Primary hepatic gastrinoma as an unusual manifestation of zollinger-ellison syndrome.
Primary hepatic gastrinoma as an unusual manifestation of zollinger-ellison syndrome.
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DOI：
10.1159/000343157
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发表时间：
2012-09
影响因子：
0.6
通讯作者：
Sasaki Y
中科院分区：
文献类型：
--
作者：
Naoe H;Iwasaki H;Kawasaki T;Ozaki T;Tsutsumi H;Okuda A;Konoe T;Nonaka K;Kaku E;Shono T;Yokomine K;Sakurai K;Iyama K;Hirota M;Sasaki Y
我们报告一例罕见的原发性肝胃泌素瘤。一位77岁的女性表现出连续8个月的水样腹泻和体重减轻。粪便细菌培养阴性，结肠镜检查未发现异常。食管胃镜检查显示严重反流性食管炎和多处十二指肠糜烂。计算机断层扫描和磁共振成像检测到两个实性肿块测量直径<2厘米，在右叶的非肝硬化。显微镜下，肿瘤与神经内分泌肿瘤（2级）一致，具有丰富的胃泌素免疫反应细胞。内镜超声检查未发现内分泌肿瘤的其他替代主要来源。在不给予H2受体拮抗剂和质子泵抑制剂的情况下，血清胃泌素水平超过40，000 pg/ml。基于动脉刺激和静脉取样试验，患者被诊断为肝脏原发性胃泌素瘤。我们的研究结果表明，Zollinger-Ellison综合征的存在下，谁后来治愈的手术切除肝脏肿瘤的患者。
We report a rare case of primary hepatic gastrinoma. A 77-year-old woman exhibited continuous watery diarrhea for 8 months and weight loss. Bacterial cultures of the stools were negative and colonoscopy revealed no abnormalities. Esophagogastroduodenoscopy showed severe reflux esophagitis and multiple duodenal erosions. Computed tomography and magnetic resonance imaging detected two solid masses measuring <2 cm in diameter in the right lobe of the non-cirrhotic liver. Microscopically, the tumor was consistent with neuroendocrine tumor (grade 2) with abundant gastrin-immunoreactive cells. Endoscopic ultrasound detected no other alternative primary source of an endocrine tumor. The serum gastrin levels exceeded 40,000 pg/ml in the absence of H2 receptor antagonist and proton pump inhibitor administrations. Based on an arterial stimulation and venous sampling test, the patient was diagnosed as primary gastrinoma of the liver. Our findings demonstrated the presence of Zollinger-Ellison syndrome in a patient who was subsequently cured by surgical resection of the liver tumors.