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Severe chronic diarrhoea secondary to primary lymph node gastrinoma
Mouhanna Abu Ghanimeh1, Khalil Abuamr2, Esmat Sadeddin2
1Internal Medicine, University of Missouri Kansas City School of Medicine, Kansas City, Missouri, USA.
BMJ Case Reports
|April 28, 2017
Summary
This study reports a rare case of primary lymph node (LN) gastrinoma, a controversial diagnosis. The successful surgical removal of the neuroendocrine tumor resolved the patient's symptoms and normalized hormone levels.
Area of Science:
- Endocrinology
- Gastroenterology
- Surgical Oncology
Background:
- Primary lymph node (LN) gastrinoma is a rare and debated entity.
- Its presence often suggests metastasis from an occult primary site, necessitating thorough investigation.
Observation:
- A 48-year-old female presented with chronic abdominal pain and watery diarrhea.
- Elevated serum gastrin and chromogranin levels indicated a suspected gastrinoma.
Findings:
- Diagnostic tests including octreotide scan, endoscopic ultrasound, and secretin stimulation confirmed gastrinoma.
- Histopathological analysis revealed a neuroendocrine tumor within a lymph node, positive for gastrin and chromogranin stains.
- Surgical enucleation of the pancreatic head lesion, with no other identified tumors, led to symptom resolution and normalized hormone levels.
Implications:
- This case supports the possibility of primary lymph node gastrinoma.
- Highlights the importance of comprehensive evaluation and follow-up for suspected gastrinoma, even in atypical locations.
- Successful surgical management of LN gastrinoma can lead to complete remission.
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