Gastrinomas are rare tumors that secrete large amounts of gastrin, causing extensive ulcers, abdominal pain, diarrhea, nausea, and vomiting. They are often associated with multiple endocrine neoplasia and require surgical removal. Proton pump inhibitors can also be used to control stomach acid production.
A gastrinoma is a relatively rare type of cancer found most commonly in the first part of the small intestine, or duodenum, and less frequently in the pancreas. Patients can have several small tumors or a single large tumor. These types of tumors secrete large amounts of a hormone called gastrin, which stimulates the stomach to produce more stomach acid; this is commonly known as Zollinger-Ellison syndrome. Most gastrinomas become cancerous, at which point they often spread to surrounding tissues and organs such as the liver.
People with gastrinomas typically have extensive ulcers in the stomach and small intestine, due to the large secretions of stomach acid triggered by gastrin. This often leads to abdominal pain. They also often have severe diarrhea resulting from overproduction of acid, and may also experience nausea and vomiting. Although treating the gastrinoma, which is the source of the symptoms, is the primary goal, proton pump inhibitors, or PPIs, can also be used to control stomach acid production.
Some gastrinoma patients present with them as part of a larger problem known as multiple endocrine neoplasia, or MEN. Those with MEN are afflicted with a variety of syndromes that cause tumors in different areas of the endocrine system. Gastrinomas are frequently associated with MEN type 1, where tumors are also found in the pituitary and parathyroid glands.
To diagnose a gastrinoma, the doctor will typically first want to understand a patient’s history. Gastrinomas often present with recurrent peptic ulcer disease or Zollinger-Ellison syndrome, so patients with these problems will be more likely to have them. A blood test will then be done to analyze the patient’s gastrin level to confirm a diagnosis. Imaging techniques such as CT scans, PET scans, or aretheriography can then be used to confirm the location of the tumor or tumors.
Treatment for a gastrinoma typically involves surgery. Because of the likelihood of tumors becoming cancerous, they usually need to be removed. Several surgical procedures may be required if there are multiple tumors located in different locations. If the tumors are small, it may only be possible to remove the tumors from the pancreas, duodenum, or occasionally other surrounding tissue. Larger tumors may also require part of the pancreas to be removed.
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