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DOI: 10.1055/s-2008-1062727
© J. A. Barth Verlag in Georg Thieme Verlag KG Stuttgart · New York
Lymph Node Gastrinoma in Multiple Endocrine Neoplasia Type 1 – a Diagnostic Challenge
Publikationsverlauf
received 18.12.2007
first decision 15.01.2008
accepted 13.02.2008
Publikationsdatum:
01. April 2008 (online)
Abstract
Background: Gastrinomas are the most frequent hormonally-active neuroendocrine tu-mours in patients with multiple endocrine neoplasia type 1 (MEN1).
Case Report: We report on the diagnostic difficulties in a 62-year-old female patient with MEN1 and lymph node gastrinoma. At six and twelve months after resection of a lymph node gastrinoma, no signs of recurrence were observed. Basal and peak gastrin levels during secretin stimulation test were normalized. Extensive explorations, including gastrointesinal endoscopy, endoscopic ultrasonography, and Ga-68-DOTATOC-PET/CT, did not reveal a primary duodenal or pancreatic tumour.
Conclusion: Localization of gastrinomas in patients with MEN1 is challenging due to their small size, frequent duodenal location, and multiplicity. Therefore, while some studies support the existence of primary lymph node gastrinoma in patients with sporadic disease, this diagnosis should not be made in MEN1 patients. In both cases, however, extensive follow-ups are required
Key words
primary lymph node gastrinoma - MEN1 - neuroendocrine tumor - 68Ga-DOTATOC - somatostatin receptor - sst - gastrin - secretin stimulation test
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Correspondence
Dr. K. MüssigMD
Medizinische Klinik IV
Universitätsklinikum Tübingen
Otfried-Müller-Str. 10
72076 Tübingen
Germany
Telefon: +49/7071/29 83 67 0
Fax: +49/7071/29 27 84
eMail: Karsten.Muessig@med.uni-tuebingen.de