CASI CLINICI   

Chirurgia 2015 February;28(1):19-21

Copyright © 2015 EDIZIONI MINERVA MEDICA

lingua: Inglese

Two-stage total gastrectomy with lymphadenectomy and pancreaticoduodenectomy for gastroduodenal neuroendocrine tumors in familial Zollinger-Ellison syndrome: a 5-year follow-up report

Nagem R. G., Chaves D. N. B.

Department of Surgery, Ipsemg Hospital, Belo Horizonte, Brazil

A 40-year-old woman presented with gastric outlet obstruction secondary to multiple polyps covering the entire gastric mucosa and the proximal duodenum. After workup she was found to have multiple endocrine neoplasia type 1 evolving with prolactinoma, hyperparathyroidism and Zollinger-Ellison Syndrome. She received standard treatment for parathyroid and pituitary adenomas. However, the gastric and duodenal tumors presented their own management challenges. Duodenal lesions were gastrinomas and their treatment may range from medications to pancreaticoduodenectomy. Lesions in the stomach were type II gastric neuroendocrine neoplasms for which literature offers no consensus in treatment. The patient received a curative-intent procedure, is asymptomatic and with no evidence of recurrence at the 5-year follow-up.