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Case summary: This report describes the case of a 7-year-old male neutered domestic mixed-breed cat that was initially referred to the Veterinary Hospital of the State University of Londrina for evaluation of a 2-week history of abdominal distension and a 2-day history of anorexia, infected with feline immunodeficiency virus (FIV). Abdominal ultrasound revealed an expansive mass located around the pancreas and right hepatic lobe. In the transoperative macroscopic observation, multiple white nodules were visualized in the liver, pancreas, mesentery, intestine, stomach and peritoneal wall. Immunohistochemical examination revealed that neoplastic cells demonstrated a strong positivity for AE1/AE3 and CK20. A sparse immunoreactivity to chromogranin A was observed, which demonstrates neuroendocrine cell labeling. The histopathologic changes associated with the immunohistochemical profile confirmed the diagnosis of metastatic carcinoma with neuroendocrine differentiation, originating from the pancreas. Relevance and novel information: Neuroendocrine tumors of the pancreas are rare and are associated with a poor prognosis in humans. In humans, approximately 7% of neuroendocrine tumors develop in the pancreas, and the 5-year survival rate for a pancreatic neuroendocrine tumor is 53%, according to the American Cancer Society. To our knowledge, only one case has been described in the feline species so far. Due to the rarity of this type of tumor in cats, there is little information about predisposition related to age, sex or breed, as well as the main clinical signs presented, survival time and treatment options.

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O Carcinoma de Células Acinares (CCA) é uma neoplasia epitelial maligna, composta por células com semelhança morfológica com células acinares e com evidências de produção de enzimas exócrinas pelas células neoplásicas. CCA é um tumor extremamente raro e agressivo: representa cerca de 1% de todas as neoplasias pancreáticas, e a taxa de sobrevida global de 5 anos encontra-se inferior a 10%. Esse relato justifica-se não só pela rara ocorrência da doença, mas também pela escassa literatura acerca dos conhecimentos da patologia estudada. Além disso, o CCA é um tumor com difícil diagnóstico e extremamente agressivo; o tratamento dessa doença continua sendo aprofundado, uma vez que novos estudos sugerem a presença de micrometástases ­ indetectáveis em exames de imagem ­ em pacientes submetidos à ressecção cirúrgica total com margens negativas. Dessa forma, há a necessidade de incrementar relatos de caso à bibliografia existente. O presente trabalho trata-se de um relato de caso de Carcinoma de Células Acinares no pâncreas de paciente do sexo masculino de 9 anos diagnosticado no Hospital da Criança Santo Antônio do Complexo Hospitalar Santa Casa de Misericórdia de Porto Alegre.

Acinar Cell Carcinoma (ACC) is an epithelial malignant neoplasm composed of cells with morphological similarity to acinar cells and with evidence of exocrine enzyme production by the neoplastic cells. ACC is extremely rare and an aggressive tumor: it represents about 1% of all pancreatic neoplasms, and the overall 5-year survival rate is less than 10%. This report justifies itself by the rare occurrence of the disease and by the scarce literature concerning the pathology studied. Moreover, ACC is a tumor that is difficult to diagnose and extremely aggressive; the treatment of this disease continues under investigation since new studies suggest the presence of micrometastases - undetectable in imaging studies - in patients undergoing total surgical resection with negative margins. Thus, there is a need to add case reports to the existing bibliography. The present study is a case report of Acinar Cell Carcinoma of the pancreas in a 9-year-old male patient diagnosed at Santo Antônio Children's Hospital, Hospital Complex Santa Casa in Porto Alegre (Hospital da Criança Santo Antônio do Complexo Hospitalar Santa Casa de Misericórdia).

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BACKGROUND: Pancreatic cancer (PC) is one of the most lethal cancers and is the eleventh most common cancer worldwide. This disease is characterized by an often-fatal evolution and a high burden of symptoms, particularly pain. Several studies have demonstrated that pancreatic cancer patients have a high prevalence of pain, with up to 82% of patients reporting pain, often requiring systemic strong opioids as mainstay treatment. This comprehensive review of pancreatic cancer related pain (PCRP), focuses on current mechanisms that lead to pain including regional invasion processes, as well as the local secretion of factors that sensitize nociceptive nerves. OBJECTIVE: Our objective was to conduct a review of PCRP and provide updates on intrathecal drug delivery in PC therapeutic recommendations. STUDY DESIGN: We used a narrative review design. We present a novel perspective in the field of pain research by converging data from intrathecal drug delivery trials with previous elements of molecular pain research in PCRP. METHODS: The literature review relating to PCRP pathophysiology and intrathecal drug delivery systems (IDDS) was done with searches of English, French, and Spanish abstracts, using PubMed, Dynamed, EMBASE, SciELO, Uptodate, Google Scholar, and manual searches of the bibliographies of known primary and review articles from IDDS inception until August 2020. Different search strings based on MESH terms were used including: pain, chronic pain, cancer pain, prevalence, pathophysiology, pancreatic cancer, analgesia, invasive pain procedures, celiac plexus neurolysis, pancreatic neuropathy, intrathecal drug delivery, or a combination of these terms. A narrative review based on these sources was prepared. RESULTS: This paper reviews aspects related to pancreatic adenocarcinoma and PCRP prevalence and focuses on recent developments in pathophysiology with IDDS as a pain management strategy. We summarize the best available evidence regarding intrathecal therapy (IT) for PCRP management; 18 studies of IDDS including at least 236 PC patients are analyzed. LIMITATIONS: Some limitations include: IDDS studies heterogeneity regarding disease stage, patient population, and technical aspects, such as catheter placement and treatment regimen, do not allow integration of studies. CONCLUSION: This review analyzes both past and current literature with a critical analysis of findings and respective recommendations. Most studies of IDDS in PCRP evaluate outcomes on pain using one-dimensional pain scales, such as VAS. Other relevant results, such as performance status or quality of life, are not frequently reported. Burden of disease variables, such as cancer stage, location, and comorbidities, like depression and systemic analgesia co-prescription, are usually not presented in these studies. In the same way, most studies do not precisely inform IDDS titration and IT medication. These factors make integration of IDDS in PC studies difficult. Future studies regarding impact of IDDS on pain control on quality of life, in this particular population, may help clinicians in deciding the optimal time and approach for IDDS. The studies should report data on particular disease, comorbidities, and treatment regimens.

