A Case of Zollinger-Ellison Syndrome whose Pancreatic Tumor Produced Multiple Hormones and a Review of 48 Cases Reported in the Japanese Literature

A 46-year-old man developed a peptic ulcer disease and a diagnosisof Zollinger-Ellison Syndrome was strongly suspected followinggastric acid studies. Plasma gastrin level was found to be elevated.The operation revealed a pancreatic tumor localized at the pancreastail. The resected tumor tissue was proved to contain largeamounts of immunoreactive gastrin. In addition, calcitonin,VIP and insulin were found to be present either as a resultof immunofluorescence studies or the respective radioimmunoassays.Therefore, this was a case of a multiple hormone producing tumorof pancreas islet cell origin, and the symptoms due to gastrinhypersecretion were the main clinical features. In addition,48 cases of Zollinger-Ellison Syndrome reported in Japaneseliteratures were reviewed.