Duodenal gastrinoma: the solution to the pancreatic paradox.
There has been a recent focus of attention on the duodenum as a major source of gastrinomas. The question has often arisen as to why the pancreas should give rise to gastrinomas because, in the adult, it contains no gastrin-producing (G) cells. However, the numerous G cells of the duodenum may proliferate and function as a "carcinoid" lesion, producing a relatively indolent tumor, much like a papillary carcinoma of the thyroid. On the contrary, islet cells of the pancreas, which do not produce gastrin, may behave much like a neuroendocrine carcinoma and may be defined as a "pancreatic gastrinoma" because they produce an ectopic hormone (gastrin). These lesions are capable of behaving much more aggressively, as do many other ectopic hormone-producing neoplasms. The recognition of the difference between these two types of gastrinoma is of considerable clinical and biological significance.
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D003952:Diagnostic Imaging; D004379:Duodenal Neoplasms / Q000150:complications / Q000473:pathology / Q000601:surgery*; D015408:Gastrinoma / Q000150:complications / Q000473:pathology / Q000601:surgery*; D006801:Humans; D018761:Multiple Endocrine Neoplasia Type 1 / Q000601:surgery; D010190:Pancreatic Neoplasms / Q000150:complications / Q000473:pathology / Q000601:surgery; D016896:Treatment Outcome; D015043:Zollinger-Ellison Syndrome / Q000209:etiology / Q000601:surgery*