Bulky gastrinoma of the common bile duct: Unusual localization of extrapancreatic gastrinoma case report

AKALIN, Sema; TARÇIN, Özlem; YAVUZ, Dilek; Aydın, Hasan; DEYNELİ, Oğuzhan; ince, umit; Yazıcı, Dilek; SANCAK, SEDA

Bulky gastrinoma of the common bile duct: Unusual localization of extrapancreatic gastrinoma case report

Özlem TARÇIN, (Marmara Üniversitesi, Hastanesi, Endocrinology ve Metabolizma Bölümü, İstanbul, Türkiye)

Dilek YAZICI, (Marmara Üniversitesi, Hastanesi, Endocrinology ve Metabolizma Bölümü, İstanbul, Türkiye)

Ümit İNCE, (Acıbadem Bakırköy Hastanesi, Pathology Kliniği, İstanbul, Türkiye)

Oğuzhan DEYNELİ, (Marmara Üniversitesi, Hastanesi, Endocrinology ve Metabolizma Bölümü, İstanbul, Türkiye)

Seda SANCAK, (Marmara Üniversitesi, Hastanesi, Endocrinology ve Metabolizma Bölümü, İstanbul, Türkiye)

Hasan AYDIN, (Yeditepe Üniversitesi, Hastanesi, Endokrinoloji ve Metabolizma Bölümü, İstanbul, Türkiye)

Dilek YAVUZ, (Marmara Üniversitesi, Hastanesi, Endocrinology ve Metabolizma Bölümü, İstanbul, Türkiye)

Sema AKALIN (Marmara Üniversitesi, Hastanesi, Endocrinology ve Metabolizma Bölümü, İstanbul, Türkiye)

Turkish Journal of Gastroenterology

2 1

Yıl: 2011 Cilt: 22 Sayı: 2 Sayfa Aralığı: 219 - 223 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

Bulky gastrinoma of the common bile duct: Unusual localization of extrapancreatic gastrinoma case report

Öz:

Zollinger-Ellison Sendromu serum gastrin düzeyinde yükseklik, artmış mide asiti, yaygın gastrointestinal ülserasyonlar ve ishal ile karakterizedir. Gastrinomalar sıklıkla (%75) sporadik olarak görülür ve gastrinoma üçgeninde yerleşirler. Cerrahiye gönderilen Zollinger-Ellison Sendromu hastalarının %5.6 kadarı ekstraduodenal, ekstrapankreatik ve ekstranodal gastrinomadır. Hastamız 44 yaşında kadın, 12 yıldır bulantı ve diyare şikâyetleri mevcuttu. Abdominal bilgisayarlı tomografi ve manyetik rezonans görüntülemede homojen, düzgün sınırlı, 6x7 cm solid kitle, karaciğer-sağ böbrek ve inferior vena cava arasında yerleşmiş olduğu görüldü. Somatostatin reseptör pozitişiği bu kitlenin nöroendokrin tümör olduğunu düşündürdü. Hastanın serum gastrin düzeyi çok yüksek bulundu ve hasta cerrahiye verildi. Cerrahi sırasında kitlenin 8x6x5 cm boyutlarında iyi kapsüllü ve koledoktan köken aldığı görüldü. Bu vakanın özelliği çok nadir görülen bir yerleşimde koledoktan köken almış olması ve çok büyük olduğu halde kapsül invazyonu ve metastaz yapmamış olmasıdır.

Anahtar Kelime:

Konular: Cerrahi

Safra yolundan köken alan dev gastrinoma: Nadir görülen ekstrapankreatik yerleşim Vaka sunumu

Öz:

Zollinger-Ellison syndrome is characterized by elevated levels of serum gastrin associated with increased gastric acid secretion, gastrointestinal ulcerations and diarrhea. Most gastrinomas (75%) occur sporadically and are located within the gastrinoma triangle. Extraduodenal, extrapancreatic and extranodal gastrinomas have been shown in 5.6% of the patients with Zollinger-Ellison syndrome who underwent surgery. We report a 44-year-old female who had been complaining of nausea and diarrhea for 12 years. Abdominal computed tomography and magnetic resonance imaging detected a homogeneous, regular-shaped 6 x 7 cm solid mass, located between the liver, right kidney and inferior vena cava. Somatostatin receptor positive scanning led us to investigate a neuroendocrine tumor. Serum gastrin level was found very high and the patient underwent surgery. Local excision of the tumor was performed, and an 8x6x5 cm, well-capsulated, solitary mass, originating from the common bile duct was removed. The unique feature of our case is the unusual localization, and although the tumor was very large in size, only capsule invasion was observed with no evidence of distant metastasis.

