PMID- 30344820
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20200929
IS  - 1918-3003 (Print)
IS  - 1918-3011 (Electronic)
IS  - 1918-3003 (Linking)
VI  - 10
IP  - 11
DP  - 2018 Nov
TI  - Gastrinoma of Cystic Duct: A Rare Association With Multiple Endocrine Neoplasia 
      Type 1.
PG  - 843-847
LID - 10.14740/jocmr3541w [doi]
AB  - Neuroendocrine tumors (NETs) of cystic duct are extremely rare, accounting for 
      less than 2% of NET cases. The association of biliary tree NET and multiple 
      endocrine neoplasm type 1 (MEN1) are even more rare. In this report, we described 
      a case of a 65-year-old woman who was referred to our neuroendocrine outpatient 
      clinic to investigate MEN1 after an incidental diagnosis of gastrinoma. Her 
      medical history initiated 7 years earlier with severe peptic disease not 
      responsive to proton pump inhibitor therapy. Endoscopic study revealed erosive 
      antral gastritis, erosive duodenitis, bulbar ulcer and pyloric deformity. During 
      follow-up she presented with abdominal pain, chronic diarrhea and weight loss; an 
      ultrasonography was performed and showed only a cholelithiasis. She underwent a 
      video laparoscopic cholecystectomy and all her symptoms were solved. 
      Histopathological study found a 1.0 cm well differentiated NET (Ki-67 labeling 
      index < 2%) located in cystic duct infiltrating the entire wall and subserosa. 
      The MEN1 investigation revealed a primary hyperparathyroidism with a brown tumor 
      in right iliac bone; the patient was referred to a total parathyroidectomy with 
      autotransplantation. No evidence of pituitary tumor was found. The patient 
      remains asymptomatic 24 months after surgery. To conclude, this case highlights 
      an unusual presentation of a cystic duct primary NET gastrinoma in a MEN1 
      context.
FAU - Moraes, Aline Barbosa
AU  - Moraes AB
AD  - Department of Internal Medicine and Endocrine Unit, Medical School and Clementino 
      Fraga Filho University Hospital, Federal University of Rio de Janeiro, Rio de 
      Janeiro, Brazil.
FAU - Treistman, Natalia
AU  - Treistman N
AD  - Department of Internal Medicine and Endocrine Unit, Medical School and Clementino 
      Fraga Filho University Hospital, Federal University of Rio de Janeiro, Rio de 
      Janeiro, Brazil.
FAU - Studart, Mariana Coutinho
AU  - Studart MC
AD  - Pathology Department, Medical School and Clementino Fraga Filho University 
      Hospital, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
FAU - Chagas, Vera Lucia Antunes
AU  - Chagas VLA
AD  - Pathology Department, Medical School and Clementino Fraga Filho University 
      Hospital, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
FAU - Brabo, Eloa Pereira
AU  - Brabo EP
AD  - Oncology Unit and Neuroendocrine Section, Clementino Fraga Filho University 
      Hospital, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
FAU - Vieira Neto, Leonardo
AU  - Vieira Neto L
AD  - Department of Internal Medicine and Endocrine Unit, Medical School and Clementino 
      Fraga Filho University Hospital, Federal University of Rio de Janeiro, Rio de 
      Janeiro, Brazil.
LA  - eng
PT  - Case Reports
DEP - 20181009
PL  - Canada
TA  - J Clin Med Res
JT  - Journal of clinical medicine research
JID - 101538301
PMC - PMC6188020
OTO - NOTNLM
OT  - Biliary tree
OT  - Cystic duct
OT  - Gastrinoma
OT  - Multiple endocrine neoplasia type 1
OT  - Neuroendocrine tumor
OT  - Zollinger-Ellison syndrome
COIS- The authors declare that there is no conflict of interest that could be perceived 
      as prejudicing the impartiality of the research reported.
EDAT- 2018/10/23 06:00
MHDA- 2018/10/23 06:01
PMCR- 2018/10/09
CRDT- 2018/10/23 06:00
PHST- 2018/07/26 00:00 [received]
PHST- 2018/08/14 00:00 [accepted]
PHST- 2018/10/23 06:00 [entrez]
PHST- 2018/10/23 06:00 [pubmed]
PHST- 2018/10/23 06:01 [medline]
PHST- 2018/10/09 00:00 [pmc-release]
AID - 10.14740/jocmr3541w [doi]
PST - ppublish
SO  - J Clin Med Res. 2018 Nov;10(11):843-847. doi: 10.14740/jocmr3541w. Epub 2018 Oct 
      9.