scholarly journals Primary Hepatic Gastrinoma as an Unusual Manifestation of Zollinger-Ellison Syndrome

2012 ◽  
Vol 6 (3) ◽  
pp. 590-595 ◽  
Author(s):  
Hideaki Naoe ◽  
Hajime Iwasaki ◽  
Takeshi Kawasaki ◽  
Tetsu Ozaki ◽  
Hideharu Tsutsumi ◽  
...  
Keyword(s):  
Unusual Manifestation ◽  
Zollinger Ellison Syndrome ◽  
Primary Hepatic Gastrinoma

scholarly journals Primary Hepatic Gastrinoma Causing Zollinger-Ellison Syndrome: A Rare and Challenging Diagnosis

Cancers ◽  
2012 ◽  
Vol 4 (1) ◽  
pp. 130-140 ◽  
Author(s):  
Adrian Harvey ◽  
Janice L. Pasieka ◽  
Hassan Al-Bisher ◽  
Elijah Dixon
Keyword(s):  
Zollinger Ellison Syndrome ◽  
Primary Hepatic Gastrinoma

scholarly journals Primary hepatic gastrinoma being diagnosed preoperatively: a case report and literature review

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Shunya Hanzawa ◽  
Hiroshi Sadamori ◽  
Masaaki Kagoura ◽  
Kazuteru Monden ◽  
Masayoshi Hioki ◽  
...  
Keyword(s):  
Serum Gastrin ◽  
Somatostatin Receptor ◽  
Gastrin Level ◽  
Serum Gastrin Level ◽  
Cystic Degeneration ◽  
Hepatic Lobectomy ◽  
Zollinger Ellison Syndrome ◽  
Right Hepatic Lobectomy ◽  
Serum Gastrin Concentration ◽  
Primary Hepatic Gastrinoma

Abstract Background A majority of gastrinomas causing Zollinger–Ellison syndrome are located in the duodenum or pancreas. Primary hepatic gastrinomas are rare and difficult to diagnose. We report a rare case of primary hepatic gastrinoma, which could be diagnosed preoperatively. Case presentation A 29-year-old man with a 55-mm tumor in segments 5 and 6 (S 5/6) of the liver was admitted to our hospital. After thorough investigations, he was treated for a suspected inflammatory pseudotumor and advised to undergo routine follow-up. Two years later, he revisited our hospital with a complaint of abdominal pain, vomiting, and diarrhea. Upper gastrointestinal endoscopy revealed multiple duodenal ulcers. His serum gastrin level was 2350 pg/mL (normal: 37–172 pg/mL), suggesting Zollinger–Ellison syndrome. Abdominal computed tomography showed a 78-mm hypervascular tumor with cystic degeneration in the S 5/6 region of the liver, with a potential to increase over time. The tumor showed hypointensity on T2-weighted and hyperintensity on diffusion-weighted abdominal contrast-enhanced magnetic resonance imaging. Somatostatin receptor scintigraphy (SRS) only detected a hepatic tumor. No tumors in the gastrinoma triangle were detected by endoscopic ultrasonography. Hence, selective arterial calcium injection (SACI) test was performed to determine the location of the gastrinoma. The serum gastrin concentration increased from 4620 pg/mL to 23,600 pg/mL at 20 s after calcium gluconate injection into the proper hepatic artery. Conversely, no effect on serum gastrin level was observed after the injection into any other arteries. Extended right hepatic lobectomy and cholecystectomy were performed after percutaneous transhepatic portal vein embolization. A histopathological examination of the liver tumor revealed a gastrinoma. The patient’s serum gastrin concentration on postoperative day 1 decreased to 65 pg/mL. Conclusion We report a surgical case of primary hepatic gastrinoma correctly diagnosed preoperatively. The patient underwent extended right hepatic lobectomy, resulting in a histological definitive diagnosis of primary hepatic gastrinoma.

Ulcerogenic Tumors of the Pancreas

1968 ◽  
Vol 26 ◽  
pp. 186-187
Author(s):  
J. C. Garancis ◽  
J. F. Kuzma ◽  
S. D. Wilson ◽  
E. H. Ellison
Keyword(s):  
Endoplasmic Reticulum ◽  
Tumor Cells ◽  
Islet Cell ◽  
Disease Process ◽  
Central Core ◽  
Islet Cell Tumors ◽  
Opaque Zone ◽  
Granular Form ◽  
Zollinger Ellison Syndrome

It has been proposed that a gastrin-like hormone elaborated by non-beta islet tumors of the pancreas may be responsible for a fulminating ulcer diathesis. Subsequently, a potent gastric secretagogue was isolated from ulcerogenic tumors of the pancreas. This disease process is known now as “Zollinger-Ellison syndrome”.In our studies of two cases of Zollinger-Ellison syndrome, pancreatic lesions were identified as alpha islet cell tumors (Fig. 1). Tumor cells were fairly uniform. The sizes of the alpha granules were not significantly different, but their number and distribution varied greatly from one cell to another. Each granule consisted of a round, highly dense central core, separated from the limiting membrane by an opaque zone. The granular form of the endoplasmic reticulum was particularly prominent. Numerous mitochondria, round or elongated, were dispersed throughout the cytoplasm. Individual or clusters of lysosomes were observed in the majority of cells.

