This is an endocrine tumor that mostly occurs in individuals with the severe peptic ulcer disease. Gastrinoma develops in the gastrin-producing cells of the duodenum or the pancreas. The hormone gastrin controls the quantity of acid in the stomach which is essential for the digestion of food. Gastrinoma can produce a large quantity of gastrin which can cause ulcers in the stomach or the small bowel as the result of the excess amount of acid. This type of tumor can spread to other parts of the body, particularly the liver. It is estimated that around 60 – 90% of the gastrinomas are cancerous.
Causes
The cause of gastrinoma is not known, although some of the risk factors for developing this type of tumor include individuals with the rare family cancer syndrome known as multiple endocrine neoplasia type 1 (MEN1).
Symptoms
The symptoms develop with the increased level of the hormone gastrin that the tumors can produce which can result in the excess production of acid in the stomach. Some of the symptoms of gastrinoma include abdominal pain, diarrhea, weight loss, bleeding, feeling sick and indigestion.
Diagnosis
Individuals with the recurrent peptic ulcers should be considered for the diagnosis of gastrinoma. The diagnosis is possible by evaluating the level of gastrin and its response to a particular type of hormone known as secretin. As most of the gastrinomas are small in size, it may be difficult to locate the tumor. However, some of the tests that are used to identify the tumors include MRI, CT scan and an endoscopic ultrasound.
Treatment
The treatment is based on the number of tumors, the overall health of the affected individual, if the tumor is cancerous or non-cancerous and its location. In most of the cases, the treatment of gastrinoma is surgery. But, when the tumor spreads to other parts of the body, the treatment is usually focused on the management of the symptoms. If the tumor is located in the small bowel, then the tumor and a small part of the small bowel may be removed. If the tumor is cancerous, during the surgery, the nearby lymph nodes may also be removed. When the tumor has spread to the liver, the option includes removal of the tumors in the liver or depending on the case, a liver transplant may be optional. When the tumor cannot be removed, alternative treatment includes radiofrequency ablation to reduce the symptoms by destroying the cancerous cells in the liver. Alternatively, medications can be used to reduce the quantity of acid that is produced as the result of the tumor which can limit the development of more serious symptoms. Chemotherapy is also optional that can help in the control of the symptoms when the tumors cannot be surgically removed.
References
http://www.cancerresearchuk.org/about-cancer/cancers-in-general/cancer-questions/gastrinomas
