A case of gastrinoma probably originating from the liver

Abstract

Primary hepatic gastrinoma is rare. We experienced a case of gastrinoma probably originating from the liver. A 35-year-old woman was referred to our hospital because of a liver tumor detected during the treatment of a duodenal ulcer. She was diagnosed with an intrahepatic cholangiocarcinoma with an intrahepatic metastasis and underwent surgical resection. However, histopathological examination pointed out that these tumors were neuroendocrine tumors. Pre- and post-surgical assessment did not find any possible primary lesions other than the liver. Fifty-three months later, the duodenal ulcer recurred and a liver tumor was again found. The fasting plasma concentration of gastrin was high. Under the diagnosis of recurrent neuroendocrine tumor producing gastrin (gastrinoma) of the liver, surgical resection was performed. During the operation, no possible primary lesions were observed. Histopathological examination indicated gastrinoma. Reassessment of the first surgical specimens also showed gastrin immunohistochemically. After the operation, the fasting concentration of plasma gastrin declined to normal range. She remained free of disease for 27 months and no extrahepatic lesions were revealed. Her clinical course strongly suggested that her tumor was primary hepatic gastrinoma. Since primary hepatic gastrinoma is a low-grade malignancy, surgical resection could contribute to long-term survival.