Gastrinomas: Advances in Diagnosis and Management

  title={Gastrinomas: Advances in Diagnosis and Management},
  author={Robert T. Jensen},
  pages={23 - 27}
  • R. Jensen
  • Published 1 October 2004
  • Medicine
  • Neuroendocrinology
Gastrinomas causing Zollinger-Ellison syndrome (ZES) are the most common functional, malignant pancreatic endocrine tumors. In this paper, the diagnosis and treatment of these tumors are reviewed, incorporating recent advances in each area. Furthermore, recent advances in their pathology, molecular pathogenesis, and aspects of their localization using somatostatin receptor scintigraphy, as well as their treatment are discussed. Recent data from our NIH prospective studies on patients with ZES… 

[Endocrine tumors of the stomach and duodenum (including gastrinoma) - management guidelines (recommended by the Polish Network of Neuroendocrine Tumors)].

Polish guidelines for biochemical, pathological and localisation diagnosis, and therapeutic approaches, considering endoscopic and surgical treatment, pharmacological and radionuclide therapy are presented.

Duodenal gastrinoma treated with endoscopic band ligation.

Tumor Detection in Syndromic NET: Zollinger-Ellison Syndrome

A 40-year-old female, presented with recurrent epigastric pain and acid reflux, uncontrolled with proton pump inhibitors is presented with a MEN1-related ZES, hypothesized on the basis of early age of onset and the evidence of multifocal tumors within the pancreas and duodenum.

Zollinger–Ellison Syndrome: Diagnosis and Management

The management of ZES falls into two categories: the control of gastric acid hypersecretion and its clinical manifestations through the use of proton-pump inhibitors and the management of the tumor itself.

Answer Wermer Syndrome and Zollinger-Ellison Syndrome

  • Medicine
  • 2009
A novel technique is presented that uses a lowdensity, barium-based oral contrast agent during the arterial phase of intravenous contrast–enhanced spiral CT of the abdomen that allows preoperative confirmation of multiple duodenal tumors, which influenced surgical planning.

Surgery for gastrinoma.

[Pancreatic endocrine tumors - management guidelines (recommended by the Polish Network of Neuroendocrine Tumors)].

These guidelines refer to biochemical and location diagnostics, including scintygraphy of somatostatin receptors, endoscopic ultrasonography and other anatomical and functional imaging methods, which determines further management of patients with PETs.

Pancreatic islet cell carcinoma presenting with concurrent Cushing's and Zollinger-Ellison syndromes: case series and literature review.

Cushing's syndrome and Zollinger-Ellison syndrome occur occasionally as a result of neuroendocrine cancers. The concurrence of the two syndromes has been considered to confer a poor clinical and

Long-term suppressive effect of octreotide on progression of metastatic gastrinoma with multiple endocrine neoplasia type 1: seven-year follow up.

The case of a 30-year-old woman with a history of prolactinoma and primary hyperparathyroidism suggests the importance of investigating the Ki67/MIB1 index and SSTR expression in patients with metastatic gastrinoma.

Sporadic duodenal macrogastrinoma: a rare case report

This case is unique as duodenal gastrinomas are usually very small, up to 1 cm, and during the follow up period the etiology of slowly decreasing hypergastrinemia remains unclear, controversial and is under investigation.



Molecular insights into gastrointestinal neuroendocrine tumours: importance and recent advances.

  • V. CorletoG. delle FaveR. Jensen
  • Medicine
    Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver
  • 2002

Gastric Secretion in Zollinger-Ellison Syndrome: Correlation with Clinical Expression, Tumor Extent and Role in Diagnosis—A Prospective NIH Study of 235 Patients and a Review of 984 Cases in the Literature

The aims of the study were to evaluate the sensitivity of proposed acid secretory criteria for the diagnosis of ZES, propose new criteria, evaluate the variability and methodology of gastric secretory testing, and correlate the symptoms and signs of Zes, tumor extent, and primary tumor size and location with the degree of Gastric acid hypersecretion.

Growth of newly diagnosed, untreated metastatic gastrinomas and predictors of growth patterns.

The growth rate of metastatic gastrinoma varies markedly in different patients and 26% demonstrate no growth, which needs to be considered in the determination of when and in whom antitumor therapy is initiated, as well as in the assessment of response to tumoricidal therapies.

Prospective study of the antitumor efficacy of long‐term octreotide treatment in patients with progressive metastatic gastrinoma

The purpose of the current study was to study prospectively the efficacy, safety, and effect on survival of long‐term treatment with octreotide in consecutive patients with progressive malignant gastrinoma.

Zollinger‐Ellison Syndrome: Clinical Presentation in 261 Patients

The initial presenting symptoms in 261 patients with Zollinger-Ellison syndrome (ZES) over a 25-year period were evaluated, finding that abdominal pain and diarrhea were the most common symptoms, present in 75% and 73% of patients, respectively.

Prospective study of the clinical course, prognostic factors, causes of death, and survival in patients with long-standing Zollinger-Ellison syndrome.

  • F. YuD. Venzon R. Jensen
  • Medicine
    Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • 1999
Gastrinoma growth is now the main single determinant of long-term survival in ZES, with one half of patients dying a gastrinoma-related death and none an acid- related death.

Does the widespread use of proton pump inhibitors mask, complicate and/or delay the diagnosis of Zollinger–Ellison syndrome?

Proton pump inhibitors are potent acid suppressants which, at normal doses, can result in hypergastrinaemia in patients with idiopathic oesophageal reflux disease and in the control of symptoms in

Does the Use of Routine Duodenotomy (DUODX) Affect Rate of Cure, Development of Liver Metastases, or Survival in Patients With Zollinger-Ellison Syndrome?

These results demonstrate that routine use of DUODX increases the short-term and long-term cure rate due to the detection of more duodenal gastrinomas, and should be routinely performed during all operations for cure of sporadic ZES.