Close
New

Medscape is available in 5 Language Editions – Choose your Edition here.

 

Gastrinoma Differential Diagnoses

  • Author: Jennifer Lynn Bonheur, MD; Chief Editor: BS Anand, MD  more...
 
Updated: Mar 02, 2016
 
 

Diagnostic Considerations

Antral G-cell hyperfunction and massive small intestine resection are other diagnostic considerations.

In a retrospective study, Rosentraeger et al noted differences in pathologic features and biologic behavior between gastrinomas and non-syndromic duodenal gastrin-producing neuroendocrine tumors (ns-gas-NETs) from 41 patients with gastrin-producing duodenal tumors.[7] Gastrinomas exhibited the following characteristics[7] :

  • Higher Ki-67 index (1.74%) than ns-gas-NETs (0.85%)
  • Increased incidence of lymph node metastases (75%) than ns-gas-NETs (6%)
  • Showed liver metastasis, resulting in more advanced disease (75%)—staged at TNM III or higher—than ns-gas-NETs (6%)
  • More often underwent surgical resection, whereas ns-gas-NETs were removed endoscopically

Differential Diagnoses

 
 
Contributor Information and Disclosures
Author

Jennifer Lynn Bonheur, MD Attending Physician, Division of Gastroenterology, Lenox Hill Hospital

Jennifer Lynn Bonheur, MD is a member of the following medical societies: American Gastroenterological Association, American Society for Gastrointestinal Endoscopy, New York Society for Gastrointestinal Endoscopy, New York Academy of Sciences, Sigma Xi

Disclosure: Nothing to disclose.

Coauthor(s)

Senthil Nachimuthu, MD, FACP 

Senthil Nachimuthu, MD, FACP is a member of the following medical societies: American College of Physicians

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Chief Editor

BS Anand, MD Professor, Department of Internal Medicine, Division of Gastroenterology, Baylor College of Medicine

BS Anand, MD is a member of the following medical societies: American Association for the Study of Liver Diseases, American College of Gastroenterology, American Gastroenterological Association, American Society for Gastrointestinal Endoscopy

Disclosure: Nothing to disclose.

Additional Contributors

Manoop S Bhutani, MD Professor, Co-Director, Center for Endoscopic Research, Training and Innovation (CERTAIN), Director, Center for Endoscopic Ultrasound, Department of Medicine, Division of Gastroenterology, University of Texas Medical Branch; Director, Endoscopic Research and Development, The University of Texas MD Anderson Cancer Center

Manoop S Bhutani, MD is a member of the following medical societies: American Association for the Advancement of Science, American College of Gastroenterology, American College of Physicians, American Gastroenterological Association, American Institute of Ultrasound in Medicine, American Society for Gastrointestinal Endoscopy

Disclosure: Nothing to disclose.

Acknowledgements

Simmy Bank, MD Chair, Professor, Department of Internal Medicine, Division of Gastroenterology, Long Island Jewish Hospital, Albert Einstein College of Medicine

Disclosure: Nothing to disclose.

References
  1. Harper S, Carroll RW, Frilling A, Wickremesekera SK, Bann S. Primary lymph node gastrinoma: 2 cases and a review of the literature. J Gastrointest Surg. 2015 Apr. 19(4):651-5. [Medline].

  2. Doi R. Determinants of surgical resection for pancreatic neuroendocrine tumors. J Hepatobiliary Pancreat Sci. 2015 Aug. 22(8):610-7. [Medline].

  3. Ruiz-Tovar J, Priego P, Martinez-Molina E, et al. Pancreatic neuroendocrine tumours. Clin Transl Oncol. 2008 Aug. 10(8):493-7. [Medline].

  4. Kohan E, Oh D, Wang H, et al. Duodenal bulb mucosa with hypertrophic gastric oxyntic heterotopia in patients with Zollinger Ellison syndrome. Diagn Ther Endosc. 2009. 2009:298381. [Medline]. [Full Text].

  5. Basuroy R, Srirajaskanthan R, Prachalias A, Quaglia A, Ramage JK. Review article: the investigation and management of gastric neuroendocrine tumours. Aliment Pharmacol Ther. 2014 May. 39(10):1071-84. [Medline].

  6. Scherubl H, Streller B, Stabenow R, et al. Clinically detected gastroenteropancreatic neuroendocrine tumors are on the rise: epidemiological changes in Germany. World J Gastroenterol. 2013 Dec 21. 19(47):9012-9. [Medline]. [Full Text].

  7. Rosentraeger MJ, Garbrecht N, Anlauf M, et al. Syndromic versus non-syndromic sporadic gastrin-producing neuroendocrine tumors of the duodenum: comparison of pathological features and biological behavior. Virchows Arch. 2015 Dec 9. [Medline].

  8. Rehfeld JF, Bardram L, Hilsted L, Goetze JP. An evaluation of chromogranin A versus gastrin and progastrin in gastrinoma diagnosis and control. Biomark Med. 2014 Apr. 8(4):571-80. [Medline].

  9. Modlin IM, Aslanian H, Bodei L, Drozdov I, Kidd M. A PCR blood test outperforms chromogranin A in carcinoid detection and is unaffected by proton pump inhibitors. Endocr Connect. 2014 Dec. 3(4):215-23. [Medline].

  10. Poitras P, Gingras MH, Rehfeld JF. The Zollinger-Ellison syndrome: dangers and consequences of interrupting antisecretory treatment. Clin Gastroenterol Hepatol. 2012 Feb. 10(2):199-202. [Medline].

  11. Granberg D, Jacobsson H, Oberg K, Gustavsson J, Lehtihet M. Regression of a large malignant gastrinoma on treatment with Sandostatin LAR: a case report. Digestion. 2008. 77(2):92-5. [Medline].

  12. Villard L, Romer A, Marincek N, et al. Cohort study of somatostatin-based radiopeptide therapy with [(90)Y-DOTA]-TOC versus [(90)Y-DOTA]-TOC plus [(177)Lu-DOTA]-TOC in neuroendocrine cancers. J Clin Oncol. 2012 Apr 1. 30(10):1100-6. [Medline].

  13. Dumont RA, Seiler D, Marincek N, et al. Survival after somatostatin based radiopeptide therapy with (90)Y-DOTATOC vs. (90)Y-DOTATOC plus (177)Lu-DOTATOC in metastasized gastrinoma. Am J Nucl Med Mol Imaging. 2015. 5(1):46-55. [Medline].

  14. Fendrich V, Bartsch DK. Surgical treatment of gastrointestinal neuroendocrine tumors. Langenbecks Arch Surg. 2011 Mar. 396(3):299-311. [Medline].

  15. Fernandez Ranvier GG, Shouhed D, Inabnet WB 3rd. Minimally invasive techniques for resection of pancreatic neuroendocrine tumors. Surg Oncol Clin N Am. 2016 Jan. 25(1):195-215. [Medline].

  16. Hall NC, Nichols SD, Povoski SP, et al. Intraoperative use of a portable Large Field Of View Gamma Camera and Handheld Gamma Detection Probe for radioguided localization and prediction of complete surgical resection of gastrinoma: proof of concept. J Am Coll Surg. 2015 Aug. 221(2):300-8. [Medline].

Previous
Next
 
 
 
 
All material on this website is protected by copyright, Copyright © 1994-2016 by WebMD LLC. This website also contains material copyrighted by 3rd parties.