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Research Article| Volume 116, ISSUE 6, P1123-1130, December 1994

Apparent lymph node primary gastrinoma

  • W.Scott Arnold
    Affiliations
    Surgical Metabolism Section, Surgery Branch, National Cancer Institute, and the National Institute of Diabetes, Digestive, and Kidney Diseases, National Institutes of Health, Bethesda, Md., USA
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  • Douglas L. Fraker
    Correspondence
    Reprint requests: Douglas L. Fraker, MD, Head, Surgical Metabolism Section, Surgery Branch, National Cancer Institute/NIH, Bldg. 10, Room 2B07, Bethesda, MD 20892.
    Affiliations
    Surgical Metabolism Section, Surgery Branch, National Cancer Institute, and the National Institute of Diabetes, Digestive, and Kidney Diseases, National Institutes of Health, Bethesda, Md., USA
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  • H.Richard Alexander
    Affiliations
    Surgical Metabolism Section, Surgery Branch, National Cancer Institute, and the National Institute of Diabetes, Digestive, and Kidney Diseases, National Institutes of Health, Bethesda, Md., USA
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  • H.Christian Weber
    Affiliations
    Surgical Metabolism Section, Surgery Branch, National Cancer Institute, and the National Institute of Diabetes, Digestive, and Kidney Diseases, National Institutes of Health, Bethesda, Md., USA
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  • Jeffrey A. Norton
    Footnotes
    Affiliations
    Surgical Metabolism Section, Surgery Branch, National Cancer Institute, and the National Institute of Diabetes, Digestive, and Kidney Diseases, National Institutes of Health, Bethesda, Md., USA
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  • Robert T. Jensen
    Affiliations
    Surgical Metabolism Section, Surgery Branch, National Cancer Institute, and the National Institute of Diabetes, Digestive, and Kidney Diseases, National Institutes of Health, Bethesda, Md., USA
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  • Author Footnotes
    a Current address: Department of Surgery, Washington University School of Medicine, St. Louis, Mo.
DOI:https://doi.org/10.5555/uri:pii:003960609490314X
Apparent lymph node primary gastrinoma
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      Abstract

      Background. The existence of lymph node (LN) primary gastrinoma as a cause of Zollinger-Ellison syndrome is controversial. We reviewed our experience with patients in whom gastrinomas were identified and excised only from LNs.
      Methods. From 1982 to 1992, 110 patients with ZES underwent exploration for gastrinoma and 21 (19%) had disease limited to one or more LNs. Standardized exploration included intraoperative ultrasonography, introoperative endoscopy with transillumination, and exploratory duodenotomy in 86%, 67%, and 24% of patients, respectively. Each patient underwent yearly biochemical and radiologic follow-up.
      Results. Thirteen patients (62%) with a median follow-up period of 5.8 years had an initial biochemical cure, whereas eight patients (38%) with a median follow-up period of 3.6 years had persistent disease. Of the 13 patients whose condition initially returned to normal, four have had biochemical recurrence, with a median time to recurrence of 4.2 years and a median follow-up period of 7.4 years. Nine patients (43%) remain biochemically cured, with a median follow-up period of 5.3 years.
      Conclusions. Resection of apparent LN primary gastrinoma is warranted, because 43% of those who underwent resection had no evidence of disease, with a median follow-up period of 5.3 years.
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      References

