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Octreotide in control of multiple liver metastases from gastrinoma
Fumito Saijo1, Hiroo Naito, Yuji Funayama
1Division of Biological Regulation and Oncology, Department of Surgery, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai 980-8574, Japan.
Abstract:
The somatostatin analogue octreotide was effective in controlling systemic effects related to multiple liver metastases from a gastrinoma. A 61-year-old man underwent distal gastrectomy for gastrinoma in the duodenum, because a curative resection was not feasible due to metastases found in paraaortic lymph nodes during operation. Multiple liver metastases, associated with an increase in serum gastrin concentration, were found by magnetic resonance imaging 16 months after the operation. Although chemotherapy with dimethyltrizenoimidazole carboxamide was not effective, subcutaneous administration of octreotide was effective in controlling the growth of the liver metastases and in stabilizing serum gastrin. The patient now receives subcutaneous injections of octreotide, at 200 microg a day, twice a week, as an outpatient.
Insights
Octreotide, a somatostatin analogue, effectively controlled liver metastases from gastrinoma. This treatment stabilized serum gastrin levels and tumor growth in a patient unresponsive to chemotherapy.
Area of Science:
- Oncology
- Endocrinology
Background:
- Gastrinoma, a neuroendocrine tumor, can lead to significant morbidity due to hormone hypersecretion and metastasis.
- Surgical resection is the primary treatment, but metastatic disease often precludes a curative outcome.
Observation:
- A patient with duodenal gastrinoma developed multiple liver metastases 16 months post-surgery.
- Elevated serum gastrin concentrations correlated with metastatic progression.
- Initial chemotherapy with dimethyltrizenoimidazole carboxamide proved ineffective.
Findings:
- Subcutaneous octreotide administration demonstrated efficacy in controlling liver metastases growth.
- Octreotide treatment successfully stabilized serum gastrin levels.
- The patient achieved disease control as an outpatient with twice-weekly octreotide injections.
Implications:
- Somatostatin analogues like octreotide represent a viable therapeutic option for managing metastatic gastrinoma.
- Octreotide offers a potential strategy for controlling systemic effects and tumor progression in advanced neuroendocrine tumors.
- This case highlights the importance of long-term monitoring and tailored treatment for patients with metastatic gastrinoma.
