title: Primary hepatic gastrinoma as an unusual manifestation of zollinger-ellison syndrome.
abstract: We report a rare case of primary hepatic gastrinoma. A 77-year-old woman exhibited continuous watery diarrhea for 8 months and weight loss. Bacterial cultures of the stools were negative and colonoscopy revealed no abnormalities. Esophagogastroduodenoscopy showed severe reflux esophagitis and multiple duodenal erosions. Computed tomography and magnetic resonance imaging detected two solid masses measuring <2 cm in diameter in the right lobe of the non-cirrhotic liver. Microscopically, the tumor was consistent with neuroendocrine tumor (grade 2) with abundant gastrin-immunoreactive cells. Endoscopic ultrasound detected no other alternative primary source of an endocrine tumor. The serum gastrin levels exceeded 40,000 pg/ml in the absence of H(2) receptor antagonist and proton pump inhibitor administrations. Based on an arterial stimulation and venous sampling test, the patient was diagnosed as primary gastrinoma of the liver. Our findings demonstrated the presence of Zollinger-Ellison syndrome in a patient who was subsequently cured by surgical resection of the liver tumors.
authors.affiliation: Departments of Gastroenterology and Hepatology.
authors.forename: Hideaki
authors.initials: H
authors.lastname: Naoe
authors.forename: Hajime
authors.initials: H
authors.lastname: Iwasaki
authors.forename: Takeshi
authors.initials: T
authors.lastname: Kawasaki
authors.forename: Tetsu
authors.initials: T
authors.lastname: Ozaki
authors.forename: Hideharu
authors.initials: H
authors.lastname: Tsutsumi
authors.forename: Ayako
authors.initials: A
authors.lastname: Okuda
authors.forename: Takeyasu
authors.initials: T
authors.lastname: Konoe
authors.forename: Kouichi
authors.initials: K
authors.lastname: Nonaka
authors.forename: Eisuke
authors.initials: E
authors.lastname: Kaku
authors.forename: Takashi
authors.initials: T
authors.lastname: Shono
authors.forename: Kazunori
authors.initials: K
authors.lastname: Yokomine
authors.forename: Kouichi
authors.initials: K
authors.lastname: Sakurai
authors.forename: Ken-Ichi
authors.initials: K
authors.lastname: Iyama
authors.forename: Masahiko
authors.initials: M
authors.lastname: Hirota
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Sasaki