A new cause of Zollinger-Ellison syndrome: non-small cell lung cancer.

Abstract:

:Numerous epidemiologic studies suggest a relationship between lung cancer and peptic ulcer disease. Furthermore, various lung cancers synthesize and release a number of peptides such as gastrin and gastrin-releasing peptide that could cause acid hypersecretion; however, Zollinger-Ellison syndrome (ZES), because of a lung tumor, has never been described. We report such a patient for the first time. A 60-year-old man with a non-small cell lung carcinoma (large cell type) presented with diarrhea, heartburn, abdominal pain, and duodenal ulcers. Evaluation showed ZES was present (fasting hypergastrinemia, hyperchlorhydria) and control of all symptoms by omeprazole. No abdominal or cardiac tumor, the other known locations of gastrinomas causing ZES, was found on detailed tumor imaging studies. Resection of the lung tumor resulted in a decrease in gastrin levels to normal values. Plasma radioimmunoassays showed elevated gastrin, chromogranin A and normal levels of gastrin-releasing peptide, and 9 other hormones. The tumor showed similar immunocytochemical results. The characteristics of this case are compared with 100 cases of sporadic abdominal gastrinomas, and the evidence reviewed suggests why ZES should be considered in patients with lung cancer with peptic symptoms.

journal_name

Gastroenterology

journal_title

Gastroenterology

authors

Abou-Saif A,Lei J,McDonald TJ,Chakrabarti S,Waxman IF,Shojamanesh H,Schrump DS,Kleiner DE,Gibril F,Jensen RT

doi

10.1053/gast.2001.23242

keywords:

subject

Has Abstract

pub_date

2001-04-01 00:00:00

pages

1271-8

issue

5

eissn

0016-5085

issn

1528-0012

pii

S0016508501634577

journal_volume

120

pub_type

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