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- Title
Primary Lymph Node Gastrinoma or Metastatic Gastrinoma with Unidentified Primary Tumor Site?
- Authors
Martin, Jack L.; Tedeschi, Michele; Jackson, James E.; Spalding, Duncan; Goldstone, Anthony P.; Cohen, Patrizia; Frilling, Andrea
- Abstract
Gastrinomas are neuroendocrine tumors that secrete gastrin and result in a clinical syndrome of peptic ulcer disease first described by Zollinger and Ellison in 1955.1 They present either sporadically or as a component of a hereditary determined syndrome, multiple endocrine neoplasia type 1. They are usually located in the pancreas and duodenum but have been reported to occur in both abdominal and extraabdominal sites.2 Reports of clinical and biochemical cure following resection of lymph nodes found to contain gastrinomas, in patients without a localized primary tumor, led investigators to cite the existence of the primary lymph node gastrinoma. Whether these cases represent metastatic disease from an, as yet, unidentified primary tumor, or de novo occurrence of a gastrinoma in a lymph node remains controversial. While some authors report that primary lymph node gastrinomas account for up to 10% of sporadic gastrinomas3,4 others question this theory, hypothesizing that their presentation represents an undetected microgastrinoma with metastatic lymph node involvement.5 Herewith, we report on a patient with Zollinger-Ellison syndrome in whom a peripancreatic lymph node with evidence of gastrinoma is the only apparent morphologic manifestation of the disease.
- Subjects
LYMPH node diseases; GASTRINOMA; MORPHOLOGY; ZOLLINGER-Ellison syndrome; BIOCHEMICAL research
- Publication
World Journal of Endocrine Surgery, 2012, Vol 4, Issue 2, p66
- ISSN
0975-5039
- Publication type
Article
- DOI
10.5005/jp-journals-10002-1098