| Theme | Update on Pancreatic Neuroendocrine Tumors | |
|---|---|---|
| Title | Diagnosis of Gastrinomas | |
| Publish Date | 2018/08 | |
| Author | Izumi Komoto | Department of Surgery, Kansai Electric Power Hospital / Neuroendocrine Tumor Center, Kansai Electric Power Hospital / Kansai Electric Power Medical Research Institute |
| Author | Yohei Hosoda | Department of Surgery, Kansai Electric Power Hospital / Neuroendocrine Tumor Center, Kansai Electric Power Hospital |
| Author | Masayuki Imamura | Department of Surgery, Kansai Electric Power Hospital / Neuroendocrine Tumor Center, Kansai Electric Power Hospital / Kansai Electric Power Medical Research Institute |
| [ Summary ] | Gastrinomas secrete gastrin and cause clinical syndromes such as severe peptic ulcer disease and diarrhea. Serum gastrin measurement alone is inadequate to diagnose gastrinomas because hypergastrinemia may be related to the use of proton pump inhibitors, and chronic atrophic gastritis, Helicobacter pylori infection, and/or renal failure. The differential diagnoses must include these conditions to accurately diagnose gastrinomas. Accurate localization of a gastrinoma is important to select the appropriate treatment. However, occasionally, an accurate localization of gastrinomas is difficult because a few gastrinomas are very small, particularly duodenal and pancreatic gastrinomas and those associated with multiple endocrine neoplasia type 1 (MEN1). Conventional CT, MRI and endoscopy serve as first-line localization modalities. EUS, SASI test, and somatostatin receptor scintigraphy are helpful when conventional localization studies are negative. Because of the frequency of MEN1 in gastrinomas, all patients with gastrinomas should undergo biochemical studies for MEN1. |
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