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Five-Year Long-Term Followup of a Primary Lymph node Gastrinoma: Is a Pancreaticoduodenectomy Justified?
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Background. Gastrinoma-positive lymph nodes and failed localization of the primary tumor during surgical exploration are described. Specialists suppose that these lymph nodes are metastases rather than a primary gastrinoma.Methods. Case report with a five-year long-term followup. A 60-year-old patient with an confirmed gastrinoma was treated in our department. All preoperative evaluations including somatostatin-receptor-scintigraphy and F-Dopa PET failed to localize the gastrinoma. Explorative laparotomy revealed a gastrinoma in two peripancreatic lymph nodes. Despite extensive intraoperative exploration, no primary gastrinoma could be detected in typical localization.Results. Over a period of 5 years, the patient's gastrin level stayed in the normal range and the patient seems to be completely cured.Conclusion. A prophylactic partial pancreatoduodenectomy is not indicated to avoid recurrence, since complete biochemical cure by local resection of the lymph node gastrinoma is possible.
Hindawi Limited
Title: Five-Year Long-Term Followup of a Primary Lymph node Gastrinoma: Is a Pancreaticoduodenectomy Justified?
Description:
Background.
Gastrinoma-positive lymph nodes and failed localization of the primary tumor during surgical exploration are described.
Specialists suppose that these lymph nodes are metastases rather than a primary gastrinoma.
Methods.
Case report with a five-year long-term followup.
A 60-year-old patient with an confirmed gastrinoma was treated in our department.
All preoperative evaluations including somatostatin-receptor-scintigraphy and F-Dopa PET failed to localize the gastrinoma.
Explorative laparotomy revealed a gastrinoma in two peripancreatic lymph nodes.
Despite extensive intraoperative exploration, no primary gastrinoma could be detected in typical localization.
Results.
Over a period of 5 years, the patient's gastrin level stayed in the normal range and the patient seems to be completely cured.
Conclusion.
A prophylactic partial pancreatoduodenectomy is not indicated to avoid recurrence, since complete biochemical cure by local resection of the lymph node gastrinoma is possible.
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