        • Bhagavan B.S.
        • Slavin R.E.
        • Goldberg J.
        • Rao R.N.
        Ectopic gastrinoma andthe Zollinger-Ellison syndrome.
        Hum Pathol. 1986; 17: 584-592
        • Bornman P.C.
        • Marks I.N.
        • Mee A.S.
        • Price S.
        Favourable response to conservative surgery for extra-pancreatic gastrinoma with lymph node metastases.
        Br J Surg. 1987; 74: 198-201
        • Delcore Jr, R.
        • Cheung L.Y.
        • Friesen S.R.
        Outcome of lymph node involvement in patients with Zollinger-Ellison syndrome.
        Ann Surg. 1988; 208: 291-298
        • Farley D.R.
        • van Heerden J.A.
        • Grant C.S.
        • Miller L.J.
        • Ilstrup S.N.
        The Zollinger-Ellison syndrome: a collective surgical experience.
        Ann Surg. 1992; 215: 561-570
        • Fox P.S.
        • Hofmann J.W.
        • DeCosse J.J.
        • Wilson S.D.
        The influence of total gastrectomy on survival in malignant Zollinger-Ellison tumors.
        Ann Surg. 1974; 180: 558-566
        • Howard T.J.
        • Zinner M.J.
        • Stabile B.E.
        • Passaro Jr, E.
        Gastrinoma excision for cure.
        Ann Surg. 1990; 211: 9-14
        • Kaplan E.L.
        • Horvath K.
        • Udekwu A.
        • et al.
        Gastrinomas: a 42year experience.
        World J Surg. 1990; 14: 365-376
        • Kitagawa M.
        • Hayakawa T.
        • Kondo T.
        • et al.
        Gastrinoma in a mesenteric lymph node.
        Am J Gastroenterol. 1989; 84: 660-662
        • Mee A.S.
        • Bornman P.L.
        • Marks I.N.
        Conservative surgery in the Zollinger-Ellison syndrome.
        Br J Surg. 1984; 71: 423-424
        • Richardson C.T.
        • Feldman M.
        • McClelland R.N.
        • Dickerman R.M.
        • Kumpuris D.
        • Fordstran J.S.
        Effect of vagotomy in Zollinger-Ellison syndrome.
        Gastroenterology. 1979; 77: 682-686
        • Schwartz D.L.
        • White J.J.
        • Saulsbury F.
        • Haller J.A.
        Gastrin response to calcium infusion: an aid to the improved diagnosis of Zollinger-Ellison syndrome in children.
        Pediatrics. 1974; 54: 599-602
        • Sircus W.
        Vagotomy in ZE syndrome [letter].
        Gastroenterology. 1980; 79: 607-608
        • Stabile B.E.
        • Passaro E.
        Benign and malignant gastrinoma.
        Am J Surg. 1984; 149: 144-150
        • Stremple J.F.
        Gastrinomas-gastrin producing tumors.
        Surg Clin North Am. 1975; 55: 303-323
        • Thompson J.C.
        • Lewis B.G.
        • Wiener I.
        • Townsend C.M.
        The role of surgery in the Zollinger-Ellison syndrome.
        Ann Surg. 1983; 197: 594-607
        • Thompson N.W.
        • Vinik A.I.
        • Eckhauser F.E.
        • Strodel W.E.
        Extrapancreatic gastrinomas.
        Surgery. 1985; 98: 1113-1120
        • Vogel S.B.
        • Wolfe M.M.
        • McGuigan J.E.
        Localization and resection of gastrinomas in Zollinger-Ellison syndrome.
        Ann Surg. 1987; 205: 550-556
        • Wilson S.D.
        The role of surgery in children with Zollinger-Ellison syndrome.
        Surgery. 1982; 92: 682-692
        • Wolfe M.M.
        • Alexander R.W.
        • McGuigan J.E.
        Extrapancreatic, extraintestinal gastrinoma: effective treatment by surgery.
        N Engl J Med. 1982; 306: 1533-1536
        • Friesen S.R.
        Treatment of the Zollinger-Ellison syndrome.
        Am J Surg. 1982; 143: 331-338
        • Burmester H.B.C.
        • Hall R.
        • Munawer N.
        The Zollinger-Ellison syndrome in a child.
        Gut. 1969; 10: 800-803
        • Norton J.A.
        • Doppman J.L.
        • Jensen R.T.
        Curative resection in Zollinger-Ellison syndrome: results of a 10 year prospective study.
        Ann Surg. 1992; 215: 8-18
        • Thompson N.W.
        • Vinik A.I.
        • Eckhauser F.E.
        Microgastrinomas of the duodenum.
        Ann Surg. 1989; 209: 396-404
        • Longo L.
        Benign lymph node enclusion.
        Hum Pathol. 1976; 7: 349-354
        • Friesen S.R.
        Are “aberrant nodal gastrinomas” pathogenetically similar to “lateral aberrant thyroid” nodules?.
        Surgery. 1990; 107: 236-238

      Article info

      Footnotes

      ☆Presented at the Fifteenth Annual Meeting of the American Association of Endocrine Surgeons, Dearborn, Mich., April 17–19, 1994.

      Identification

      DOI: https://doi.org/10.5555/uri:pii:003960609490314X

      Copyright

      © 1994 Published by Elsevier Inc.

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