Investigation
Diagnosis is made on the basis of: (1,2)
- high fasting plasma gastrin
- high gastric acid secretion:
- usually in excess of 100 mmol/h
- diminished response to pentagastrin
localisation of tumour:
- demonstrable pancreatic or gastrointestinal tumour - by CT or venous sampling for gastrin
- more than 90% of gastrinomas have somatostatin receptors, and somatostatin receptor scintigraphy has been reported to be an especially sensitive method to image gastrinomas
- also, with a skilled operator, endoscopic ultrasonography (also combined with biopsy) is also a very sensitive method to detect pancreatico-duodenal tumours
References:
- Zimmer V, Glanemann M, Lammert F; Zollinger-Ellison syndrome. CMAJ. 2019 Dec 9;191(49)
- Epelboym I, Mazeh H; Zollinger-Ellison syndrome: classical considerations and current controversies. Oncologist. 2014;19(1):44-50.
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