Clinical treatment of gastrinoma: A case report and review of the literature

Zhang, Guoqing; Liu, Daren; Wang, Pei; Zhao, Jiangang; Wang, Zhefang; Chen, Li

doi:10.3892/ol.2016.4397

Cited by 12 publications

(11 citation statements)

References 23 publications

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“…In several of the recent ZES papers reviewed above, the results of SRI in hypergastrinemic patients was used to support a diagnosis of ZES, rather than confirming the diagnosis with an assessment of gastric pH, as is recommended in the existing guidelines [82, 90–92, 96, 98] (Table 1). While the presence of a tissue diagnosis of a NET in a patient with hypergastrinemia and/or typical symptoms has always been used to help confirm the diagnosis (75;83–85;89;91], this approach is increasingly being used [83, 84, 99, 113], without a preceding measurement of acid secretory capability, because of the increased availability of endoscopic ultrasound and percutaneous biopsy/cytologic techniques. However, this approach has not yet been factored into any proposed guidelines for the diagnosis of ZES and not all NETs identified this way, are invariably the cause of the hypergastrinemia.…”

Section: Examination Of the Basis For The Current Controversies Imentioning

confidence: 99%

“…Using positive cytology or a biopsy for a NET or gastrinoma in combination with the detection of fasting hypergastrinemia to diagnose ZES has been used in several recently reported ZES cases [84, 85, 89, 113], but here too, there can be several concerns depending on the clinical circumstances. Fasting hypergastrinemia in a patient not taking PPIs, but with active GERD or peptic ulcer disease or a history of diarrhea responding to PPI therapy, is strongly supportive of ZES in the presence of a positive biopsy or cytology for a NET, and especially so if a gastrinoma is identified.…”

Section: Proposed Solutions To the Current Controversies In The mentioning

confidence: 99%

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Diagnosis of Zollinger–Ellison Syndrome in the Era of Ppis, Faulty Gastrin Assays, Sensitive Imaging and Limited Access to Acid Secretory Testing

Metz

Cadiot

Poitras

et al. 2017

Int. J. Endo. Oncol.

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In recent years the diagnosis of Zollinger-Ellison syndrome (ZES) has become increasingly controversial with several new approaches and criteria proposed, differing from the classical biochemical criterion of inappropriate hypergastrinemia (i.e., hypergastrinemia in the presence of hyperchlorhydria) (Table 1). These changes have come about because of the difficulty and potential dangers of stopping proton pump inhibitors (PPIs) for gastric acid analysis; the recognition than many of the current assays used to assess gastrin concentrations are unreliable; the development of sensitive imaging modalities that detect neuroendocrine tumors (NETs) including an increasing number of the primary gastrinomas; the increased use of percutaneous or endoscopic ultrasound (EUS)-directed biopsies/cytology and the general lack of availability of acid secretory testing. In this article we will discuss the basis for these controversies, review the proposed changes in diagnostic approaches and make recommendations for supporting the diagnosis of ZES in the modern era.

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Section: Examination Of the Basis For The Current Controversies Imentioning

confidence: 99%

Section: Proposed Solutions To the Current Controversies In The mentioning

confidence: 99%

Diagnosis of Zollinger–Ellison Syndrome in the Era of Ppis, Faulty Gastrin Assays, Sensitive Imaging and Limited Access to Acid Secretory Testing

Metz

Cadiot

Poitras

et al. 2017

Int. J. Endo. Oncol.

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“…Gastrinomas are neuroendocrine tumors characterized by gastrin overexpression resulting in Zollinger-Ellison syndrome [1]. Approximately 80% are sporadic, and 20% are associated with multiple endocrine neoplasia type 1 (MEN1).…”

Section: Introductionmentioning

confidence: 99%

“…Approximately 80% are sporadic, and 20% are associated with multiple endocrine neoplasia type 1 (MEN1). The annual incidence is 0.5-2 per million, with a higher incidence among males [1,2]. The diagnosis is frequently made between the ages of 20 and 50 years [3].…”

Section: Introductionmentioning

confidence: 99%

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De novo Gastrinoma: A Case Report

Barbosa¹,

Gomes²,

Fonseca³

et al. 2019

GE Port J Gastroenterol

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Gastrinomas are neuroendocrine tumors characterized by gastrin overexpression -80% are sporadic and 20% are associated with multiple endocrine neoplasia type 1. A 75-yearold male patient, surgically treated at the age of 50 years for gastrinoma, followed on an outpatient basis because of chronic non-bloody diarrhea, was admitted to our hospital because of abdominal pain, watery diarrhea, and nonbiliary vomits. He was hypotensive and showed no response to fluids. Blood cultures were positive for Salmonella, and a diagnosis of septic shock due to Salmonella infection was made. The patient's condition improved, but the history of chronic diarrhea was still not explained. To investigate chronic diarrhea, gastrinoma recurrence was considered. Serum gastrin measurement was five times higher than the upper limit of the normal range (536 pg/mL). A positive somatostatin receptor scintigraphy was diagnostic for neuroendocrine tumor. Metastases were excluded. The patient was proposed to curative surgery, and a diagnosis of a well-differentiated neuroendocrine tumor was made. para tumor neuroendócrino. Foram excluídas metástases. O doente foi proposto para cirurgia curativa e foi feito o diagnóstico de tumor neuroendócrino bem diferenciado.

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