Osteoblastic bone metastasis in Zollinger-Ellison syndrome

Area of Science:

• Oncology
• Endocrinology
• Gastroenterology

Background:

• Zollinger-Ellison syndrome is characterized by hypergastrinemia due to a neuroendocrine tumor, typically in the pancreas or duodenum.
• Gastric hyperacidity is a hallmark symptom, often necessitating surgical intervention like gastrectomy.
• Metastatic disease can occur, but osteoblastic metastases are rare in this context.

Observation:

• A 53-year-old woman with Zollinger-Ellison syndrome presented with a pancreatic tumor.
• Following a total gastrectomy for hyperacidity, she developed a gradually enlarging liver.
• Subsequent development of osteoblastic bone metastases was observed.

Findings:

• The patient received steptozotocin for liver involvement.
• Radiation therapy was administered to sites of bony metastases.
• Complete alleviation of pain was achieved following radiation therapy.

Implications:

• This case highlights a rare presentation of osteoblastic metastasis in Zollinger-Ellison syndrome.
• It underscores the importance of considering diverse metastatic patterns in neuroendocrine tumors.
• Effective pain management strategies for bone metastases in this syndrome are demonstrated.