Twenty-two years' survival of metastatic gastrinoma evidenced recently by somatostatin-receptor-specific scintigraphy.
An 18-year-old male presented in 1979 with a gastrinoma of unknown primary origin. Massive upper-digestive haemorrhage led to total gastrectomy, at which histology evidenced liver metastases, confirmed 9 months later at reoperation for an intestinal occlusion. Postoperative morphological evidence of liver metastases was repeatedly negative using abdominal ultrasound and computerized tomography (CT) scans and magnetic resonance imaging (MRI), but a recent somatostatin-receptor-specific scintigraphy (Octreoscan) was positive only in the liver area. Twenty-two years after diagnosis, the primary tumour has not been identified, the patient leads a normal life, and his circulating gastrin levels, although still elevated at 317-550 pg/ml (normal < 127 pg/ml), have fallen over recent years from > 1000 pg/ml. We discuss the relevance of the described prognostic factors.
Webb
Susan M
SM
Departments of Endocrinology and Gastroenterology, Hospital de la Santa Creu i Sant Pau, Autonomous University of Barcelona, Spain.
Monés
Joan
J
D000328:Adult; D015408:Gastrinoma / Q000000981:diagnostic imaging / Q000401:mortality* / Q000556:secondary; D006801:Humans; D007205:Indium Radioisotopes; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000401:mortality / Q000556:secondary*; D008297:Male; D009382:Neoplasms, Unknown Primary / Q000401:mortality*; D011877:Radionuclide Imaging; D013004:Somatostatin / Q000031:analogs & derivatives; D013997:Time Factors
D007205:Indium Radioisotopes; D013004:Somatostatin; C081788:pentetreotide