Eur J Pediatr Surg 2009; 19(1): 38-40
DOI: 10.1055/s-2008-1038628
Special Report

© Georg Thieme Verlag KG Stuttgart · New York

Gastrinoma in Childhood: Case Report and Update on Diagnosis and Treatment

S. T. Schettini1 , R. C. Ribeiro1 , C. G. Facchin1 , S. C. V. Abib1
  • 1Division of Pediatric Surgery, Pediatric Oncology Institute – Federal University of São Paulo, São Paulo, Brazil
Weitere Informationen

Publikationsverlauf

received January 30, 2008

accepted after revision March 28, 2008

Publikationsdatum:
16. Februar 2009 (online)

Abstract

We report a case of gastrinoma in a child and review the literature on gastrinoma in childhood, particularly with regard to the clinical, laboratory, radiological and scintigraphic characteristics, therapeutic approaches and prognosis. An eleven-year-old boy with gastrinoma underwent surgical resection. One year later resection of the left lateral lobe of the liver was performed due to a liver metastasis. The boy has been followed up for four years since this last procedure. The outcome was satisfactory for one year after the primary resection and then for a further four years after resection of a liver metastasis. Based on our data and that of the literature, it is our opinion that gastrinoma should be considered as a potentially malignant disease. The best approach is an early diagnosis and surgical treatment through resection of the primary tumor, followed by periodic postoperative clinical, laboratory, radiological and scintigraphic evaluations, because of the risk of metastatic disease. Such metastases must be resected as soon as possible.

References

  • 1 Bello Arques P, Hervas Benito I, Mateo Navarro A. Scintigraphy with 111In-octreotide in a case of primary hepatic gastrinoma.  Rev Esp Méd Nucl. 2001;  20 381-385
  • 2 Farley D R, van Heerden J A, Grant C S. et al . Extra pancreatic gastrinomas: surgical experience.  Arch Surg. 1994;  129 506-511
  • 3 Kianmanesh R, O'Toole D, Sauvanet A. et al . Surgical treatment of gastric, enteric and pancreatic endocrine tumors. Part 1. Treatment of primary endocrine tumors.  J Chir (Paris). 2005;  142 132-149
  • 4 Li M L, Norton J A. Gastrinoma.  Curr Treat Options Oncol. 2001;  2 337-346
  • 5 Mignon M, Cadiot G, Marmuse J P. et al . Is gastrinoma a medical disease?.  Yale J Biol Med. 1996;  69 289-300
  • 6 Oshio G, Hosotani R, Imamura M. et al . Gastrinoma with multiple liver metastases: effectiveness of dacarbazine (DTIC) therapy.  J Hepatobiliary Pancreat Surg. 1998;  5 339-433
  • 7 Quatrini M, Castoldi L, Rossi G. et al . A follow up study of patients with Zollinger-Ellison syndrome in the period 1966–2002: effects of surgical and medical treatments on long term survival.  J Clin Gastroenterol. 2005;  39 376-380
  • 8 Van Nieuwenhove Y, Vandaele S, Op de Beeck B. et al . Neuroendocrine tumors of the pancreas.  Surg Endosc. 2003;  17 1658-1662
  • 9 Wilson S D. The role of surgery in children with Zollinger-Ellison syndrome.  Surgery. 1982;  92 682-692
  • 10 Zhang T, Zhao Y, Xu X. et al . The diagnosis and treatment of gastrinoma: report of 17 cases.  Chin Med Sci J. 1999;  14 185-188
  • 11 Zollinger R M, Ellison E. Primary peptic ulceration of the jejunum associated with islet cell tumors of the pancreas.  Ann Surg. 1955;  142 709-728

Prof. Sérgio Tomaz Schettini, Associated Professor

Division of Pediatric Surgery
Federal University of São Paulo

Rua Botucatu, 743

04023-062 São Paulo

Brazil

eMail: stschettini@uol.com.br

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