Denève E, Hamoui M, Chalançon A, Blanc P -M, Aufort S, Fabre J -M, Nocca D
Service de chirurgie digestive II, hôpital Saint-Eloi, centre hospitalo-universitaire de Montpellier, avenue Bertin-Sans, 34295 Montpellier, France.
Ann Endocrinol (Paris). 2009 Sep;70(4):242-5. doi: 10.1016/j.ando.2008.12.002. Epub 2009 Jan 22.
The Zollinger-Ellison syndrome is due to an endocrine gastrin-secreting tumor, the gastrinoma. This tumor is often malignant and patients develop metastases in 25% of cases. The usual localizations of gastrinomas are at the head of the pancreas, the duodenal wall and the peripancreatic lymph nodes. Ectopic localizations, such as stomach, small bowel, gallbladder, liver or ovaries, are rare. We report the case of an intrahepatic gastrinoma, surgically treated by left hepatectomy. Upon review of scientific literature, we found 19 cases of intrahepatic gastrinoma. This diagnosis is always difficult to establish, even after a complete preoperative imaging and an extensive operative search for a possible primary tumor. The best evidence for diagnosis is the gastrinemia decreasing to a normal range after liver resection, and the absence of recurrence in long-term follow-up.
佐林格-埃利森综合征是由一种分泌胃泌素的内分泌肿瘤即胃泌素瘤引起的。这种肿瘤通常是恶性的,25%的病例会发生转移。胃泌素瘤的常见定位在胰头、十二指肠壁和胰腺周围淋巴结。异位定位,如胃、小肠、胆囊、肝脏或卵巢,则较为罕见。我们报告一例经左肝切除术手术治疗的肝内胃泌素瘤病例。查阅科学文献时,我们发现了19例肝内胃泌素瘤病例。即使在术前进行了完整的影像学检查并在手术中广泛寻找可能的原发肿瘤后,这种诊断也总是很难确立。诊断的最佳证据是肝切除术后胃泌素血症降至正常范围,且长期随访无复发。