Sporadic duodenal macrogastrinoma: a rare case report
Gastroenterology
Dainius Šimčikas
Eligijus Poškus
Juozas Stanaitis
Ernesta Rinkevičiūtė
Algirdas Edvardas Tamošiūnas
Kęstutis Strupas
Published 2013-01-31
https://doi.org/10.6001/actamedica.v19i4.2548
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Keywords

gastrinoma
duodenal macrogastrinoma
Zollinger-Ellison syndrome

How to Cite

Šimčikas D., Poškus E., Stanaitis J., Rinkevičiūtė E., Tamošiūnas A. E. and Strupas K. (2013) “Sporadic duodenal macrogastrinoma: a rare case report”, Acta medica Lituanica, 19(4), pp. 395-402. doi: 10.6001/actamedica.v19i4.2548.

Abstract

Gastrinomas are rare neuroendocrine tumors characterized by the secretion of gastrin, which causes hyperchlorhydria, thereby producing the Zollinger-Ellison syndrome. In most cases this syndrome manifests as severe peptic ulcer disease. We are presenting an extremely rare clinical case of sporadic duodenal macrogastrinoma. The patient underwent investigation due to six-year history of epigastric pain, heartburn and episodic diarrhea. Endoscopy, endosonoscopy and histologic examination of biopsy specimens indicated the presence of duodenal gastrinoma with no signs of peptic ulcers. Pyloroduodenal segment including 3.5 cm macrogastrinoma was resected. This case is unique as duodenal gastrinomas are usually very small, up to 1 cm. During the follow up period we observed slowly decreasing hypergastrinemia. Somatostatin receptor scintigraphy, CT and upper GI endoscopy were performed to reveal the reasons, though did not find any abnormalities. 8 months of follow-up did not reveal any progression of the disease. The etiology of slowly decreasing hypergastrinemia remains unclear, controversial and is under investigation.
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