Gastrinoma: Difference between revisions

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{{Infobox medical condition (new)
{{SI}}
| name           = Gastrinoma
{{Infobox medical condition
| synonyms        =
| name                   = Gastrinoma
| image           = Gastric_neuroendocrine_tumour_-_intermed_mag.jpg
| image                   = [[File:Gastric_neuroendocrine_tumour_-_intermed_mag.jpg|left|thumb|Gastrinoma under intermediate magnification]]
| width          = 200
| caption                = Histopathological image of a gastrinoma
| caption        = [[Micrograph]] of a [[neuroendocrine tumour]] of the stomach. [[H&E stain]].
| field                  = [[Endocrinology]]
| pronounce      =
| synonyms                = Zollinger-Ellison syndrome
| field           = [[General surgery]]
| symptoms                = [[Abdominal pain]], [[diarrhea]], [[gastroesophageal reflux disease]]
| symptoms        =
| complications           = [[Peptic ulcer disease]], [[esophagitis]], [[malabsorption]]
| complications  =
| onset                   = Typically between ages 30 and 50
| onset           =  
| duration               = Chronic
| duration       =
| causes                 = [[Neuroendocrine tumor]] of the [[pancreas]] or [[duodenum]]
| types          =  
| risks                   = [[Multiple endocrine neoplasia type 1]] (MEN1)
| causes         =  
| diagnosis               = [[Serum gastrin level]], [[secretin stimulation test]], [[imaging studies]]
| risks           =  
| differential           = [[Peptic ulcer disease]], [[Helicobacter pylori]] infection, [[hypercalcemia]]
| diagnosis       =  
| treatment               = [[Proton pump inhibitors]], [[surgical resection]], [[somatostatin analogs]]
| differential   =
| medication             = [[Omeprazole]], [[Lansoprazole]], [[Octreotide]]
| prevention      =  
| prognosis               = Variable, depending on metastasis
| treatment       =  
| frequency               = Rare
| medication     =  
| deaths                 = Dependent on stage and treatment
| prognosis       =  
| frequency       =  
| deaths         =  
}}
}}
A '''gastrinoma''' is a [[tumor]] in the pancreas or duodenum that secretes excess of [[gastrin]] leading to ulceration in the duodenum, stomach and the small intestine. There is hypersecretion of HCl acid into the duodenum, which causes the ulcers. Excessive HCl acid production also causes hyperperistalsis, and inhibits the activity of lipase, causing severe diarrhea.
{{Short description|A type of tumor that secretes gastrin}}
 
==Gastrinoma==
It is frequently the source of the gastrin in [[Zollinger-Ellison syndrome]].<ref name="urlDorlands Medical Dictionary:gastrinoma">{{cite web |url=http://www.mercksource.com/pp/us/cns/cns_hl_dorlands_split.jsp?pg=/ppdocs/us/common/dorlands/dorland/four/000043773.htm |title=Dorlands Medical Dictionary:gastrinoma |work= |accessdate=}}</ref>
A '''gastrinoma''' is a type of [[neuroendocrine tumor]] that secretes excessive amounts of the hormone [[gastrin]]. This hormone stimulates the stomach to produce acid, leading to [[peptic ulcers]] and other gastrointestinal symptoms. Gastrinomas are often associated with a condition known as [[Zollinger-Ellison syndrome]].
 
==Pathophysiology==
It is usually found in the duodenum, although it may arise in the stomach or pancreas. Those occurring in the pancreas have a greater potential for malignancy. Most gastrinomas are found in the [[gastrinoma triangle]]; this is bound by the junction of cystic and common bile ducts, junction of the second and third parts of the duodenum, and the junction of the neck and body of the pancreas.
Gastrinomas arise from the [[G cells]] of the [[duodenum]] or the [[pancreas]]. These tumors are part of a group of [[neuroendocrine tumors]] that can secrete various hormones. The overproduction of gastrin by these tumors leads to increased gastric acid secretion, which can cause recurrent and severe [[peptic ulcers]], [[gastroesophageal reflux disease]] (GERD), and [[diarrhea]].
 
==Clinical Presentation==
==Signs and symptoms==
Patients with gastrinomas typically present with symptoms related to excessive gastric acid production. These include:
Gastrinoma causes the following symptoms:{{mcn|date=March 2017}}
* Recurrent [[peptic ulcers]], often in unusual locations such as the [[jejunum]].
*[[Hypergastrinemia]]
* Abdominal pain.
*[[Ulcers]] of the [[duodenum]], stomach, and small intestine.
* [[Diarrhea]], which may be severe and persistent.
*Severe [[diarrhea]].
* [[Gastroesophageal reflux disease]] (GERD).
*Generalized cancer symptoms.
* [[Weight loss]] due to malabsorption and chronic diarrhea.
 
==Diagnosis==
==Diagnosis==
*Fasting serum gastrin
The diagnosis of gastrinoma involves several steps:
*In case of moderate hypergastrinemia, a secretin stimulation test can help in the diagnosis
* Measurement of fasting serum gastrin levels, which are typically elevated.
*Localization by somatostatin scintigraphy
* Secretin stimulation test, which can help differentiate gastrinomas from other causes of hypergastrinemia.
 
