Document Detail

Multiple endocrine neoplasm, type 1. Gastrinomas, pancreatic neoplasms, microcarcinoids, the Zollinger-Ellison syndrome, lymph nodes, and hepatic metastases.
MedLine Citation:
PMID:  8105768     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: We reviewed the age of presentation, malignant potential, and outcome of gastrinomas and pancreatic tumors in patients with multiple endocrine neoplasm, type 1. DESIGN: Screening of one very large and one smaller, possibly related family on an island, including serum gastrin estimations and, when indicated, pancreatic ultrasound. SETTING AND PATIENTS: Over 2000 family members and their family physicians were advised on screening procedures. INTERVENTION: Data were collected and reviewed retrospectively and prospectively for all medical records, investigations, surgical procedures, and available tissue samples. OUTCOME MEASUREMENTS: Criteria for diagnosis were established for radiological, biochemical, and histological studies. RESULTS: Sixty-two patients had evidence of gastrinoma or pancreatic neoplasm. In 19 patients the diagnosis was based on demonstration of a tumor. In 21 patients the diagnosis was based on elevated serum gastrin concentration in the absence of demonstrable tumor. None of these patients required gastric surgery if they first underwent parathyroidectomy. In 18 patients the diagnosis was based on the combination of demonstrated pancreatic tumor plus elevated glucagon (two patients), gastrin (11 patients), or insulin (five patients) concentration. Peptic ulcer was difficult to control in seven of the 11 patients with elevated gastrin concentrations plus demonstrated tumor. Four patients had liver metastases that appeared to be secondary to the pancreatic gastrinoma. In patients with insulinomas, the first symptoms occurred before age 20 years. Elevated serum gastrin concentrations were not seen before age 24 years and were observed to occur for the first time in two patients after age 50 years.
J J Shepherd; D R Challis; P F Davies; J P McArdle; B T Teh; S Wilkinson
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Archives of surgery (Chicago, Ill. : 1960)     Volume:  128     ISSN:  0004-0010     ISO Abbreviation:  Arch Surg     Publication Date:  1993 Oct 
Date Detail:
Created Date:  1993-11-16     Completed Date:  1993-11-16     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9716528     Medline TA:  Arch Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1133-42     Citation Subset:  AIM; IM    
Department of Surgery, University of Tasmania, Hobart, Australia.
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MeSH Terms
Age Factors
Aged, 80 and over
Follow-Up Studies
Gastrinoma* / blood,  diagnosis,  epidemiology,  secondary,  surgery
Gastrins / blood
Glucagon / blood
Insulin / blood
Insulinoma* / blood,  diagnosis,  epidemiology,  secondary,  surgery
Liver Neoplasms* / blood,  diagnosis,  epidemiology,  secondary,  surgery
Lymphatic Metastasis
Middle Aged
Multiple Endocrine Neoplasia* / blood,  epidemiology,  pathology,  surgery
Pancreatic Neoplasms* / blood,  epidemiology,  pathology,  surgery
Prospective Studies
Retrospective Studies
Zollinger-Ellison Syndrome* / blood,  epidemiology,  pathology,  surgery
Reg. No./Substance:
0/Gastrins; 11061-68-0/Insulin; 9007-92-5/Glucagon

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