PMID- 9586830
OWN - NLM
STAT- MEDLINE
DCOM- 19980624
LR  - 20180213
IS  - 0012-2823 (Print)
IS  - 0012-2823 (Linking)
VI  - 59
IP  - 2
DP  - 1998
TI  - Gastric carcinoid with histamine production, histamine transporter and expression 
      of somatostatin receptors.
PG  - 160-6
AB  - A case of sporadic, histamine-producing gastric carcinoid with liver metastases 
      is reported. The patient was treated with somatostatin analogue (octreotide) 
      combined with cortisone and blockade of histamine receptors prior to surgery, 
      which included subtotal gastrectomy, excision of lymph node metastases and 
      superficial liver metastases. Residual liver metastases were injected with 
      ethanol. These interventions markedly reduced the urinary excretion of the main 
      histamine metabolite (MelmAA). Eighteen months later combined immuno- and 
      chemotherapy was initiated due to tumour progression and recurrent hormonal 
      symptoms with good clinical results over 12 months. Scintigraphy, using 
      111In-DTPA-D-Phe1-octreotide, visualized somatostatin receptors (sstr) in primary 
      tumour, lymph node metastases and liver metastases. The tissue/blood 111In 
      concentration ratios of tumour biopsies were very high. Northern analyses 
      confirmed expression of all subtypes of sstr1-5. Immunocytochemically, tumour 
      cells were strongly positive for chromogranin A, histamine and vesicular 
      monoamine transporter (VMAT) 2 (histamine transporter), but negative for VMAT 1, 
      suggesting an origin from gastric enterochromaffin-like cells. In primary tumour 
      cell cultures, histamine, 5-HTP and 5-HIAA, but not 5-HT, could be detected in 
      conditioned culture medium, indicating a defective decarboxylation of the 
      tryptamine precursor. This rare case of histamine-producing gastric carcinoid 
      demonstrates that excellent symptom relief can be achieved despite disseminated 
      disease, if active, multimodal treatment strategy is instituted. The presence of 
      high numbers of sstr in tumour tissue also raises the possibility of 
      receptor-guided radiotherapy.
FAU - Kolby, L
AU  - Kolby L
AD  - Department of Surgery, Sahlgrenska University Hospital, Goteborg, Sweden.
FAU - Wangberg, B
AU  - Wangberg B
FAU - Ahlman, H
AU  - Ahlman H
FAU - Jansson, S
AU  - Jansson S
FAU - Forssell-Aronsson, E
AU  - Forssell-Aronsson E
FAU - Erickson, J D
AU  - Erickson JD
FAU - Nilsson, O
AU  - Nilsson O
LA  - eng
PT  - Case Reports
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - Switzerland
TA  - Digestion
JT  - Digestion
JID - 0150472
RN  - 0 (Membrane Glycoproteins)
RN  - 0 (Membrane Transport Proteins)
RN  - 0 (Neuropeptides)
RN  - 0 (Neurotransmitter Agents)
RN  - 0 (RNA, Messenger)
RN  - 0 (Receptors, Histamine)
RN  - 0 (Receptors, Somatostatin)
RN  - 0 (Vesicular Biogenic Amine Transport Proteins)
RN  - 0 (Vesicular Monoamine Transport Proteins)
RN  - 820484N8I3 (Histamine)
SB  - IM
MH  - Aged
MH  - Biological Transport/genetics
MH  - Blotting, Northern
MH  - Carcinoid Tumor/*metabolism/pathology/ultrastructure
MH  - Female
MH  - Gene Expression/genetics
MH  - Histamine/*analysis/*biosynthesis
MH  - Humans
MH  - Immunohistochemistry
MH  - Membrane Glycoproteins/genetics
MH  - *Membrane Transport Proteins
MH  - *Neuropeptides
MH  - Neurotransmitter Agents/genetics
MH  - RNA, Messenger/analysis/genetics
MH  - Receptors, Histamine/analysis/biosynthesis
MH  - Receptors, Somatostatin/*genetics
MH  - Stomach Neoplasms/chemistry/*metabolism/pathology
MH  - Tumor Cells, Cultured
MH  - Vesicular Biogenic Amine Transport Proteins
MH  - Vesicular Monoamine Transport Proteins
EDAT- 1998/05/20 02:05
MHDA- 2000/10/06 11:01
CRDT- 1998/05/20 02:05
PHST- 1998/05/20 02:05 [pubmed]
PHST- 2000/10/06 11:01 [medline]
PHST- 1998/05/20 02:05 [entrez]
AID - dig59160 [pii]
AID - 10.1159/000007482 [doi]
PST - ppublish
SO  - Digestion. 1998;59(2):160-6. doi: 10.1159/000007482.