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Epitheliotropic Gastrointestinal T-Cell Lymphoma With Concurrent Insulinoma and Adrenocortical Carcinoma in a Domestic Ferret (Mustela putorius furo)

https://doi.org/10.1053/j.jepm.2015.12.011Get rights and content

Abstract

A 5-year-old male castrated ferret was presented for evaluation of chronic diarrhea, unresponsive to medical therapy. Initial examination and minimum database findings failed to determine an underlying etiology for the ferret’s gastrointestinal disorder. Biopsies obtained by exploratory surgery confirmed a diagnosis of epitheliotropic gastrointestinal T-cell lymphoma. Several treatment strategies were discussed, and ultimately palliative care with prednisolone was elected. Over the course of treatment, the ferret developed concurrent pancreatic beta-cell adenomas (insulinoma) and a left adrenocortical carcinoma. At the time of necropsy, nearly 15 months after the exploratory surgery, the lymphoma appeared to be in regression despite the use of only palliative therapy.

Section snippets

Discussion

The ferret’s initial history and physical examination findings could support any number of differential disease diagnoses, necessitating diagnostic testing. The prior treatment response with amoxicillin, metronidazole, and bismuth subsalicylate may have indicated Helicobacter mustelidae gastric ulceration; however, these medications may also have addressed an enteric bacterial dysbiosis due to other disease conditions. Fecal analyses failed to indicate parasitic involvement or evidence of

References (46)

  • M.E. Davies

    Normal mouth and intestinal flora of the ferret (Mustela furo L.)

    Nature

    (1955)
  • T.J. Stein et al.

    Treatment of feline gastrointestinal small-cell lymphoma with chlorambucil and glucocorticoids

    J Am Anim Hosp Assoc

    (2010)
  • K.M. Rassnick et al.

    Phase I evaluation of CCNU (lomustine) in tumor-bearing cats

    J Vet Intern Med

    (2001)
  • K.M. Rassnick et al.

    Efficacy of combination chemotherapy for treatment of gastrointestinal lymphoma in dogs

    J Vet Int Med

    (2009)
  • B. Hoogstraten et al.

    CCNU (1-(2-chloroethyl)-3-cyclohexyl-1-nitrosourea, NSC-79037) in the treatment of cancer. Phase II study

    Cancer

    (1973)
  • J. Fondacaro et al.

    Feline gastrointestinal lymphoma: 67 cases

    Eur J Comp Gastroenterol

    (1999)
  • J.K. Carreras et al.

    Feline epitheliotropic intestinal malignant lymphoma: 10 cases (1997-2000)

    J Vet Intern Med

    (2003)
  • A.L. Zwingenberger et al.

    Ultrasonographic evaluation of the muscularis propria in cats with diffuse small intestinal lymphoma or inflammatory bowel disease

    J Vet Intern Med

    (2010)
  • X. Li et al.

    Cutaneous lymphoma in a ferret (Mustela putorius furo)

    Vet Pathol

    (1995)
  • N. Schoemaker

    Ferrets: Endocrine and Neoplastic Diseases

    (2009)
  • M. Louwerens et al.

    Feline lymphoma in the post-feline leukemia virus era

    J Vet Intern Med

    (2005)
  • M.E. Pinkerton et al.

    Primary epitheliotropic intestinal T-cell lymphoma in a horse

    J Vet Diagn Invest

    (2002)
  • M.G. Sanz et al.

    Primary epitheliotropic intestinal T-cell lymphoma as a cause of diarrhea in a horse

    Can Vet J

    (2010)
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