title: Liver metastases of endocrine tumour associated with multiple endocrine neoplasia type 1: a sustained response to interferon therapy or a peculiar benign course?
abstract: The authors describe the case of a 51-year-old male with Zollinger-Ellison syndrome manifested by epigastralgia, nausea, vomiting, hypergastrinemia and multiple endocrine neoplasia type 1. History included a Billroth II procedure for a perforated duodenal ulcer. Multiple metastatic liver lesions were found that were gastrin-negative and chromogranin-positive. Endoscopy revealed a large ulcerated gastro-jejuno-colonic fistula which was surgically repaired. Pre- and postoperative imaging studies, including the highly sensitive somatostatin-receptor scintigraphic scan using In-pentetreotide, have consistently failed to disclose other tumors. Recent reports indicate that most Zollinger-Ellison syndrome-associated gastrinomas are small, easily overlooked lesions located in the proximal duodenum rather than in the pancreas as formerly believed. In the present patient therapy with omeprazole and alpha-interferon has produced complete remission of the Zollinger-Ellison syndrome and a stabilization of tumor growth has occurred during the last 7 years, allowing the patient to live a normal life. This peculiar response to therapy is discussed.
authors: Istituto di Medicina Interna e Geriatria, Policlinico Universitario A. Gemelli, Università Cattolica del S. Cuore, Roma, Italy.
authors: A
authors: A
authors: Grieco
authors: A
authors: A
authors: Bianco
authors: B
authors: B
authors: Alfei
authors: V
authors: V
authors: Rufini
authors: F M
authors: FM
authors: Vecchio
authors: S
authors: S
authors: Marcoccia
authors: G
authors: G
authors: Gasbarrini
mesh_terms: D006801:Humans; D016898:Interferon-alpha / Q000627:therapeutic use*; D008113:Liver Neoplasms / Q000556:secondary* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D018761:Multiple Endocrine Neoplasia Type 1 / Q000628:therapy*; D009853:Omeprazole / Q000627:therapeutic use; D015043:Zollinger-Ellison Syndrome / Q000628:therapy*
chemical_list: D016898:Interferon-alpha; D009853:Omeprazole