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Primary Lymph Node Gastrinoma or Metastatic Gastrinoma with Unidentified Primary Tumor Site?

#690

Introduction: The existence of primary lymph node gastrinoma remains controversial.

Aim(s): Investigation of a lymph node containing a gastrinoma with an unidentified primary tumor.

Materials and methods: We report on a male aged 42 presenting in 1999 with nausea, vomiting and reflux symptoms (1). ZES was diagnosed but no tumor was identified and PPI treatment did not improve symptoms. Fasting plasma gastrin and basal gastric acid production was elevated but chromogranin A was normal. EUS showed a thickened duodenal wall. On repeated EUS in 2010 a 5x8 mm prepyloric mass was revealed which was positive on 68 Ga DOTATATE PET/CT and confirmed on angiography. Chromogranin A was elevated (90 pmol/l) and fasting plasma gastrin further elevated (290 pmol/l).

Conference: 10th Annual ENETSConcerence (2013)

Presenting Author:

Authors: Martin J, Tedeschi M, Jackson J, Spalding D, Goldstone A,

Keywords: gastrinoma, lymph node,

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