* Imaging studies such as [[CT scan]], [[MRI]], or [[somatostatin receptor scintigraphy]] to localize the tumor.
* Endoscopic ultrasound may be used to identify small tumors in the pancreas or duodenum.
==Treatment==
==Treatment==
Treatment can involve [[surgery]] or [[proton pump inhibitor]]s.{{Citation needed|date=September 2016}}
The treatment of gastrinoma involves both medical and surgical approaches:
 
* '''Medical management''': High-dose [[proton pump inhibitors]] (PPIs) are used to control gastric acid secretion and manage symptoms.
* '''Surgical resection''': If the tumor is localized and resectable, surgical removal is the preferred treatment.
* '''Management of metastatic disease''': In cases where the tumor has metastasized, treatment may include [[chemotherapy]], [[targeted therapy]], or [[liver-directed therapies]] such as embolization.
==Prognosis==
The prognosis of gastrinoma depends on several factors, including the size and location of the tumor, the presence of metastases, and the patient's overall health. Early detection and treatment can improve outcomes, but metastatic disease may require long-term management.
==See also==
==See also==
* [[Multiple endocrine neoplasia type 1]]
* [[Zollinger-Ellison syndrome]]
 
* [[Neuroendocrine tumor]]
==References==
* [[Peptic ulcer disease]]
{{reflist}}
* [[Gastroesophageal reflux disease]]
 
==External links==
{{Medical resources
| DiseasesDB      = 14279
| ICD10          =
| ICD9            =
| ICDO            = {{ICDO|8153|1}}
| OMIM            =
| MedlinePlus    =
| eMedicineSubj  = med
| eMedicineTopic  = 2678
| MeshID          = D015408
}}
* [http://emedicine.medscape.com/article/184332-overview Emedicine]
 
{{Tumor histology}}
{{Endocrine gland neoplasia}}
 
[[Category:Endocrine neoplasia]]
[[Category:Endocrine neoplasia]]
 
[[Category:Gastroenterology]]
 
[[Category:Rare diseases]]
{{neoplasm-stub}}
 
== Gastrinoma ==
<gallery>
File:Gastric_neuroendocrine_tumour_-_intermed_mag.jpg
</gallery>

Latest revision as of 01:50, 7 April 2025

Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
Founder, WikiMD Wellnesspedia &
W8MD medical weight loss NYC and sleep center NYC

Gastrinoma
Gastrinoma under intermediate magnification
Synonyms Zollinger-Ellison syndrome
Pronounce N/A
Specialty N/A
Symptoms Abdominal pain, diarrhea, gastroesophageal reflux disease
Complications Peptic ulcer disease, esophagitis, malabsorption
Onset Typically between ages 30 and 50
Duration Chronic
Types N/A
Causes Neuroendocrine tumor of the pancreas or duodenum
Risks Multiple endocrine neoplasia type 1 (MEN1)
Diagnosis Serum gastrin level, secretin stimulation test, imaging studies
Differential diagnosis Peptic ulcer disease, Helicobacter pylori infection, hypercalcemia
Prevention N/A
Treatment Proton pump inhibitors, surgical resection, somatostatin analogs
Medication Omeprazole, Lansoprazole, Octreotide
Prognosis Variable, depending on metastasis
Frequency Rare
Deaths Dependent on stage and treatment


A type of tumor that secretes gastrin


Gastrinoma[edit]

A gastrinoma is a type of neuroendocrine tumor that secretes excessive amounts of the hormone gastrin. This hormone stimulates the stomach to produce acid, leading to peptic ulcers and other gastrointestinal symptoms. Gastrinomas are often associated with a condition known as Zollinger-Ellison syndrome.

Pathophysiology[edit]

Gastrinomas arise from the G cells of the duodenum or the pancreas. These tumors are part of a group of neuroendocrine tumors that can secrete various hormones. The overproduction of gastrin by these tumors leads to increased gastric acid secretion, which can cause recurrent and severe peptic ulcers, gastroesophageal reflux disease (GERD), and diarrhea.

Clinical Presentation[edit]

Patients with gastrinomas typically present with symptoms related to excessive gastric acid production. These include:

Diagnosis[edit]

The diagnosis of gastrinoma involves several steps:

  • Measurement of fasting serum gastrin levels, which are typically elevated.
  • Secretin stimulation test, which can help differentiate gastrinomas from other causes of hypergastrinemia.
  • Imaging studies such as CT scan, MRI, or somatostatin receptor scintigraphy to localize the tumor.
  • Endoscopic ultrasound may be used to identify small tumors in the pancreas or duodenum.

Treatment[edit]

The treatment of gastrinoma involves both medical and surgical approaches:

  • Medical management: High-dose proton pump inhibitors (PPIs) are used to control gastric acid secretion and manage symptoms.
  • Surgical resection: If the tumor is localized and resectable, surgical removal is the preferred treatment.
  • Management of metastatic disease: In cases where the tumor has metastasized, treatment may include chemotherapy, targeted therapy, or liver-directed therapies such as embolization.

Prognosis[edit]

The prognosis of gastrinoma depends on several factors, including the size and location of the tumor, the presence of metastases, and the patient's overall health. Early detection and treatment can improve outcomes, but metastatic disease may require long-term management.

See also[edit]