Journal
DIGESTION
Volume 77, Issue 2, Pages 92-95Publisher
KARGER
DOI: 10.1159/000122229
Keywords
gastrinoma; carcinoid tumor; duodenum; somatostatin analogs; metastasis; octreotide; neuroendocrine tumors; somatostatin receptor scintigraphy
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Gastrinomas may occur in the pancreas, duodenum or peri-pancreatic lymph nodes. The gastrin overproduction leads to the Zollinger-Ellison syndrome with multiple gastric and duoudenal ulcers and diarrhea. About two thirds of gastrinomas are malignant. Diagnosis is made by clinical history, gastroscopy, and measurement of serum gastrin, gastric juice pH, CT scan, endoscopic ultrasonography and somatostatin receptor scintigraphy. Surgery should always be considered if the liver is not involved. Proton pump inhibitors offer symptomatic relief. Medical therapy for tumor control includes biotherapy with alpha-interferon and somatostatin analogs yielding a response rate of about 10-15%, chemotherapy or targeted radiotherapy. We describe a patient with almost complete response on treatment with Sandostatin LAR (R), a long-acting somatostatin analog. In patients with metastatic gastrinomas not suitable for chemotherapy, interferon or targeted radiotherapy, single therapy with somatostatin analogs may be an alternative. Copyright (C) 2008 S. Karger AG, Basel.
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