PMID- 24363522
OWN - NLM
STAT- MEDLINE
DCOM- 20140612
LR  - 20211021
IS  - 2219-2840 (Electronic)
IS  - 1007-9327 (Print)
IS  - 1007-9327 (Linking)
VI  - 19
IP  - 45
DP  - 2013 Dec 7
TI  - Biliary tree gastrinomas in multiple endocrine neoplasia type 1 syndrome.
PG  - 8312-20
LID - 10.3748/wjg.v19.i45.8312 [doi]
AB  - AIM: To describe our patients affected with ectopic biliary tree gastrinoma and 
      review the literature on this topic. METHODS: Between January 1992 and June 2012, 
      28 patients affected by duodenopancreatic endocrine tumors in multiple endocrine 
      neoplasia type 1 (MEN1) syndrome underwent surgery at our institution. This 
      retrospective review article analyzes our experience regarding seventeen of these 
      patients subjected to duodenopancreatic surgery for Zollinger-Ellison syndrome 
      (ZES). Surgical treatment consisted of duodenopancreatectomy (DP) or total 
      pancreatectomy (TP). Regional lymphadenectomy was always performed. Any hepatic 
      tumoral lesions found were removed during surgery. In MEN1 patients, removal of 
      duodenal lesions can sometimes lead to persistence or recurrence of 
      hypergastrinemia. One possible explanation for this unfavorable outcome could be 
      unrecognized ectopic localization of gastrin-secreting tumors. This study 
      described three cases among the seventeen patients who were found to have an 
      ectopic gastrinoma located in the biliary tree. RESULTS: Seventeen MEN1 patients 
      affected with ZES were analyzed. The mean age was 40 years. Fifteen patients 
      underwent DP and two TP. On histopathological examination, duodeno pancreatic 
      endocrine tumors were found in all 17 patients. Eighty-one gastrinomas were 
      detected in the first three portions of the duodenum. Only one gastrinoma was 
      found in the pancreas. The mean number of gastrinomas per patient was 5 (range 
      1-16). Malignancy was established in 12 patients (70.5%) after lymph node, liver 
      and omental metastases were found. Three patients exhibited biliary tree 
      gastrinomas as well as duodenal gastrinoma(s). In two cases, the ectopic 
      gastrinoma was removed at the same time as pancreatic surgery, while in the third 
      case, the biliary tree gastrinoma was resected one year after DP because of 
      recurrence of ZES. CONCLUSION: These findings suggest the importance of checking 
      for the presence of ectopic gastrinomas in the biliary tree in MEN1 patients 
      undergoing ZES surgery.
CI  - (c) 2013 Baishideng Publishing Group Co., Limited. All rights reserved.
FAU - Tonelli, Francesco
AU  - Tonelli F
AD  - Francesco Tonelli, Francesco Giudici, Gabriella Nesi, Giacomo Batignani, Maria 
      Luisa Brandi, Surgical Unit, Department of Surgery and Translational Medicine, 
      University of Florence, 50014 Florence, Italy.
FAU - Giudici, Francesco
AU  - Giudici F
AD  - Francesco Tonelli, Francesco Giudici, Gabriella Nesi, Giacomo Batignani, Maria 
      Luisa Brandi, Surgical Unit, Department of Surgery and Translational Medicine, 
      University of Florence, 50014 Florence, Italy.
FAU - Nesi, Gabriella
AU  - Nesi G
AD  - Francesco Tonelli, Francesco Giudici, Gabriella Nesi, Giacomo Batignani, Maria 
      Luisa Brandi, Surgical Unit, Department of Surgery and Translational Medicine, 
      University of Florence, 50014 Florence, Italy.
FAU - Batignani, Giacomo
AU  - Batignani G
AD  - Francesco Tonelli, Francesco Giudici, Gabriella Nesi, Giacomo Batignani, Maria 
      Luisa Brandi, Surgical Unit, Department of Surgery and Translational Medicine, 
      University of Florence, 50014 Florence, Italy.
FAU - Brandi, Maria Luisa
AU  - Brandi ML
AD  - Francesco Tonelli, Francesco Giudici, Gabriella Nesi, Giacomo Batignani, Maria 
      Luisa Brandi, Surgical Unit, Department of Surgery and Translational Medicine, 
      University of Florence, 50014 Florence, Italy.
LA  - eng
PT  - Case Reports
PT  - Journal Article
PT  - Review
PL  - United States
TA  - World J Gastroenterol
JT  - World journal of gastroenterology
JID - 100883448
SB  - IM
MH  - Adult
MH  - Bile Duct Neoplasms/*pathology/surgery
MH  - Biopsy
MH  - Duodenal Neoplasms/*pathology/surgery
MH  - Female
MH  - Gastrinoma/*pathology/surgery
MH  - Humans
MH  - Lymph Node Excision
MH  - Male
MH  - Middle Aged
MH  - Multiple Endocrine Neoplasia Type 1/*pathology/surgery
MH  - Pancreatectomy
MH  - Pancreatic Neoplasms/*pathology/surgery
MH  - Pancreaticoduodenectomy
MH  - Retrospective Studies
MH  - Time Factors
MH  - Tomography, X-Ray Computed
MH  - Treatment Outcome
MH  - Young Adult
MH  - Zollinger-Ellison Syndrome/*pathology/surgery
PMC - PMC3857454
OTO - NOTNLM
OT  - Biliary tree
OT  - Duodenopancreatectomy
OT  - Ectopic gastrinoma
OT  - Gastrinoma
OT  - Multiple endocrine neoplasia type 1
OT  - Zollinger-Ellison Syndrome
EDAT- 2013/12/24 06:00
MHDA- 2014/06/13 06:00
PMCR- 2013/12/07
CRDT- 2013/12/24 06:00
PHST- 2013/04/29 00:00 [received]
PHST- 2013/06/29 00:00 [revised]
PHST- 2013/07/04 00:00 [accepted]
PHST- 2013/12/24 06:00 [entrez]
PHST- 2013/12/24 06:00 [pubmed]
PHST- 2014/06/13 06:00 [medline]
PHST- 2013/12/07 00:00 [pmc-release]
AID - 10.3748/wjg.v19.i45.8312 [doi]
PST - ppublish
SO  - World J Gastroenterol. 2013 Dec 7;19(45):8312-20. doi: 10.3748/wjg.v19.i45.8312.