Zollinger Ellison syndrome

Case contributed by Dr Jake Ball

Presentation

Abnormal gastroscopy findings

Patient Data

Age: 65 years
Gender: Female
ct

Multiple arterial hyperenhancing lesions within the duodenum and pancreas with diffuse mucosal thickening of the stomach.

Dotatate

Nuclear medicine

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;

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