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Gastrinoma is a tumor of pancreas that produces excessive amounts of hormone called gastrin, which stimulates the stomach to secrete enzymes and acid, resulting in peptic ulcer. Most individuals with gastrinoma have few tumors clustered near or in the pancreas. Approx. 50% of the gastrinoma tumors are cancerous. In some cases, a gastrinoma occurs as a part of a hereditary disorder, multiple endocrines neoplasia, where tumor arises from the cell of different endocrine glands including pancreas insulin-producing cells. The excess gastrin secreted by symptoms of gastrinoma causes, known as Zollinger-Ellison syndrome, which includes mild to severe pain in the abdomen from duodenum, peptic ulcer, and elsewhere in the patient’s intestine. Obstruction, bleeding, and perforation of the intestine may occur and may be life-threatening. In about 35-40% of the individuals with gastrinoma, diarrhea is the first symptom. A physician suspects gastrinoma, when a patient has several peptic or frequent ulcers that do not respond to the common ulcer treatment. Blood tests are then performed to determine high gastrine levels. Also, gastric juice sample, taken by placing a slender tube through the patient’s nose into the stomach, reveal excessive levels of acid. Finding the tumor can be difficult because generally it is small and there are many of such tumors. A physician uses few imaging techniques including arteriography, ultrasound scan, and CT. Approx. 20% of people who do not have multiple endocrine neoplasias may be treated surgically. For such people before operation and for other people, standard ulcer medications (such as Famotidine, Ranitidine, and Cimetidine) can relieve gastrinoma symptoms. If this treatment fails, omeprazole (which lowers acid secretions by other means) can be helpful. If all these treatment options fail, a surgery gastrectomy total (removal of the stomach) can be needed. Such a surgery does not remove the tumor but the gastrin may no longer harm the stomach, so the gastrinoma’s symptoms disappear. If total gastrectomy is performed, daily calcium and vitamin B12 is necessary. If malignant tumor spreads to other areas of the body, chemotherapy can help lower the tumor cell number and the gastrin blood levels. This therapy however does not treat the cancer, which is usually fatal.
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