Primary Peptic Ulcerations of the Jejunum Associated with Islet Cell Tumors of the Pancreas

Zollinger, Robert M.; Ellison, Edwin H.

doi:10.3322/canjclin.39.4.231

Cited by 78 publications

(90 citation statements)

References 12 publications

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“…Zollinger-ellison syndrome (ZES) was first described in 1955 as a constellation of findings, which included: refractory peptic ulceration, gastric acid hypersecretion, diarrhea, and a non-β islet cell tumor of the pancreas [1] . It was later confirmed that the islet cell tumor secreted peptide hormone gastrin and was the cause of ZES.…”

Section: Introductionmentioning

confidence: 99%

Primary hepatic gastrinoma: Report of a case and review of literature

Tsalis

Vrakas²,

Vradelis³

et al. 2011

WJGP

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Primary hepatic gastrinoma is a very rare ectopic gastrinoma with less than 20 cases reported worldwide. We report the case of a patient with hypergastrinemia who was subjected to exhaustive preoperative and intraoperative imaging and also careful surgical exploration of the duodenum and pancreas which failed initially to identify the primary tumour. Eventually the patient was subjected to left liver lobectomy, as a small palpable lesion was noted intraoperatively. The diagnosis of gastrinoma requires a high index of clinical suspicion and the flawless cooperation of many specialties.

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Section: Introductionmentioning

confidence: 99%

Primary hepatic gastrinoma: Report of a case and review of literature

Tsalis

Vrakas²,

Vradelis³

et al. 2011

WJGP

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“…Indeed, excessive secretion of gastrin resulting in the induction of gastrointestinal ulcers and diarrhoea is a typical feature of patients with ZollingerEllison syndrome [17,18], and previous studies reported increased islet size in pancreatic specimens from patients with gastrinomas [18][19][20]. Pancreatic endocrine tumours may release many growth factors [21]; thus, the apparent increase in islet size might have been due to paracrine release of tumour-related factors rather than systemic gastrin.…”

Section: Introductionmentioning

confidence: 99%

Increased islet beta cell replication adjacent to intrapancreatic gastrinomas in humans

Meier¹,

Butler²,

Galasso³

et al. 2006

Diabetologia

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Aims/hypothesis Type 1 and type 2 diabetes are characterised by a beta cell deficit. Islet hyperplasia has been described in patients with Zollinger-Ellison syndrome secondary to gastrin-producing tumours (gastrinomas), and gastrin therapy has increased beta cell mass in rodents and human islets in vitro. In the present studies we addressed the following questions: (1) In pancreas specimens from gastrinoma cases, is the fractional beta cell area increased? (2) If so, is this restricted to tumour-adjacent islets or also present in tumour-distant islets? (3) Is new beta cell formation (beta cell replication and islet neogenesis) increased and beta cell apoptosis decreased in pancreas specimens from gastrinoma cases? Methods Pancreas was obtained at surgery from four patients with Zollinger-Ellison syndrome caused by pancreatic gastrinomas and 15 control subjects at autopsy. Results Islet fractional beta cell area (p<0.001), islet size (p<0.001) and beta cell replication (Ki67 staining) (p<0.05) were increased in islets adjacent to the tumours, but not in tumour-distant pancreas, compared with control subjects. We did not observe any differences in beta cell apoptosis or in the number of insulin-positive cells in ducts either adjacent to or distant from the tumour. Conclusions/interpretationOne or more factors released by human gastrinomas increase beta cell replication in islets immediately adjacent to the tumour, but not in tumourdistant islets. While these findings demonstrate that adult human beta cells can be driven into the cell cycle, they caution against the therapeutic usefulness of gastrin, since islets located >1 cm away from the gastrinomas did not exhibit changes in beta cell turnover, despite markedly elevated systemic gastrin levels sufficient to cause severe gastrointestinal symptoms.

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“…Somewhat paradoxically, the stomach, which under physiological conditions contains most of the G cells of the organism, appears as a very rare site of origin for gastrinomas [7,14,16]. A review of the literature disclosed fewer than 20 reported gastric gastrinomas presenting as a mucosal polyp or as unique or multiple intramural nodules [9,12,13,14].…”

Section: Discussionmentioning

confidence: 99%

Gastric collision between a papillotubular adenocarcinoma and a gastrinoma in a patient with Zollinger-Ellison syndrome

et al. 2002

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We report a unique case of a gastric collision tumor composed of an intramural gastrin-secreting tumor and a papillotubular adenocarcinoma of the intestinal type discovered at autopsy in a patient with Zollinger-Ellison syndrome. There was extensive metastatic dissemination of the neuroendocrine component to regional lymph nodes and to the liver. The unusual macroscopical, histological, and immunohistochemical features of this case and its specific clinical setting are discussed

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Primary Peptic Ulcerations of the Jejunum Associated with Islet Cell Tumors of the Pancreas

Cited by 78 publications

References 12 publications

Primary hepatic gastrinoma: Report of a case and review of literature

Primary hepatic gastrinoma: Report of a case and review of literature

Increased islet beta cell replication adjacent to intrapancreatic gastrinomas in humans

Gastric collision between a papillotubular adenocarcinoma and a gastrinoma in a patient with Zollinger-Ellison syndrome

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