Presentation
Abnormal gastroscopy findings
Patient Data
Age: 65 years
Gender: Female
From the case:
Zollinger Ellison syndrome
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Multiple arterial hyperenhancing lesions within the duodenum and pancreas with diffuse mucosal thickening of the stomach.
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The arterial enhancing lesions on the CT demonstrate dotatate avidity. It is also noted that the stomach is intensely avid. A liver metastasis is also demonstrated.
Case Discussion
Multiple hormonally active neuroendocrine tumors (gastrinomas) produce an excess of the gastrin hormone that causes stomach to produce too much acid. There is an associated Multiple Endocrine Neoplasia 1 syndrome (PiPanPar).
Gastrinomas are the most common type of Neuroendocrine tumor and it is thought up to 90% arise from the Gastrinoma triangle;
- superiorly: confluence of the cystic and common bile ducts
- inferiorly: junction of the second and third portions of the duodenum
- medially: junction of the neck and body of the pancreas