative results after one hundred and twenty days, with careful follow-up, with periodic evaluations and without any clinical alterations or complications after the procedure. Histopathology showed no evidence of malignancy, only the presence of simple columnar tissue associated with the epithelial tissue of the pancreatic parenchyma.

Keywords: computed tomography, pancreas, resection, surgery.

Título: Cisto pancreático felino

Descritores: Tomografia computadorizada, pâncreas, ressecção, cirurgia.