Anahtar Kelime:

Konular: Cerrahi

Belge Türü: Makale Makale Türü: Olgu Sunumu Erişim Türü: Erişime Açık

1. Boushey RP. Gastrointestinal hormones and gut endocrine tumors. In: Kronenberg HM, Melmed S, Polonsky KS, Larsen PR, eds. Williams textbook of endocrinology. 10th ed. Pennsylvania: Saunders, 2002; 1790-1.
2. Zollinger RM, Ellison EH. Primary peptic ulcerations of the jejunum associated with islet cell tumors of the pancreas. Ann Surg 1955; 142: 709-23; discussion, 724-8.
3. Roy PK, Venzon DJ, Shojamanesh H, et al. Zollinger-Ellison syndrome. Clinical presentation in 261 patients. Medicine (Baltimore) 2000; 79: 379-411.
4. McCarthy DM, Jensen RT. Zollinger-Ellison syndrome: current issues. 1985; 25.
5. Wu PC, Alexander HR, Bartlett DL, et al. A prospective analysis of the frequency, location, and curability of ectopic (nonpancreaticoduodenal, nonnodal) gastrinoma. Surgery 1997; 122: 1176-82.
6. Bhagavan BS, Slavin RE, Goldberg J, Rao RN. Ectopic gastrinoma and Zollinger-Ellison syndrome. Hum Pathol 1986; 17: 584-92.
7. Fox PS, Hofmann JW, DeCosse JJ, Wilson SD. The influence of total gastrectomy on survival in malignant Zollinger-Ellison tumors. Ann Surg 1974; 180: 558-66.
8. Friesen SR, Bolinger RE, Pearse AG, McGuigan JE. Serum gastrin levels in malignant Zollinger-Ellison syndrome after total gastrectomy and hypophysectomy. Ann Surg 1970; 172: 504-21.
9. Sircus W. Vagotomy in Z-E syndrome. Gastroenterology 1979; 79: 607-8.
10. Stabile BE, Passoro JE. Benign and malignant gastrinoma. Am J Surg 1985; 148: 144-50.
11. Wolfe MM, Alexander RW, McGuigan JE. Extrapancreatic, extraintestinal gastrinoma. N Engl J Med 1982; 306: 1533-6.
12. Zollinger RM. Gastrinoma: factors influencing prognosis. Surgery 1985; 97: 49-54.
13. Mozell E, Stenzel P, Woltering EA, et al. Functional endocrine tumors of the pancreas: clinical presentation, diagnosis, and treatment. Curr Probl Surg 1990; 27: 301-86.
14. Meko JB, Doherty GM, Siegel BA, Norton JA. Evaluation of somatostatin-receptor scintigraphy for detecting neuroendocrine tumors. Surgery 1996; 120: 975-83; discussion 983-4.
15. Anderson MA, Carpenter S, Thompson NW, et al. Endoscopic ultrasound is highly accurate and directs management in patients with neuroendocrine tumors of the pancreas. Am J Gastroenterol 2000; 95: 2271-7.
16. Alexander HR, Fraker DL, Norton JA, et al. Prospective study of somatostatin receptor scintigraphy and its effect on operative outcome in patients with Zollinger-Ellison syndrome. Ann Surg 1998; 228: 228-38.
17. Eriksson B, Oberg K, Stridsberg M. Tumor markers in neuroendocrine tumors. Digestion 2000; 62 (Suppl): 33-8.
18. Hirschowitz BI, Simmons J, Mohnen J. Long-term lansoprazole control of gastric acid and pepsin secretion in ze and non-ze hypersecretors: a prospective 10-year study. Aliment Pharmacol Ther 2001; 15: 1795-806.
19. Norton JA, Fraker DL, Alexander HR, et al.. Surgery to cure the Zollinger-Ellison syndrome. N Engl J Med 1999; 341: 635-44.
20. Martignoni ME, Friess H, Lübke D, et al. Study of a primary gastrinoma in the common hepatic duct a case report. Digestion 1999; 60: 187-90.

