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Ovarian carcinoma as a cause of Zollinger-Ellison syndrome. Natural history, secretory products, and response to provocative tests.
Gastroenterology. 1989 Aug; 97(2):468-71.G

Abstract

Zollinger-Ellison syndrome is usually caused by a gastrin-secreting tumor in or near the pancreas. We describe a patient in whom an ovarian cystadenocarcinoma was the cause of the syndrome. The patient presented with a short history of peptic ulceration and development of a large pelvic mass. Investigations demonstrated a basal acid output of 37.8 mEq/h and a maximal acid output of 36.0 mEq/h, and the plasma concentration of gastrin was 830 pg/ml (normal less than 100). Secretin and calcium infusion tests were positive, and a meal test was compatible with Zollinger-Ellison syndrome. Imaging studies demonstrated a normal liver and pancreas but a large cystic right ovarian mass. Resection of the mass resulted in a marked reduction in gastric acid output, a fall in plasma gastrin concentration to normal, negative calcium and secretin tests, and a normal (positive) meal test. Histology of the mass showed it to be a mucinous cystadenocarcinoma. The tumor stained with immunoperoxidase technique was positive for gastrin, and the cyst fluid contained high concentrations of gastrin and calcitonin. One year later, the patient has no biochemical or imaging evidence of tumor. Ovarian, gastrin-producing tumors and pancreatic gastrinomas cannot be distinguished by provocative tests, and negative imaging studies do not exclude a pancreatic tumor. Patients with an ovarian mass and Zollinger-Ellison syndrome should have a bilateral oophorectomy and a careful exploration of the pancreatic area.

Authors+Show Affiliations

Digestive Diseases Branch, National Institute of Diabetes and Digestive and Kidney Disease, Bethesda, Maryland.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

2663614

Citation

Maton, P N., et al. "Ovarian Carcinoma as a Cause of Zollinger-Ellison Syndrome. Natural History, Secretory Products, and Response to Provocative Tests." Gastroenterology, vol. 97, no. 2, 1989, pp. 468-71.
Maton PN, Mackem SM, Norton JA, et al. Ovarian carcinoma as a cause of Zollinger-Ellison syndrome. Natural history, secretory products, and response to provocative tests. Gastroenterology. 1989;97(2):468-71.
Maton, P. N., Mackem, S. M., Norton, J. A., Gardner, J. D., O'Dorisio, T. M., & Jensen, R. T. (1989). Ovarian carcinoma as a cause of Zollinger-Ellison syndrome. Natural history, secretory products, and response to provocative tests. Gastroenterology, 97(2), 468-71.
Maton PN, et al. Ovarian Carcinoma as a Cause of Zollinger-Ellison Syndrome. Natural History, Secretory Products, and Response to Provocative Tests. Gastroenterology. 1989;97(2):468-71. PubMed PMID: 2663614.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Ovarian carcinoma as a cause of Zollinger-Ellison syndrome. Natural history, secretory products, and response to provocative tests. AU - Maton,P N, AU - Mackem,S M, AU - Norton,J A, AU - Gardner,J D, AU - O'Dorisio,T M, AU - Jensen,R T, PY - 1989/8/1/pubmed PY - 1989/8/1/medline PY - 1989/8/1/entrez SP - 468 EP - 71 JF - Gastroenterology JO - Gastroenterology VL - 97 IS - 2 N2 - Zollinger-Ellison syndrome is usually caused by a gastrin-secreting tumor in or near the pancreas. We describe a patient in whom an ovarian cystadenocarcinoma was the cause of the syndrome. The patient presented with a short history of peptic ulceration and development of a large pelvic mass. Investigations demonstrated a basal acid output of 37.8 mEq/h and a maximal acid output of 36.0 mEq/h, and the plasma concentration of gastrin was 830 pg/ml (normal less than 100). Secretin and calcium infusion tests were positive, and a meal test was compatible with Zollinger-Ellison syndrome. Imaging studies demonstrated a normal liver and pancreas but a large cystic right ovarian mass. Resection of the mass resulted in a marked reduction in gastric acid output, a fall in plasma gastrin concentration to normal, negative calcium and secretin tests, and a normal (positive) meal test. Histology of the mass showed it to be a mucinous cystadenocarcinoma. The tumor stained with immunoperoxidase technique was positive for gastrin, and the cyst fluid contained high concentrations of gastrin and calcitonin. One year later, the patient has no biochemical or imaging evidence of tumor. Ovarian, gastrin-producing tumors and pancreatic gastrinomas cannot be distinguished by provocative tests, and negative imaging studies do not exclude a pancreatic tumor. Patients with an ovarian mass and Zollinger-Ellison syndrome should have a bilateral oophorectomy and a careful exploration of the pancreatic area. SN - 0016-5085 UR - https://www.unboundmedicine.com/medline/citation/2663614/Ovarian_carcinoma_as_a_cause_of_Zollinger_Ellison_syndrome__Natural_history_secretory_products_and_response_to_provocative_tests_ L2 - https://linkinghub.elsevier.com/retrieve/pii/0016-5085(89)90085-1 DB - PRIME DP - Unbound Medicine ER -