Gastrinomas

• Epidemiology:

  • >50% of Gastrinomas = Local invasion or metastasis at the time of diagnosis

  • ~25% of patients = Gastrinomas in conjunction with other endocrine tumours (MEN-1 syndrome)

  • MEN-1 Gastrinomas = Multifocal
• Localisation:

  • Gastrinoma triangle:

  • Duodenum
  • Peri - Pancreatic soft tissues
  • Pancreas
• Clinical Features (Zollinger Ellison Syndrome):

  • Hypergastrinaemia → Increased gastric acid secretion → Peptic ulceration
  • Peptic ulcers (unresponsive to usual therapy) in the stomach and duodenum, but also in unusual locations (e.g. jejunum)
  • Diarrhoea in >50% of patients