APA	TARÇIN Ö, Yazıcı D, ince u, DEYNELİ O, SANCAK S, Aydın H, YAVUZ D, AKALIN S (2011). Bulky gastrinoma of the common bile duct: Unusual localization of extrapancreatic gastrinoma case report. , 219 - 223.
Chicago	TARÇIN Özlem,Yazıcı Dilek,ince umit,DEYNELİ Oğuzhan,SANCAK SEDA,Aydın Hasan,YAVUZ Dilek,AKALIN Sema Bulky gastrinoma of the common bile duct: Unusual localization of extrapancreatic gastrinoma case report. (2011): 219 - 223.
MLA	TARÇIN Özlem,Yazıcı Dilek,ince umit,DEYNELİ Oğuzhan,SANCAK SEDA,Aydın Hasan,YAVUZ Dilek,AKALIN Sema Bulky gastrinoma of the common bile duct: Unusual localization of extrapancreatic gastrinoma case report. , 2011, ss.219 - 223.
AMA	TARÇIN Ö,Yazıcı D,ince u,DEYNELİ O,SANCAK S,Aydın H,YAVUZ D,AKALIN S Bulky gastrinoma of the common bile duct: Unusual localization of extrapancreatic gastrinoma case report. . 2011; 219 - 223.
Vancouver	TARÇIN Ö,Yazıcı D,ince u,DEYNELİ O,SANCAK S,Aydın H,YAVUZ D,AKALIN S Bulky gastrinoma of the common bile duct: Unusual localization of extrapancreatic gastrinoma case report. . 2011; 219 - 223.
IEEE	TARÇIN Ö,Yazıcı D,ince u,DEYNELİ O,SANCAK S,Aydın H,YAVUZ D,AKALIN S "Bulky gastrinoma of the common bile duct: Unusual localization of extrapancreatic gastrinoma case report." , ss.219 - 223, 2011.
ISNAD	TARÇIN, Özlem vd. "Bulky gastrinoma of the common bile duct: Unusual localization of extrapancreatic gastrinoma case report". (2011), 219-223.

APA	TARÇIN Ö, Yazıcı D, ince u, DEYNELİ O, SANCAK S, Aydın H, YAVUZ D, AKALIN S (2011). Bulky gastrinoma of the common bile duct: Unusual localization of extrapancreatic gastrinoma case report. Turkish Journal of Gastroenterology, 22(2), 219 - 223.
Chicago	TARÇIN Özlem,Yazıcı Dilek,ince umit,DEYNELİ Oğuzhan,SANCAK SEDA,Aydın Hasan,YAVUZ Dilek,AKALIN Sema Bulky gastrinoma of the common bile duct: Unusual localization of extrapancreatic gastrinoma case report. Turkish Journal of Gastroenterology 22, no.2 (2011): 219 - 223.
MLA	TARÇIN Özlem,Yazıcı Dilek,ince umit,DEYNELİ Oğuzhan,SANCAK SEDA,Aydın Hasan,YAVUZ Dilek,AKALIN Sema Bulky gastrinoma of the common bile duct: Unusual localization of extrapancreatic gastrinoma case report. Turkish Journal of Gastroenterology, vol.22, no.2, 2011, ss.219 - 223.
AMA	TARÇIN Ö,Yazıcı D,ince u,DEYNELİ O,SANCAK S,Aydın H,YAVUZ D,AKALIN S Bulky gastrinoma of the common bile duct: Unusual localization of extrapancreatic gastrinoma case report. Turkish Journal of Gastroenterology. 2011; 22(2): 219 - 223.
Vancouver	TARÇIN Ö,Yazıcı D,ince u,DEYNELİ O,SANCAK S,Aydın H,YAVUZ D,AKALIN S Bulky gastrinoma of the common bile duct: Unusual localization of extrapancreatic gastrinoma case report. Turkish Journal of Gastroenterology. 2011; 22(2): 219 - 223.
IEEE	TARÇIN Ö,Yazıcı D,ince u,DEYNELİ O,SANCAK S,Aydın H,YAVUZ D,AKALIN S "Bulky gastrinoma of the common bile duct: Unusual localization of extrapancreatic gastrinoma case report." Turkish Journal of Gastroenterology, 22, ss.219 - 223, 2011.
ISNAD	TARÇIN, Özlem vd. "Bulky gastrinoma of the common bile duct: Unusual localization of extrapancreatic gastrinoma case report". Turkish Journal of Gastroenterology 22/2 (2011), 219-223.