Exp Clin Endocrinol Diabetes 2008; 116(9): 554-557
DOI: 10.1055/s-2008-1062727
Short Communication

© J. A. Barth Verlag in Georg Thieme Verlag KG Stuttgart · New York

Lymph Node Gastrinoma in Multiple Endocrine Neoplasia Type 1 – a Diagnostic Challenge

K. Müssig 1 , M. Wehrmann 2 , M. Horger 3 , R. Bares 4 , H.-U. Häring 1 , B. Gallwitz 1 , S. Petersenn 5
  • 1Division of Endocrinology, Diabetology, Nephrology, Angiology, and Clinical Chemistry, Department of Internal Medicine, University Hospital of Tübingen, Tübingen, Germany
  • 2Department of General Pathology, University Hospital of Tübingen, Tübingen, Germany
  • 3Department of Diagnostic Radiology, University Hospital of Tübingen, Tübingen, Germany
  • 4Department of Nuclear Medicine, University Hospital of Tübingen, Germany
  • 5Division of Endocrinology, Medical Center, University of Essen, Germany
Further Information

Publication History

received 18.12.2007 first decision 15.01.2008

accepted 13.02.2008

Publication Date:
01 April 2008 (online)

Abstract

Background: Gastrinomas are the most frequent hormonally-active neuroendocrine tu-mours in patients with multiple endocrine neoplasia type 1 (MEN1).

Case Report: We report on the diagnostic difficulties in a 62-year-old female patient with MEN1 and lymph node gastrinoma. At six and twelve months after resection of a lymph node gastrinoma, no signs of recurrence were observed. Basal and peak gastrin levels during secretin stimulation test were normalized. Extensive explorations, including gastrointesinal endoscopy, endoscopic ultrasonography, and Ga-68-DOTATOC-PET/CT, did not reveal a primary duodenal or pancreatic tumour.

Conclusion: Localization of gastrinomas in patients with MEN1 is challenging due to their small size, frequent duodenal location, and multiplicity. Therefore, while some studies support the existence of primary lymph node gastrinoma in patients with sporadic disease, this diagnosis should not be made in MEN1 patients. In both cases, however, extensive follow-ups are required

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Correspondence

Dr. K. MüssigMD 

Medizinische Klinik IV

Universitätsklinikum Tübingen

Otfried-Müller-Str. 10

72076 Tübingen

Germany

Phone: +49/7071/29 83 67 0

Fax: +49/7071/29 27 84

Email: Karsten.Muessig@med.uni-tuebingen.de