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A foregut carcinoid tumor causing Zollinger-Ellison syndrome
G B Werbel1, S P Nelson, P G Robinson
1Department of Surgery, Veterans Administration Lakeside Medical Center, Chicago, IL.
Archives of Surgery (Chicago, Ill. : 1960)
|March 1, 1989
Summary
A rare gastric carcinoid tumor caused Zollinger-Ellison syndrome by producing excess gastrin. Surgical removal normalized gastrin levels and resolved severe peptic ulcer disease complications.
Area of Science:
- Gastroenterology
- Surgical Oncology
- Endocrinology
Background:
- Peptic ulcer disease can present with severe complications like gastric outlet obstruction and fistulas.
- Zollinger-Ellison syndrome is characterized by hypergastrinemia leading to acid-related disorders.
Observation:
- A patient with severe peptic ulcer disease and elevated serum gastrin levels underwent surgery.
- A 1.5-cm benign gastric carcinoid tumor in the antrum was identified as the source of gastrin production.
Findings:
- Surgical resection of the gastric carcinoid tumor normalized serum gastrin levels.
- The patient's peptic acid diathesis and associated complications resolved post-surgery.
- Immunohistochemistry confirmed the carcinoid tumor contained gastrin, chromogranin, cholecystokinin, and neuron-specific enolase.
Implications:
- This case highlights gastric carcinoid tumors as a potential cause of Zollinger-Ellison syndrome.
- Benign foregut carcinoids can secrete gastrin, leading to significant gastrointestinal pathology.
- Surgical management of such tumors can effectively treat hypergastrinemia and related conditions.