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A Theory

Edward Passaro, Jr, MD; Thomas J. Howard, MD; Mark P. Sawicki, MD; Philip C. Watt, MD; Bruce E. Stabile, MD

Arch Surg. 1998;133:13-16.

Sporadic gastrinomas are found predominantly within the gastrinoma triangle (85%), frequently within lymph nodes in the triangle (40%) and often multiple (40%). In addition, they are homologous with pancreatic polypeptidomas and express pancreatic polypeptide. We hypothesized that, if gastrinomas were of ventral pancreatic bud origin, several (7) predictions could be made. The data from the investigation of these predictions have supported the theory. We postulate that sporadic gastrinomas in the triangle arise from stem cells from the ventral pancreatic bud that become dispersed and incorporated into lymph tissue and the duodenal wall during the ventral bud's embryonic dorsal rotation within the area of the triangle.

From the Surgical Services, West Los Angeles Veterans Affairs Medical Center (Drs Passaro, Sawicki, and Watt), and the Roudebush Veterans Affairs Medical Center (Dr Howard); and the Department of Surgery, Harbor University of California at Los Angeles Medical Center (Dr Stabile), Los Angeles.

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