Primary lymph node gastrinoma – a single institution experience
Abstract
BackgroundGastrinomas are rare neuroendocrine tumors that ectopically secrete gastrin and classically originate within the duodenum or pancreas. The presence of primary lymph node (LN) gastrinoma is controversial. Here we... [ view full abstract ]
Background
Gastrinomas are rare neuroendocrine tumors that ectopically secrete gastrin and classically originate within the duodenum or pancreas. The presence of primary lymph node (LN) gastrinoma is controversial. Here we report on a single institution’s experience with gastrinoma, with focus on primary LN tumors.
Methods
Patients who underwent surgical resection of gastrinoma between 1992 and 2016 at a single institution were identified. A diagnosis of primary LN gastrinoma was defined as tumor confined to one or more resected peripancreatic lymph nodes, negative localization for any extra-nodal disease and normal gastrin post-resection.
Results
39 consecutive patients underwent surgical resection of gastrinoma. Mean age was 53y and 49% were male. 93% of patients had successful pre-operative localization. 19 patients (49%) underwent enucleation of their tumor and 14 (35.9%) a pancreatic resection. Overall 5 and 10-year survival for all patients was 80.8% and 60.7% respectively. Primary LN gastrinoma was identified in 11 cases (28.2%). The presentation of primary LN and non-primary LN patients were similar. There was no significant difference surgery type, tumor size or overall survival. At median follow-up of 46 months, patients with primary LN gastrinoma were less likely to have persistent or recurrent disease (9.1% vs 42.9%, p=0.04).
Conclusion
This series supports the existence of primary LN gastrinomas, and indicates that as many as 1 in 4 patients with gastrinoma have this form of the disease. This entity should be considered when an isolated pathologic lymph node is identified, although thorough exploration is still recommended to exclude other occult disease.
Authors
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Yufei Chen
(Massachusetts General Hospital)
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Vikram Deshpande
(Massachusetts General Hospital)
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Cristina Ferrone
(Massachusetts General Hospital)
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Lawrence Blaszkowsky
(Massachusetts General Hospital)
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Sareh Parangi
(Massachusetts General Hospital)
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Andrew Warshaw
(Massachusetts General Hospital)
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Keith Lillemoe
(Massachusetts General Hospital)
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Carlos Fernandez-del Castillo
(Massachusetts General Hospital)
Topic Areas
Endocrine Surgery , General Surgery
Session
QS-Br/Endo » Quick-Shot Presentations: Breast/Endocrine (15:00 - Thursday, 21st September, Bradley 400)