title: Selective Arterial Embolization of Liver Metastases from Gastrinomas: A Single-Centre Experience.
abstract: Background. Gastrinomas are rare functional neuroendocrine tumors causing the Zollinger-Ellison syndrome (ZES). At presentation, up to 25% of gastrinomas are metastasized, predominantly to the liver. Embolization of liver metastases might reduce symptoms of ZES although a postembolization syndrome can occur. In this study, the results of embolization are presented, and the literature results are described. Methods. From a prospective database of pancreatic neuroendocrine tumors, all patients with liver metastatic gastrinomas were selected if treated with arterial embolization. Primary outcome parameters were symptom reduction, complications, and response rate. The literature search was performed with these items. Results. Three patients were identified; two presented with synchronous liver metastases. All the three patients had symptoms of ZES before embolization. Postembolization syndrome occurred in two patients. Six months after embolization, all the 3 patients had a clinical and complete radiological response; a biochemical response was seen in 2/3 patients. From the literature, only a small number of gastrinoma patients treated with liver embolization for liver metastases were found, and similar results were described. Conclusion. Selective liver embolization is an effective and safe therapy for the treatment of liver metastatic gastrinomas in the reduction of ZES. Individual treatment strategies must be made for the optimal success rate.
authors.affiliation: Department of Surgery, Academic Medical Center, Meibergdreef 9, P.O. Box 22660, 1105 AZ Amsterdam, The Netherlands.
authors.forename: Anneke P J
authors.initials: AP
authors.lastname: Jilesen
authors.affiliation: Department of Medical Oncology, Academic Medical Center, Meibergdreef 9, P.O. Box 22660, 1105 AZ Amsterdam, The Netherlands.
authors.forename: Heinz Josef
authors.initials: HJ
authors.lastname: Klümpen
authors.affiliation: Department of Surgery, Academic Medical Center, Meibergdreef 9, P.O. Box 22660, 1105 AZ Amsterdam, The Netherlands.
authors.forename: Olivier R C
authors.initials: OR
authors.lastname: Busch
authors.affiliation: Department of Surgery, Academic Medical Center, Meibergdreef 9, P.O. Box 22660, 1105 AZ Amsterdam, The Netherlands.
authors.forename: T M
authors.initials: TM
authors.lastname: van Gulik
authors.affiliation: Department of Intervention Radiology, Academic Medical Center, Meibergdreef 9, P.O. Box 22660, 1105 AZ Amsterdam, The Netherlands.
authors.forename: Krijn P
authors.initials: KP
authors.lastname: van Lienden
authors.affiliation: Department of Surgery, Academic Medical Center, Meibergdreef 9, P.O. Box 22660, 1105 AZ Amsterdam, The Netherlands.
authors.forename: Dirk J
authors.initials: DJ
authors.lastname: Gouma
authors.affiliation: Department of Surgery, Academic Medical Center, Meibergdreef 9, P.O. Box 22660, 1105 AZ Amsterdam, The Netherlands.
authors.forename: Els J M
authors.initials: EJ
authors.lastname: Nieveen van Dijkum