PMID- 24319020
OWN - NLM
STAT- MEDLINE
DCOM- 20141030
LR  - 20220331
IS  - 1549-490X (Electronic)
IS  - 1083-7159 (Print)
IS  - 1083-7159 (Linking)
VI  - 19
IP  - 1
DP  - 2014 Jan
TI  - Zollinger-Ellison syndrome: classical considerations and current controversies.
PG  - 44-50
LID - 10.1634/theoncologist.2013-0369 [doi]
AB  - Zollinger-Ellison syndrome (ZES) is an endocrinopathy characterized by 
      gastrin-secreting tumors, responsible for causing the formation of multiple, 
      refractory, and recurrent peptic ulcers in the distal duodenum and proximal 
      jejunum. Two main variants have been described, sporadic and those found in 
      association with parathyroid and pituitary tumors, a genetic disorder known as 
      multiple endocrine neoplasia-1 (MEN-1). Biochemical serum evaluation for elevated 
      gastrin, followed by radiological or nuclear localization of the primary lesion, 
      is mandated for establishing diagnosis. The mainstays of treatment include 
      management of hypersecretory state with medical suppression of gastric acid 
      production and surgical resection of primary tumor for the prevention of 
      malignant transformation and metastatic complications. Medical therapy with 
      proton pump inhibitors has virtually eliminated the need for acid-reducing 
      surgical procedures. Surgical approach to sporadic and MEN-1-associated ZES 
      varies based on our understanding of the natural history of the condition and the 
      probability of cure; however, resection to a negative microscopic margin is 
      indicated in both cases. Postoperative surveillance involves measurement of 
      gastrin level, followed by imaging if elevation is detected. Re-excision of 
      recurrent or resection of metastatic disease is a subject of controversy; 
      however, at the present time aggressive cytoreductive approach is favored.
FAU - Epelboym, Irene
AU  - Epelboym I
AD  - Department of Surgery, Columbia University Medical Center, New York, New York, 
      USA; Department of Surgery, Hadassah-Hebrew University Medical Center, Mount 
      Scopus, Jerusalem, Israel.
FAU - Mazeh, Haggi
AU  - Mazeh H
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20131206
PL  - England
TA  - Oncologist
JT  - The oncologist
JID - 9607837
SB  - IM
MH  - Gastrinoma/diagnosis/therapy
MH  - Humans
MH  - Multiple Endocrine Neoplasia Type 1/diagnosis/therapy
MH  - Zollinger-Ellison Syndrome/*diagnosis/*therapy
PMC - PMC3903066
OTO - NOTNLM
OT  - Gastric acid
OT  - Gastrinoma
OT  - Multiple endocrine neoplasia type 1
OT  - Peptic ulcer
COIS- Disclosures of potential conflicts of interest may be found at the end of this 
      article.
EDAT- 2013/12/10 06:00
MHDA- 2014/10/31 06:00
PMCR- 2015/01/01
CRDT- 2013/12/10 06:00
PHST- 2013/12/10 06:00 [entrez]
PHST- 2013/12/10 06:00 [pubmed]
PHST- 2014/10/31 06:00 [medline]
PHST- 2015/01/01 00:00 [pmc-release]
AID - theoncologist.2013-0369 [pii]
AID - 13369 [pii]
AID - 10.1634/theoncologist.2013-0369 [doi]
PST - ppublish
SO  - Oncologist. 2014 Jan;19(1):44-50. doi: 10.1634/theoncologist.2013-0369. Epub 2013 
      Dec 6.