Five-Year Long-Term Followup of a Primary Lymph node Gastrinoma : Is a Pancreaticoduodenectomy Justified?

الملخص EN

Background.

Gastrinoma-positive lymph nodes and failed localization of the primary tumor during surgical exploration are described.

Specialists suppose that these lymph nodes are metastases rather than a primary gastrinoma.

Methods.

Case report with a five-year long-term followup.

A 60-year-old patient with an confirmed gastrinoma was treated in our department.

All preoperative evaluations including somatostatin-receptor-scintigraphy and F-Dopa PET failed to localize the gastrinoma.

Explorative laparotomy revealed a gastrinoma in two peripancreatic lymph nodes.

Despite extensive intraoperative exploration, no primary gastrinoma could be detected in typical localization.

Results.

Over a period of 5 years, the patient's gastrin level stayed in the normal range and the patient seems to be completely cured.

Conclusion.

A prophylactic partial pancreatoduodenectomy is not indicated to avoid recurrence, since complete biochemical cure by local resection of the lymph node gastrinoma is possible.