Most common site for gastrinoma ?
Ans. is 'a' i.e., Duodenum Upto 50% gastrinoma are found in duodenum. Gastrinoma (Zollinger-Ellison syndrome) ZES is a non Beta-cell endocrine tumour. > 80% of gastrinoma found in gastrinoma triangle bounded by superiorly cystic and common bile ducts, inferiorly junction of the 2nd and 3rd pa of duodenum, medially junction of the neck and body of the pancres. Upto 50% gastrinoma found in duodenum. Less common extra pancreatic sites are stomach, bones, ovareies, hea, liver and lymphnodes. More than 60% tumours are malignant and with upto 30 to 50% patients having multiple lesions of metastatic diseases at presentation. In Z.E.S. patient multiple severe peptic ulcer at unusual sites. Such as post bulbar, duodenum, jejunum or oesophagus. There is poor response to standard ulcer therapy. Proton pump inhibitors are the treatment of choice.
Duodenum
Pylorus
Antrum
Colon