A Case of Zollinger-Ellison Syndrome in Multiple Endocrine Neoplasia Type 1 with Urolithiasis as the Initial Presentation / 대한소화기학회지
The Korean Journal of Gastroenterology
; : 333-337, 2013.
Article
em En
| WPRIM
| ID: wpr-39210
Biblioteca responsável:
WPRO
ABSTRACT
Zollinger-Ellison syndrome (ZES) is characterized by gastrinoma and resultant hypergastrinemia, which leads to recurrent peptic ulcers. Because gastrinoma is the most common pancreatic endocrine tumor seen in multiple endocrine neoplasia type I (MEN 1), the possibility of gastrinoma should be investigated carefully when patients exhibit symptoms associated with hormonal changes. Ureteral stones associated with hyperparathyroidism in the early course of MEN 1 are known to be its most common clinical manifestation; appropriate evaluation and close follow-up of patients with hypercalcemic urolithiasis can lead to an early diagnosis of gastrinoma. We report a patient with ZES associated with MEN 1, and urolithiasis as the presenting entity. A 51-year-old man visited the emergency department with recurrent epigastric pain. He had a history of calcium urinary stone 3 years ago, and 2 years later he had 2 operations for multiple jejunal ulcer perforations; these surgeries were 9 months apart. He was taking intermittent courses of antiulcer medication. Multiple peripancreatic nodular masses, a hepatic metastasis, parathyroid hyperplasia, and a pituitary microadenoma were confirmed by multimodal imaging studies. We diagnosed ZES with MEN 1 and performed sequential surgical excision of the gastrinomas and the parathyroid adenoma. The patient received octreotide injection therapy and close follow-up.
Palavras-chave
Texto completo:
1
Índice:
WPRIM
Assunto principal:
Pâncreas
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Hipófise
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Glândula Tireoide
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Gastrinas
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Imuno-Histoquímica
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Imageamento por Ressonância Magnética
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Gastrinoma
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Tomografia Computadorizada por Raios X
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Síndrome de Zollinger-Ellison
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Artéria Mesentérica Superior
Tipo de estudo:
Screening_studies
Limite:
Humans
/
Male
Idioma:
En
Revista:
The Korean Journal of Gastroenterology
Ano de publicação:
2013
Tipo de documento:
Article