Multiple Carcinoid of the Remnant Stomach with Hypergastrinemia in a Patient with Zollinger-Ellison Syndrome with Multiple Endocrine Neoplasia Type 1

Naoto Takahashi, Hideyuki Kashiwagi, Nobuo Omura, Kazuhito Tsuboi and Katsuhiko Yanaga

Department of Surgery, Jikei University School of Medicine

A 43-year-old woman undergoning vagotomy and antrectomy for Zollinger-Ellison syndrome (ZES) 11 years earlier exhibited postoperative serum gastrin level exceeding 1,000 pg/ml, for which H₂ receptor antagonist (H₂RA) or proton pump inhibitor (PPI) was administered. In October 1995, endoscopic examination showed numerous tiny elevated lesions in the remnant stomach and around the anastomosis, for which endoscopic biopsy showed carcinoid cells. We suspected that hypergastrinemia triggered ECL-cells to hyperplasia or carcinoids of the remnant stomach. In May 1997, we conducted remnant gastorectomy. Histrological examination of the resected specimen showed carcinoids of the remnant stomach. The woman remains well 20 years after her first operation.

Key words
duodenal gastrinoma, multiple endocrine neoplasia, gastric carcinoid

Reprint requests
Naoto Takahashi Department of Surgery, The Jikei University
3-25-8 Nishi-shinbashi, Minato-ku, 105-8471 JAPAN

Accepted
May 31, 2007

To read the PDF file you will need Abobe Reader installed on your computer.