Regression of Type II Gastric Carcinoids in Multiple Endocrine Neoplasia Type 1 Patients with Zollinger-Ellison Syndrome after Surgical Excision of All Gastrinomas
dc.contributor.author | Thompson, Norman W. | en_US |
dc.contributor.author | Gauger, Paul G. | en_US |
dc.contributor.author | Richards, Melanie L. | en_US |
dc.contributor.author | Giordano, Thomas J. | en_US |
dc.date.accessioned | 2006-09-08T19:06:40Z | |
dc.date.available | 2006-09-08T19:06:40Z | |
dc.date.issued | 2004-07 | en_US |
dc.identifier.citation | Richards, Melanie L.; Gauger, Paul; Thompson, Norman W.; Giordano, Thomas J.; (2004). "Regression of Type II Gastric Carcinoids in Multiple Endocrine Neoplasia Type 1 Patients with Zollinger-Ellison Syndrome after Surgical Excision of All Gastrinomas." World Journal of Surgery 28(7): 652-658. <http://hdl.handle.net/2027.42/41302> | en_US |
dc.identifier.issn | 1432-2323 | en_US |
dc.identifier.issn | 0364-2313 | en_US |
dc.identifier.uri | https://hdl.handle.net/2027.42/41302 | |
dc.identifier.uri | http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=retrieve&db=pubmed&list_uids=15383867&dopt=citation | en_US |
dc.description.abstract | Enterochromaffin-like (ECL) tumors are documented in patients with hypergastrinemia secondary to chronic atrophic gastritis or with Zollinger-Ellison syndrome and multiple endocrine neoplasia type 1 (ZES-MEN-1). In patients with ECL tumors and atrophic gastritis, normogastrinemia after antrectomy has resulted in resolution, regression, or stabilization of ECL tumors. The natural history of ECL tumors associated with ZES-MEN-1 following normalization of gastrin levels after gastrinoma resection has not been previously reported. The purpose of this study was to determine the course of ECL tumors in patients with ZES-MEN-1 following normalization of serum gastrin levels after gastrinoma resection. Two patients with ZES-MEN-1 had biopsy-proven ECL tumors on endoscopic evaluation. They then underwent surgical exploration that included distal pancreatectomy, enucleation of pancreatic head tumors, duodenotomy with excision of submucosal tumors, and peripancreatic lymphadenectomy. Gastric ECL tumors larger than 1.0 cm were locally excised. Patients underwent long-term follow-up with biochemical and endoscopic surveillance. Normogastrinemia was achieved and sustained following gastrinoma resection in two patients with ZES-MEN-1. Periodic endoscopic surveillance over a 6-year period showed complete resolution of the ECL tumors. The development of ECL tumors associated with ZES-MEN-1 is multifactorial. Studies identified a genetic influence on tumor growth with loss of heterozygosity at the MEN-1 gene locus in ECL tumors. The resolution of ECL tumors in ZES-MEN-1 patients who are normogastrinemic indicates that an elevated gastrin level is a primary initiator for development of these tumors. Therefore both genetic defects and hypergastrinemia are causative agents. Normalization of serum gastrin levels is critical for the prevention of aggressive forms of ECL tumors. | en_US |
dc.format.extent | 151371 bytes | |
dc.format.extent | 3115 bytes | |
dc.format.mimetype | application/pdf | |
dc.format.mimetype | text/plain | |
dc.language.iso | en_US | |
dc.publisher | Springer-Verlag; Société Internationale de Chirurgie | en_US |
dc.subject.other | Medicine | en_US |
dc.title | Regression of Type II Gastric Carcinoids in Multiple Endocrine Neoplasia Type 1 Patients with Zollinger-Ellison Syndrome after Surgical Excision of All Gastrinomas | en_US |
dc.type | Article | en_US |
dc.subject.hlbsecondlevel | Surgery and Anesthesiology | en_US |
dc.subject.hlbtoplevel | Health Sciences | en_US |
dc.description.peerreviewed | Peer Reviewed | en_US |
dc.contributor.affiliationum | Department of General Surgery, Division of Endocrine Surgery, University of Michigan Hospital, 1500 E. Medical Drive, 48109, Ann Arbor, Michigan, USA, | en_US |
dc.contributor.affiliationum | Department of Pathology, University of Michigan Hospital, 1500 E. Medical Drive, 48109, Ann Arbor, Michigan, USA, | en_US |
dc.contributor.affiliationum | Department of General Surgery, Division of Endocrine Surgery, University of Michigan Hospital, 1500 E. Medical Drive, 48109, Ann Arbor, Michigan, USA, | en_US |
dc.contributor.affiliationother | Department of Surgery, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, 78284, San Antonio, Texas, USA, | en_US |
dc.contributor.affiliationumcampus | Ann Arbor | en_US |
dc.identifier.pmid | 15383867 | en_US |
dc.description.bitstreamurl | http://deepblue.lib.umich.edu/bitstream/2027.42/41302/1/268_2004_Article_7345.pdf | en_US |
dc.identifier.doi | http://dx.doi.org/10.1007/s00268-004-7345-0 | en_US |
dc.identifier.source | World Journal of Surgery | en_US |
dc.owningcollname | Interdisciplinary and Peer-Reviewed |
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