Zollinger-Ellison syndrome. Cure by surgical resection of a jejunal gastrinoma containing growth hormone releasing factor.

Zollinger-Ellison syndrome developed in a 46-yr-old woman due to a gastrinoma originating in the proximal jejunum. Resection of the tumor and adjacent lymph nodes containing metastatic carcinoma resulted in prompt reversal of all clinical and biochemical abnormalities, and she remains well 42 mo after surgery. To our knowledge, this patient is one of the first well-documented cases of primary jejunal gastrinoma causing the Zollinger-Ellison syndrome. The tumor contained numerous cells positive for gastrin and smaller numbers positive for serotonin, somatostatin, or bovine pancreatic polypeptide, as diagnosed by immunohistochemistry. In addition, a small subset of tumor cells was positive for growth hormone releasing factor. Our case is the first to document the presence of this neuropeptide in an enteric gastrinoma.