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What are Gastrinomas?

Shannon Kietzman
Shannon Kietzman

Gastrinomas are tumors characterized by secretions of large amounts of gastrin, a hormone that increases the amount of acid released by the stomach. They are most commonly associated with Zollinger-Ellison syndrome (ZES), a rare gastroenterological disorder. This disorder is more commonly referred to as peptic ulcer disease and is also sometimes called gastrinoma because of its close association with these tumors.

Most often, gastrinomas occur in the duodenum and the pancreas, though they may also occur in the pituitary gland and the hyperfunction of the parathyroid gland. About 66% are malignant, often spreading to the patient’s liver. In addition, due to the increased production of acids by the tumors, patients with ZES develop large numbers of severe ulcers. These are mostly located in the stomach or the duodenum.

Peptic ulcers are most commonly seen in an individual with gastrinomas.
Peptic ulcers are most commonly seen in an individual with gastrinomas.

In the early stages of ZES disease, peptic ulcers are the most typical symptom. After ZES has become more established in the body, these ulcers start to cause more problems for the patient and become more difficult to treat with anti-ulcer therapy. At this point, additional symptoms such as diarrhea and abdominal pain may develop. In fact, diarrhea is the most common symptom of gastrinomas.

Surgery may be a treatment for gastrinomas.
Surgery may be a treatment for gastrinomas.

A blood test is usually necessary for diagnosing gastrinomas. This test is designed to determine the amount of gastrin in the patient’s blood. A level of over 200 picograms per milliliter (pg/mL), which is four to ten times more than the normal level, is a strong sign. In severe cases, patients have gastrin levels measuring 450,000 pg/mL.

If the test does not show high levels of gastrin in the patient’s blood, a physician may instruct the patient to eat specific foods or may inject the patient with certain substances in order to create a response. A secretin injection test is the most common method used. This test almost always creates a response in patients with gastrinomas.

Several abdominal organs, including the pancreas and duodenum.
Several abdominal organs, including the pancreas and duodenum.

Gastrinomas may be treated with surgery, though they are difficult to find. In fact, the tumors in 10 to 20% of patients go unseen during surgery. In these cases, the gastrinomas may not be found until they have metastasized and caused additional symptoms.

In some cases, gastrinomas may also be treated with anti-ulcer medication. A patient taking medication to successfully control them will need to stay on the medication for the remainder of his or her life. Otherwise, ulcers will recur. In addition, anti-ulcer medications do not heal gastrinomas, and for many patients, they are not an effective long-term treatment.

Discussion Comments

anon335236

I am currently pregnant and have a lump almost the size of an orange on the outside of my vagina. I would say it's where my ovaries are located. I noticed this lump with my last two pregnancies. At the end of my last one, I was one stage away from cervical cancer when they checked me. Then, after I delivered, they did a biopsy and said it came back good, but this knot is back and has gotten very large. Does anyone know what this could be or have any suggestions? By the way, when I bear down while having a bowel movement, it really sticks out. I have issues urinating and having bowel movements and have had since my last two pregnancies. Please, someone give me some advice.

anon265377

Could a hyperintense of T2 have caused my fractured hip?

medicchristy

@snowywinter: That's a great question. I looked up a few things on it and they don't list anything specific as far as food.

However, they all seem to be consistent in using some type of calcium response. This is only if the amount of gastrin in the person's blood is low.

I am going to continue to research this and I will post any findings.

SnowyWinter

Very interesting article. I do have one question: The article stated that if there weren't high levels of gastrin in the blood, certain foods could be eaten to create a response.

What foods are these and what kind of response would it cause?

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    • Peptic ulcers are most commonly seen in an individual with gastrinomas.
      By: psdesign1
      Peptic ulcers are most commonly seen in an individual with gastrinomas.
    • Surgery may be a treatment for gastrinomas.
      By: Kzenon
      Surgery may be a treatment for gastrinomas.
    • Several abdominal organs, including the pancreas and duodenum.
      Several abdominal organs, including the pancreas and duodenum.
    • Peptic ulcers are the most common symptom in the early stages of ZES disease.
      By: designua
      Peptic ulcers are the most common symptom in the early stages of ZES disease.
    • A blood test is usually necessary for diagnosing gastrinomas.
      By: Tim UR
      A blood test is usually necessary for diagnosing gastrinomas.