Five-Year Long-Term Followup of a Primary Lymph node Gastrinoma: Is a Pancreaticoduodenectomy Justified?

Background. Gastrinoma-positive lymph nodes and failed localization of the primary tumor during surgical exploration are described. Specialists suppose that these lymph nodes are metastases rather than a primary gastrinoma. Methods. Case report with a five-year long-term followup. A 60-year-old pati...

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Bibliographic Details
Main Authors: Bernd Jaenigen, Gian Kayser, Berthold Steinke, Oliver Thomusch
Format: Article
Language:English
Published: Wiley 2009-01-01
Series:Case Reports in Medicine
Online Access:http://dx.doi.org/10.1155/2009/762791
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Summary:Background. Gastrinoma-positive lymph nodes and failed localization of the primary tumor during surgical exploration are described. Specialists suppose that these lymph nodes are metastases rather than a primary gastrinoma. Methods. Case report with a five-year long-term followup. A 60-year-old patient with an confirmed gastrinoma was treated in our department. All preoperative evaluations including somatostatin-receptor-scintigraphy and F-Dopa PET failed to localize the gastrinoma. Explorative laparotomy revealed a gastrinoma in two peripancreatic lymph nodes. Despite extensive intraoperative exploration, no primary gastrinoma could be detected in typical localization. Results. Over a period of 5 years, the patient's gastrin level stayed in the normal range and the patient seems to be completely cured. Conclusion. A prophylactic partial pancreatoduodenectomy is not indicated to avoid recurrence, since complete biochemical cure by local resection of the lymph node gastrinoma is possible.
ISSN:1687-9627
1687-9635