BACKGROUND: The existence of lymph node (LN) primary gastrinoma as a cause of Zollinger-Ellison syndrome is controversial. We reviewed our experience with patients in whom gastrinomas were identified and excised only from LNs. METHODS: From 1982 to 1992, 110 patients with ZES underwent exploration for gastrinoma and 21 (19%) had disease limited to one or more LNs. Standardized exploration included intraoperative ultrasonography, intraoperative endoscopy with transillumination and exploratory duodenotomy in 86%, 67%, and 24% of patients, respectively. Each patient underwent yearly biochemical and radiologic follow-up. RESULTS: Thirteen patients (62%) with a median follow-up period of 5.8 years had an initial biochemical cure, whereas eight patients (38%) with a median follow-up period of 3.6 years had persistent disease. Of the 13 patients whose condition initially returned to normal, four have had biochemical recurrence, with a median time to recurrence of 4.2 years and a median follow-up period of 7.4 years. Nine patients (43%) remain biochemically cured, with a median follow-up period of 5.3 years. CONCLUSIONS: Resection of apparent LN primary gastrinoma is warranted, because 43% of those who underwent resection had no evidence of disease, with a median follow-up period of 5.3 years.
BACKGROUND: The existence of lymph node (LN) primary gastrinoma as a cause of Zollinger-Ellison syndrome is controversial. We reviewed our experience with patients in whom gastrinomas were identified and excised only from LNs. METHODS: From 1982 to 1992, 110 patients with ZES underwent exploration for gastrinoma and 21 (19%) had disease limited to one or more LNs. Standardized exploration included intraoperative ultrasonography, intraoperative endoscopy with transillumination and exploratory duodenotomy in 86%, 67%, and 24% of patients, respectively. Each patient underwent yearly biochemical and radiologic follow-up. RESULTS: Thirteen patients (62%) with a median follow-up period of 5.8 years had an initial biochemical cure, whereas eight patients (38%) with a median follow-up period of 3.6 years had persistent disease. Of the 13 patients whose condition initially returned to normal, four have had biochemical recurrence, with a median time to recurrence of 4.2 years and a median follow-up period of 7.4 years. Nine patients (43%) remain biochemically cured, with a median follow-up period of 5.3 years. CONCLUSIONS: Resection of apparent LN primary gastrinoma is warranted, because 43% of those who underwent resection had no evidence of disease, with a median follow-up period of 5.3 years.
Authors: Fernando López; Juan P Rodrigo; Carl E Silver; Missak Haigentz; Justin A Bishop; Primož Strojan; Dana M Hartl; Patrick J Bradley; William M Mendenhall; Carlos Suárez; Robert P Takes; Marc Hamoir; K Thomas Robbins; Ashok R Shaha; Jochen A Werner; Alessandra Rinaldo; Alfio Ferlito Journal: Head Neck Date: 2015-12-29 Impact factor: 3.147
Authors: David J Worhunsky; Geoffrey W Krampitz; Peter D Poullos; Brendan C Visser; Pamela L Kunz; George A Fisher; Jeffrey A Norton; George A Poultsides Journal: HPB (Oxford) Date: 2013-08-29 Impact factor: 3.647
Authors: Jeffrey A Norton; Douglas L Fraker; H R Alexander; Fathia Gibril; David J Liewehr; David J Venzon; Robert T Jensen Journal: Ann Surg Date: 2006-09 Impact factor: 12.969
Authors: Simon Harper; Richard W Carroll; Andrea Frilling; Susrutha K Wickremesekera; Simon Bann Journal: J Gastrointest Surg Date: 2015-01-27 Impact factor: 3.452
Authors: Jeffrey A Norton; H Richard Alexander; Douglas L Fraker; David J Venzon; Fathia Gibril; Robert T Jensen Journal: Ann Surg Date: 2004-05 Impact factor: 12.969
Authors: Jeffrey A Norton; H Richard Alexander; Douglas L Fraker; David J Venzon; Fathia Gibril; Robert T Jensen Journal: Ann Surg Date: 2003-05 Impact factor: 12.969