Typical Zollinger-Ellison syndrome-atypical location of gastrinoma and absence of hypergastrinemia:A case report and review of literature  

作　　者：Jin-Ming Zhang Chu-Wei Zheng Xiao-Wen Li Zhi-Yun Fang Mu-Xin Yu Hai-Yan Shen Xia Ji 

机构地区：[1]Department of Gastroenterology,The Second Affiliated Hospital of Jiaxing University,Jiaxing 314001,Zhejiang Province,China [2]Department of Pathology,The Second Affiliated Hospital of Jiaxing University,Jiaxing 314001,Zhejiang Province,China [3]College of Medicine,Jiaxing University,Jiaxing 314001,Zhejiang Province,China

出　　处：《World Journal of Clinical Cases》2023年第26期6223-6230,共8页世界临床病例杂志

基　　金：National Natural Science Foundation of China,No.82100612;Zhejiang Medical Health Science and Technology Plan Project,No.2021KY1116。

摘　　要：BACKGROUND Zollinger–Ellison syndrome(ZES)results from hypersecretion of gastrin from pancreatic or duodenal neuroendocrine tumors,commonly referred to as gastrinomas.The high levels of gastrin lead to a typical presentation involving watery diarrhea and multiple ulcers in the duodenum.Here,we have presented the rare case of a patient with ZES and absence of hypergastrinemia as well as an atypical location of gastrinoma.CASE SUMMARY A 72-year-old woman presented with the typical clinical manifestations of ZES,including upper abdominal pain,significant watery diarrhea,and acidic liquid vomitus.Surprisingly,however,she did not have an increased level of serum gastrin.In addition,there was no evidence of gastrinoma or any other ulcerogenic tumor.Esophagogastroduodenoscopy was conducted to examine the upper digestive tract.Revised diagnoses were considered,and an individualized treatment plan was developed.The patient responded to antacid medication while experiencing intermittent,recurring bouts of ZES.18F-AlF-NOTAoctreotide positron emission tomography(18F-OC PET)/computed tomography(CT)helped locate the tumor.Postoperative pathology and immunohistochemistry results suggested that the tumor was a gastrinoma located at an unconventional site.CONCLUSION This present case study demonstrates the possibility of ZES-like manifestation in patients with absence of hypergastrinemia.18F-OC PET/CT is a relatively new imaging technique that can be applied for diagnosing even tiny gastrinomas that are atypical in terms of location.

关 键 词：Zollinger-Ellison syndrome GASTRINOMA Atypical location Absence of hypergastrinemia 18F-AlF-NOTAoctreotide Case report 

分 类 号：R542.2[医药卫生—心血管疾病]