Department of Gastroenterology, St. Luke's International Hospital, Tokyo 104-8560, Japan.
Department of Pathology, Shizuoka Cancer Center, Shizuoka 411-8777, Japan.
World J Gastroenterol. 2021 Jan 7;27(1):129-142. doi: 10.3748/wjg.v27.i1.129.
Gastric gastrinoma and spontaneous tumor regression are both very rarely encountered. We report the first case of spontaneous regression of gastric gastrinoma.
A 37-year-old man with a 9-year history of chronic abdominal pain was referred for evaluation of an 8 cm mass in the lesser omentum discovered incidentally on abdominal computed tomography. The tumor was diagnosed as grade 2 neuroendocrine neoplasm (NEN) on endoscopic ultrasound-guided fine-needle aspiration. Screening esophagogastroduodenoscopy revealed a 7 mm red polypoid lesion with central depression in the gastric antrum, also confirmed to be a grade 2 NEN. Laparoscopic removal of the abdominal mass confirmed it to be a metastatic gastrinoma lesion. The gastric lesion was subsequently diagnosed as primary gastric gastrinoma. Three months later, the gastric lesion had disappeared without treatment. The patient remains symptom-free with normal fasting serum gastrin and no recurrence of gastrinoma during 36 mo of follow-up.
Gastric gastrinoma may arise as a polypoid lesion in the gastric antrum. Spontaneous regression can rarely occur after biopsy.
胃泌素瘤和自发性肿瘤消退均非常罕见。我们报告首例胃泌素瘤自发性消退的病例。
一名 37 岁男性，慢性腹痛 9 年，因腹部 CT 偶然发现小网膜 8 cm 肿块而就诊。肿瘤在超声内镜引导下细针抽吸活检诊断为 2 级神经内分泌肿瘤（NEN）。食管胃十二指肠镜检查显示胃窦部有一个 7mm 的红色息肉样病变，中央凹陷，也被证实为 2 级 NEN。腹腔镜下切除腹部肿块证实为转移性胃泌素瘤病变。胃病变随后被诊断为原发性胃泌素瘤。3 个月后，未经治疗，胃病变消失。患者无症状，空腹血清胃泌素正常，在 36 个月的随访中无胃泌素瘤复发。
胃泌素瘤可能在胃窦部以息肉样病变的形式出现。活检后罕见自发消退。