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Squamous cell carcinoma (SCC) is a common oral neoplasm in domestic cats, but there are only a few reports in wild felids. A captive 10-years-old, female Siberian tiger (Panthera tigris altaica), with history of chronic renal disease and serologically positive for Leishmania sp. developed a lytic mandibular nodule that was histologically diagnosed as SCC. At necropsy was also observed an exocrine pancreatic carcinoma, which was considered an incidental finding, and a chronic lympho-plasmocytic interstitial nephritis associated with a membranous glomerulopathy, compatible with the chronic renal disease presented by the animal. To the best of our knowledge this is the first report of an invasive and non-metastatic mandibular SCC in a Siberian tiger.

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Squamous cell carcinoma (SCC) is a common oral neoplasm in domestic cats, but there are only a few reports in wild felids. A captive 10-years-old, female Siberian tiger (Panthera tigris altaica), with history of chronic renal disease and serologically positive for Leishmania sp. developed a lytic mandibular nodule that was histologically diagnosed as SCC. At necropsy was also observed an exocrine pancreatic carcinoma, which was considered an incidental finding, and a chronic lympho-plasmocytic interstitial nephritis associated with a membranous glomerulopathy, compatible with the chronic renal disease presented by the animal. To the best of our knowledge this is the first report of an invasive and non-metastatic mandibular SCC in a Siberian tiger.(AU)

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Las metástasis oculares constituyen el tumor maligno intraocular más frecuente en la población adulta. Estas tienen en su mayoría un compromiso coroideo. Se describe el caso de una paciente que presentó disminución de la agudeza visual rápidamente progresiva en el ojo derecho. Sin antecedentes personales relevantes, durante la evaluación oftalmológica se observa una lesión coroidea, la cual clínica y radiológicamente sugería una metástasis coroidea como primera impresión diagnóstica. Posterior a la realización de estudios de extensión se confirmó histopatológicamente un tumor pancreático como origen de la metástasis. Las metástasis oculares ocasionadas por el páncreas son extremadamente raras, lo cual se confirma en la revisión de la literatura realizada.

The ocular metastases are the most common intraocular malignant tumor in the adult population. These have mostly a choroid commitment. This case report describes a female patient who presented with a rapidly progressive decrease in visual acuity in the right eye, no other symptoms were referred and her medical history was no relevant. A choroidal lesion was found, which clinically and radiologically suggested a choroid metastasis as the diagnosis. With extension studies was confi rmed histopathologically a pancreatic tumor as the primary tumor. The ocular metastases that are originated for the pancreas are extremely rare; this is confirmed by the review of the literature.

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Pancreatic cancer is a malignancy of great impact in developed countries and is having an increasing impact in Latin America. Incidence and mortality rates are similar for this cancer. This is an important reason to offer to the patients the best treatments available. During the Latin American Symposium of Gastroenterology Oncology (SLAGO) held in Viña del Mar, Chile, in April 2015, a multidisciplinary group of specialists in the field met to discuss about this disease. The main conclusions of this meeting, where practitioners from most of Latin American countries participated, are listed in this consensus that seek to serve as a guide for better decision making for patients with pancreatic cancer in Latin America.

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Presentamos un caso en el que se revela la importancia que puede tener la utilización de la tecnología PET-FDG en el control del tratamiento del carcinoma pancreático con metástasis hepáticas mediante el HIFU (ultrasonidos enfocados de alta intensidad). Esta novedosa técnica de tratamiento será de gran ayuda a otras técnicas terapéuticas existentes en dicho tipo de patologías. A pesar de ello, nuevos estudios tanto de los resultados de esta técnica como de la utilidad del PET en el seguimiento de sus resultados serán necesarios para tener una mayor fidelidad de los mismos.

In our text we show a case that reveal the importance of FDG-PET technology in the treatment control of pancreatic carcinoma with hepatic metastases by means of HIFU (High Intensity Focused Ultrasound). This novelty treatment technique will be an important aid to another treatments in being in this kind of pathologies. In spite of this fact, newer studies are needed to check the results of HIFU and the utility of PET in the continuation of HIFU results will be necessary in order to obtain a bigger fidelity in these ones.

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