What is a gastrinoma
Gastrinomas are rare endocrine tumors and commonly present with severe recurrent peptic ulcer disease. More than 60% of gastrinomas are cancerous and the tumor eventually spreads to the liver and other parts of the body.
How are gastrinomas diagnosed?
A diagnosis of a gastrinoma should be considered in a patient with peptic ulcers that recur frequently and are resistant to treatment. A biochemical study to measure the level of gastrin and its response to a hormone called secretin is utilized to make the diagnosis.
Once a diagnosis is made, localizing the tumor is important. Most gastrinomas are small lesions and therefore, localizing the tumor may be difficult. Some of the tests that are performed to localize the tumor include a CT scan, octreotide scan and MRI and an endoscopic ultrasound.
An experienced surgeon will detect these tumors at surgery even when they are not visible on preoperative imaging tests
How are gastrinomas treated?
Treatment of choice for gastrinoma is to remove the surgically where possible. Peptic ulcers must be aggressively treated and controlled prior to surgery. The type of surgery for gastrinomas depends on the location of the tumor. Since these tumors may frequently occur at more than one spot in the pancreas and the surrounding tissues more than one procedure may be required. The following operative procedures may be utilized to treat gastrinomas.
Other islet cell tumors of the pancreas
Other neuroendocrine tumors such as glucagonoma, VIPoma and somastatinoma
are extremely uncommon tumors. These tumors are malignant in the vast
majority of patients and may present as large tumors at the time of diagnosis.
Up to 70% of patients have evidence of spread of the tumor at the time
of the diagnosis? Aggressive surgical removal of as much tumor as possible
is often indicated to relieve some of the severe symptoms that these tumors
may cause because of secretion of hormones from these tumors.
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