Beginning >> Reference >> Diseases >> Gastrinoma

Gastrinoma


Etiology

In 90% of cases the malignant metastatic tumor, in 80% is located in PZhZh, in 15% — in a duodenum wall. In 25% of cases meets within a syndrome of multiple endocrine neoplaziya of 1 type

Pathogeny

Uncontrollable products of gastrin, hyper stimulation and hyperplasia of covering cells of a stomach, increase in products of hydrochloric acid

Epidemiology

<1% of patients with round ulcers; frequency of new cases — 0,5 on 1 million. In a year

Main clinical manifestations

1. Recurrent round ulcers, refractory to usual therapy, are more often in a duodenum bulb

2. Diarrhea and steatorrhea (50% of cases)

3. Metastasises of a malignant gastrinoma in a liver and other bodies (60%)

Diagnosis

1. The gastrin level increased at least by 3 times

2. Increase of basal level of secretion of hydrochloric acid at an intact stomach more than 15 mmol/h, and at resected more than 5 mmol/h

3. Topical diagnosis of a tumor

Differential diagnosis

Peptic ulcer

Treatment

Tumor resection; at not operability — anti-proliferative (oktreotid) and symptomatic (omeprazol) therapy

Forecast

5-year survival among considerably operated patients of 90%, at detection of metastasises — 20%

 
"Inflammation   Glucagonoma"