Abstract | INTRODUCTION: PRESENTATION OF CASE: The patient is a 57 year old female diagnosed with ZES, suspected of having a primary lymph node gastrinoma. The patient underwent an exploratory laparotomy and excision of a portacaval lymph node with a frozen section which was positive for gastrinoma. Intraoperative sonography of the pancreas, upper endoscopy with transillumination of the duodenum, and a duodenotomy with bimanual examination of the duodenal wall were also performed. The patient was found to have a 4mm duodenal mass near the pylorus, which was excised. DISCUSSION: Pathology showed that the duodenal mass was primary gastrinoma. Serum gastrin levels taken four months postoperatively were normal and the repeat octreotide scan did not show any evidence of recurrence. CONCLUSION: Primary lymph node gastrinoma is a diagnosis of exclusion. The duodenum and pancreas must be fully explored to rule out a primary gastrinoma that may be occult.
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Authors | Annabelle Teng, Christopher Haas, David Y Lee, John Wang, Edward Lung, Fadi Attiyeh |
Journal | International journal of surgery case reports
(Int J Surg Case Rep)
Vol. 5
Issue 11
Pg. 849-52
( 2014)
ISSN: 2210-2612 [Print] Netherlands |
PMID | 25462049
(Publication Type: Journal Article)
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Copyright | Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved. |