The dichotomous distribution of gastrinomas
M. P. Sawicki, T. J. Howard, M. Dalton, B. E. Stabile and E. Passaro Jr
Department of Surgery, UCLA School of Medicine.
Our experience with 47 sporadic gastrinomas suggests that no less than 85%
of these tumors are located to the right of the superior mesenteric artery.
This finding is unexpected because approximately 75% of insulinomas and
glucagonomas are located to the left of the superior mesenteric artery. All
of our extrapancreatic gastrinomas have been located to the right. These
observations prompted us to determine if other extrapancreatic gastrinomas
were also predominantly located to the right side. We searched the world's
literature and found 10 cases of ovarian gastrinomas and one case of a
renal gastrinoma. Nine of these remote extrapancreatic gastrinomas were
located on the right side. This distribution of remote extrapancreatic
gastrinomas is similar to our experience with peripancreatic gastrinomas.
This unexpected right-sided preponderance of both remote and peripancreatic
gastrinomas suggests a common origin for both.
