| Pancreatic islet cell carcinoma presenting with concurrent Cushing's and Zollinger-Ellison syndromes: case series and literature review. | |
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MedLine Citation:
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PMID: 19770666 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Cushing's syndrome and Zollinger-Ellison syndrome occur occasionally as a result of neuroendocrine cancers. The concurrence of the two syndromes has been considered to confer a poor clinical and therapeutic outcome. In this study, we are reviewing two patients with pancreatic islet cell carcinomas and with both Zollinger-Ellison and Cushing's syndromes, one followed up for more than 5 years, and the other still receiving therapy, 5 years since diagnosis. A literature review showed that surgery has limited utility as the majority of these patients had metastases at the time of diagnosis. Proton-pump inhibitors, ketoconazole, and somatostatin antagonists have a major role in controlling symptoms. Interferon and systemic chemotherapeutic agents play a role in the management of metastatic and fast-growing cases. Chemoembolization and bland embolization show encouraging results in controlling liver metastases. The latter was used effectively and more than once in the two patients presented herein. On the basis of recent molecular genetics studies, target therapy may be helpful, however, ongoing trials will define it's utility. As the data confers a worse prognosis versus other pancreatic neuroendocrine tumors, the relatively favorable outcome of the two patients reported herein may reflect the impact of multiple therapeutic modalities. |
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Authors:
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Rabih Said; Eileen M O'Reilly; Leslie Blumgart; Jinru Shia; Ghassan K Abou-Alfa |
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Publication Detail:
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Type: Case Reports; Journal Article; Review |
Journal Detail:
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Title: European journal of gastroenterology & hepatology Volume: 22 ISSN: 1473-5687 ISO Abbreviation: Eur J Gastroenterol Hepatol Publication Date: 2010 Feb |
Date Detail:
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Created Date: 2010-01-11 Completed Date: 2010-03-12 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9000874 Medline TA: Eur J Gastroenterol Hepatol Country: England |
Other Details:
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Languages: eng Pagination: 246-52 Citation Subset: IM |
Affiliation:
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Staten Island University Hospital, New York, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adrenalectomy Adult Aged Antineoplastic Agents / therapeutic use Carcinoma, Islet Cell / complications*, secondary, therapy Combined Modality Therapy Cushing Syndrome / etiology*, pathology, therapy Embolization, Therapeutic Fatal Outcome Female Gastrointestinal Agents / therapeutic use Hormone Antagonists / therapeutic use Humans Liver Neoplasms / secondary Pancreatic Neoplasms / complications*, pathology, therapy Treatment Outcome Zollinger-Ellison Syndrome / etiology*, pathology, therapy |
| Chemical | |
Reg. No./Substance:
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0/Antineoplastic Agents; 0/Gastrointestinal Agents; 0/Hormone Antagonists |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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