Primary lymph node gastrinoma: a case report and review of the literature

• Published in: World journal of surgical oncology 2020-04, Vol.18 (1), p.80-80, Article 80
• Main Authors: Cavalcanti, Elisabetta, Stasi, Elisa, Coletta, Sergio, Lorusso, Dionigi, Rinaldi, Caterina Mammone, Armentano, Raffaele
• Format: Article
• Language: English
• Subjects: Abdomen; Abdominal Pain - diagnosis; Abdominal Pain - etiology; Abdominal Pain - surgery; Care and treatment; Case Report; Case reports; Case studies; Diagnosis; Endoscopy; Gastrinoma; Gastrinoma - complications; Gastrinoma - diagnosis; Gastrinoma - pathology; Gastrinoma - surgery; Humans; Laboratories; Literature reviews; Localization; Lymph Node Excision; Lymph nodes; Lymph Nodes - diagnostic imaging; Lymph Nodes - pathology; Lymphadenopathy - complications; Lymphadenopathy - diagnosis; Lymphadenopathy - pathology; Lymphadenopathy - surgery; Lymphatic diseases; Lymphatic system; Magnetic resonance imaging; Male; Metastases; Metastasis; NEN (neuroendocrine neoplasm); Neoplasia; Neuroendocrine tumors; Pain; Pancreas; Patients; Primitive lymph node; Proton pump inhibitors; Signs and symptoms; Tomography, X-Ray Computed; Treatment Outcome; Tumors; Ultrasonic imaging; Young Adult
• ISSN: 1477-7819; 1477-7819
• DOI: 10.1186/s12957-020-01860-5

Gastrinoma is a rare form of neuroendocrine neoplasm. The presence of a primary lymph node localization of gastrinoma is a much debated and controversial topic in the literature, as regards whether these cases represent metastatic disease from an as yet unidentified primary tumor, or the de novo occurrence of a gastrinoma in a lymph node. We report the case of a 24-year-old male with intense epigastric pain treated at the beginning with high dose proton pump inhibitors. Further workup with CT and subsequent laparotomy revealed a single peripancreatic lymph node. Histological examination highlighted a well-differentiated neuroendocrine tumor. This case underlines that the primitive lymph node gastrinoma is a distinct nosological entity with a precise location in the context of rare neuroendocrine tumors that should be considered when specific symptoms are associated with the identification of isolated lymph nodes, after excluding any possible primitive locations of neoplastic localization.