首页 | 本学科首页   官方微博 | 高级检索  
     


Multiple gastrinoma successfully resected with the aid of intraoperative arterial secretin injection test
Authors:Osamu Ishikawa  Hiroaki Ohigashi  Fujiko Sasakuma  Takao Shimizu  Shinzaburo Noguchi  Yo Sasaki  Hiroshi Furukawa  Shingi Imaoka  Shinji Kitamura
Affiliation:1. Department of Surgery, The Center for Adult Diseases, Osaka, 3-Nakamichi, 1-chome, Higashinari-ku, 537, Osaka, Japan
2. Department of Endocrinology, The Center for Adult Diseases, Osaka, 3-Nakamichi, 1-chome, Higashinari-ku, 537, Osaka, Japan
3. The Second department of Internal Medicine, Medical School of Osaka University, 2-15 Yamadaoka, 565, Suita, Osaka, Japan
Abstract:
Since gastrinoma is likely to develop in multiple sites, we should pay special attention to the removal of all daughter tumors, as well as the main tumor, during surgery for this disease. In a 24-year-old woman with pituitary prolactinoma, multiple gastrinomas were detected in a limited area of the pancreaticoduodenal region by preoperative imaging techniques, selective arterial secretin injection (SASI) test, and intraoperative inspection using ultrasonography. A pancreatoduodenectomy was performed, and it was intraoperatively confirmed that the serum gastrin concentration in the portal vein had decreased from 753 to 83 pg/ml (normal,<120pg/ml). However, intraoperative SASI test for the remnant pancreas showed a positive response, which prompted us to perform a histological examination of frozen sections obtained from the body and tail of the pancreas, despite the normal appearance. Many islet cell microtumors were discovered, and the remnant pancreas was completely removed. Postoperativelly, all of the tumors were immunohistochemically proven to be microgastrinomas. The patient is still disease-free, 2 years after the surgery, with a serum gastrin level of less than 30pg/ml. This report stresses the role of the intraoperative SASI test in preventing residual microgastrinomas before closure of the abdomen.
Keywords:multiple gastrinoma  selective arterial secretin injection (SASI) test  microgastrinoma
本文献已被 SpringerLink 等数据库收录!
设为首页 | 免责声明 | 关于勤云 | 加入收藏

Copyright©北京勤云科技发展有限公司  京ICP备09084417号