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A New Look at Regression of Gastrinomas

Romano Delcore, MD; Stanley R. Friesen, MD

Arch Surg. 1991;126(5):556-558.

Abstract
• Of 44 patients with the Zollinger-Ellison syndrome treated at our institution, nine appeared to have undergone "regression" of their gastrinomas. Six of the nine patients had sporadic gastrinomas and became permanently eugastrinemic following excision of nodal metastases and total gastrectomy (n = 4), antrectomy (n=1), or pancreatoduodenectomy (n-1) (mean survival, 13 years). The other three patients had Zollinger-Ellison syndrome as part of the multiple endocrine adenopathy type 1 syndrome and became temporarily eugastrinemic after total gastrectomy (mean survival, 11 years). Occult submucosal duodenal-wall microgastrinomas (mean size, 3.0 mm) were found to have been serendipitously excised in four patients. Long-term follow-up of these nine patients, as well as of six other patients described in the literature, demonstrates that excision of occult duodenal-wall gastrinomas provides a plausible explanation for the phenomenon of apparent regression of primary gastrinomas and the eugastrinemia that may follow total gastrectomy.

(Arch Surg. 1991;126:556-558)

Author Affiliations
From the Department of Surgery, the University of Kansas Medical Center, Kansas City.

Footnotes
Accepted for publication January 20, 1991.

Reprint requests to the Department of Surgery, University of Kansas Medical Center, 39th and Rainbow Blvd, Kansas City, KS 66103 (Dr Delcore).

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