title: Synchronous Peripancreatic Lymph Node Gastrinoma and Gastric Neuroendocrine Tumor Type 2.
abstract: A 34-year-old man was referred to our hospital with gastric polypoid lesions and biopsy-confirmed neuroendocrine tumor (NET). Computed tomography (CT) revealed a 3×3.5×8-cm retroperitoneal mass behind the pancreas, with multiple hepatic metastases. His serum gastrin level was elevated to 1,396 pg/mL. We performed a wedge resection of the stomach, a right hemi-hepatectomy, and a retroperitoneal mass excision. After careful review of the clinical, radiological, histopathological, and immunohistochemical findings, peripancreatic gastrinoma, and synchronous gastric NET were ultimately diagnosed. We reviewed a CT scan that had been performed 6 years previously after surgery for a duodenal perforation. There was no evidence of gastric or hepatic lesions, but the retroperitoneal mass was present at the same site. Had gastrinoma been detected earlier, our patient could have been cured using less invasive treatment. This case demonstrates how important it is to consider Zollinger-Ellison syndrome in patients with a recurrent or aggressive ulcer.
authors.affiliation: Department of Internal Medicine, Gachon University Gil Medical Center, Gachon University College of Medicine, Incheon, Korea.
authors.forename: Hee Woo
authors.initials: HW
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Gachon University Gil Medical Center, Gachon University College of Medicine, Incheon, Korea.
authors.forename: Jun-Won
authors.initials: JW
authors.lastname: Chung
authors.affiliation: Department of Internal Medicine, Gachon University Gil Medical Center, Gachon University College of Medicine, Incheon, Korea.
authors.forename: Yoon Jae
authors.initials: YJ
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Gachon University Gil Medical Center, Gachon University College of Medicine, Incheon, Korea.
authors.forename: Kwang Ahn
authors.initials: KA
authors.lastname: Kwon
authors.affiliation: Department of Internal Medicine, Gachon University Gil Medical Center, Gachon University College of Medicine, Incheon, Korea.
authors.forename: Eui Joo
authors.initials: EJ
authors.lastname: Kim
authors.affiliation: Department of Surgery, Gachon University Gil Medical Center, Gachon University College of Medicine, Incheon, Korea.
authors.forename: Keon Kuk
authors.initials: KK
authors.lastname: Kim
authors.affiliation: Department of Surgery, Gachon University Gil Medical Center, Gachon University College of Medicine, Incheon, Korea.
authors.forename: Woon Ki
authors.initials: WK
authors.lastname: Lee
authors.affiliation: Department of Hematology, Gachon University Gil Medical Center, Gachon University College of Medicine, Incheon, Korea.
authors.forename: Sun Jin
authors.initials: SJ
authors.lastname: Sym
keywords: Gastrinoma; Neuroendocrine tumors; Zollinger-Ellison syndrome