Localization of hormone-producing gastrointestinal tumours by ultrasonic scanning

The value of ultrasonic scanning in the localization of hormone producing gastrointestinal tumours was assessed in 16 patients. Fifteen patients had Zollinger-Ellison syndrome and one patient had a VIP tumour. In four patients with Zollinger-Ellison syndrome ultrasonic scanning demonstrated a solid mass lesion of the head of the pancreas of 2.2.4 and 8 cm respectively. One of these diagnoses was verified by autopsy, one was also found by subsequent CT-scanning and angiography. In one patient ultrasonic scanning demonstrated a 3 cm tumour of the tail of the pancreas. At ultrasonically guided percutaneous fine needle biopsy tumour cells were aspirated. Biochemistry confirmed a VIP tumour. In 11 patients ultrasonic scanning was normal. By laparotomy in nine of these tumours of 1--3 cm were found in three patients 5.9 and 15 months after scanning and in two patients multiple 0.5 cm tumours within the duodenal wall were demonstrated one half and 9 months after ultrasound. In four patients tumours were not demonstrated by surgery. Two of the 11 patients were not operated upon, and the tumours have not been localized. The advantages of the complete atraumatic, rapid and relatively cheap ultrasound technique and the ability of an ultrasonically guided biopsy for the demonstration of malignancy justify ultrasonic scanning to be an initial method of investigation in the localization of hormone producing gastrointestinal tumours.