Gastrinoma- Symptoms, Diagnosis and Treatment

Gastrinomas are rare tumors forming in the pancreas or duodenum, which is the first part of the small intestine. These growths can form as a single tumor or group of tumors. They begin in the cells that produce gastrin, which is a hormone responsible for secreting gastric acid. If you have a gastrinoma, your body secretes large amounts of gastrin, resulting in a higher level of stomach acid. This higher level can cause the formation of ulcers in your stomach and small bowel. Gastrinomas can be either benign or malignant.

Symptoms

Because gastrinomas cause an increase in stomach acid production, the symptoms are similar to those of peptic ulcers. Some people live with symptoms for several years before their doctor makes a diagnosis.

Symptoms of a gastrinoma include:

• stomach pain
• diarrhea
• indigestion or heartburn
• bloating
• vomiting
• nausea
• bleeding
• weight loss
• poor appetite

Even though ulcers can occur with tumors, having an ulcer doesn’t mean you have a tumor. Your doctor, however, may check for a gastrinoma if you have a persistent ulcer and one of the following conditions:

• intestinal perforation and bleeding
• high calcium levels
• a family history of gastrinoma
• excessive stomach acid that doesn’t improve with treatment

Causes

Gastrinomas are the uncontrolled division of cells that produce gastrin. The exact cause of this condition is unknown, although there may be a genetic link.

This hereditary disorder is characterized by the development of tumors in hormone-producing glands. Other symptoms of MEN1 may include higher hormone levels, kidney stones, diabetes, muscle weakness, and fractures.

Diagnosis

• Secretin test/fasting serum gastrin
• Gastric pH test
• Imaging tests
• Biopsy

Treatment

The location of tumors, and whether they’ve spread to other parts of the body, determines how your doctor treats gastrinoma. Surgery is the primary treatment, and the objective of surgery is to remove cancer from the body and cure the disease.

The procedure your doctor recommends is also based on the location of the tumor. Surgical options may include:

• removal of the entire tumor
• removal of the head of the pancreas or the tail of the pancreas
• small bowel resection (removal of part of the small bowel and the tumor)
• surgery to remove tumors that have spread to other organs, such as the lymph nodes or liver

Risks associated with surgery include infection, pain, and blood loss. Talk to your doctor to understand your risks.

Sometimes, surgery isn’t an option, or the cancer spreads and becomes incurable. If you develop secondary liver cancer from gastrinoma, treatment options include:

• radiofrequency ablation (uses heat to kill cancer cells)
• transarterial chemoembolization (injects chemotherapy directly into the tumor)
• selective internal radiotherapy (a therapy that targets the blood supply to the liver)

Other treatments for gastrinomas include:

• chemotherapy (kills cancer cells that can’t be removed surgically)
• proton-pump inhibitors (reduce the production of stomach acid)

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