Efficacious long-term maintenance therapy with pantoprazole (PAN) in patients with Zollinger-Ellison syndrome

2001 ◽  
Vol 120 (5) ◽  
pp. A613-A613
Author(s):  
P BORNMAN ◽  
K RADEBOLD ◽  
H DEBAERE ◽  
L VENTER ◽  
H HEINZE ◽  
...  
Keyword(s):  
Maintenance Therapy ◽  
Zollinger Ellison Syndrome ◽  
Term Maintenance

Excluded Gastric Antrum Simulating the Zollinger-Ellison Syndrome

1964 ◽  
Vol 47 (2) ◽  
pp. 184-187 ◽  
Author(s):  
Brian A. Scobie ◽  
Douglas B. McGill ◽  
James T. Priestley ◽  
Randolph A. Rovelstad
Keyword(s):  
Gastric Antrum ◽  
Zollinger Ellison Syndrome

Zollinger-Ellison Syndrome

1963 ◽  
Vol 44 (4) ◽  
pp. 512-518 ◽  
Author(s):  
L. Angervall ◽  
G. Dotevall ◽  
K.-E. Lehmann ◽  
P.B. Norberg
Keyword(s):  
Zollinger Ellison Syndrome

Zollinger-Ellison Syndrome: A Case Report

1999 ◽  
Vol 41 (6) ◽  
pp. 1173 ◽  
Author(s):  
Dong Jin Jung ◽  
Hyun Kwon Ha ◽  
Pyo Nyun Kim ◽  
Moon Gyu Lee ◽  
Yong Ho Auh
Keyword(s):  
Case Report ◽  
Zollinger Ellison Syndrome

A non-resolving splenic ‘abscess’ in an elderly male – An unusual manifestation of splenic lymphoma

2020 ◽  
pp. 004947552098130
Author(s):  
Raj K Nagarajan ◽  
Balasubramanian Gopal ◽  
Muhamed Tajudeen ◽  
Sarath C Sistla ◽  
K Balamourougan
Keyword(s):  
Risk Factors ◽  
Splenic Abscess ◽  
Low Grade ◽  
Surgical Drainage ◽  
Elderly Male ◽  
Unusual Manifestation ◽  
Splenic Lymphoma ◽  
Haematogenous Spread ◽  
Uncommon Condition ◽  
Abscess Wall

Splenic abscess is a relatively uncommon condition, posing a diagnostic and therapeutic challenge for the treating physician. It occurs due to haematogenous spread from endocarditis or other septic foci, especially in immune-compromised individuals and diabetics. We describe an elderly male who presented with splenomegaly and low-grade fever with no predisposing factors. Examination revealed a tender splenomegaly. Ultrasonography (US) showed a hypoechoic area within the spleen from which guided aspiration of pus grew Staphylococcus aureus and Klebsiella pneumoniae. Percutaneous drainage and culture-based antibiotics failed to resolve the abscess, obligating surgical drainage. Intraoperative biopsy from the abscess wall was reported as splenic marginal lymphoma. This unusual presentation of lymphoma needs to be considered in splenic abscess without known risk factors.

scholarly journals Gastric Acid-Related Diseases: Focus on Esomeprazole

2010 ◽  
Vol 2 ◽  
pp. CMT.S4500
Author(s):  
B. Al-Judaibi ◽  
N. Chande ◽  
G.K. Dresser ◽  
N. Sultan ◽  
J.C. Gregor
Keyword(s):  
Duodenal Ulcer ◽  
Helicobacter Pylori ◽  
Symptom Relief ◽  
Competitive Inhibitor ◽  
Gastric Ph ◽  
Disease Treatment ◽  
Ulcer Disease ◽  
Zollinger Ellison Syndrome ◽  
Prevention And Treatment ◽  
Inflammatory Drugs

Esomeprazole (S-omeprazole) is a single optical enantiomer proton-pump inhibitor (PPI) approved for the management of gastro-oesophageal reflux disease, the prevention and treatment of Non-Steroidal Anti-Inflammatory Drugs (NSAID) associated gastric ulcer disease, treatment of duodenal ulcer disease associated with Helicobacter pylori infection, and the treatment of Zollinger-Ellison syndrome. Esomeprazole has been shown to be safe and effective during pregnancy and was introduced to the market in 2001. PPI therapy may interact with clopidogrel by cytocrome 2C19. Clopidogrel is a prodrug which is partially activated by cytochrome 2C19 and esomeprazole is a competitive inhibitor of 2C19. Esomeprazole is more effective than other PPIs in controlling esophageal and gastric pH, but efficacy in symptom relief is less clear.

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