gastrins and Cystadenoma

A Zollinger-Ellison syndrome due to an ovarian mucinous cystadenoma of borderline malignancy is reported in a 76-year-old woman. Immunostaining procedures showed reactivity for gastrin in neoplastic cells. After operation, the patient has remained without symptoms for 6 years. This is the fifth case reported in the literature. All of these ovarian tumors were considered mucinous cystadenomas histologically.

Topics: Aged; Cystadenoma; Female; Gastrins; Hormones, Ectopic; Humans; Ovarian Neoplasms; Zollinger-Ellison Syndrome

An ovarian gastrinoma would appear to be an extremely rare cause of the Zollinger-Ellison syndrome. Nevertheless, two consecutive cases of Zollinger-Ellison syndrome seen at our institution each proved to be caused by a gastrin-producing ovarian mucinous cystadenoma. That the ovarian tumor was the source of gastrin production was established by preoperative and postoperative gastrin and gastric secretory studies and by specific immunocytochemistry of the excised tissue. After oophorectomy, each patient was apparently cured of the disease. Ovarian gastrinomas may not be as uncommon as is generally believed and should be considered as a possible cause of the Zollinger-Ellison syndrome in any female patient in whom a primary gastrointestinal or pancreatic tumor cannot be located.

Topics: Adult; Cystadenoma; Female; Gastrinoma; Gastrins; Humans; Middle Aged; Ovarian Neoplasms; Zollinger-Ellison Syndrome

We report a case of a clinically and biologically typical hypergastrinemia syndrome due to ovarian mucinous cystadenoma. When examined under histoimmunofluorescence, this "border-line" tumor was shown to contain a polymorphous endocrine cell proliferation, composed primarily of G cells and, to some degree, of D cells. Electron microscopic study further evidenced a small amount of prolactin containing cells, which coincided with elevated prolactin-levels in blood. Ovariectomy combined with vagotomy and pyloroplasty resulted in a prompt disappearance of both clinical and biological abnormalities. Ovarian mucinous cystadenomas have been known for a long time to contain endocrine cells, but only five cases, including the present one, have been described with fully developed endocrine expression. We suggest that this particular condition could be more frequent than generally admitted, and could justify systematic screening for mucinous cystadenoma in the case of peptide hormone dysfunction.

Topics: Adult; Cystadenoma; Female; Gastrins; Humans; Hyperprolactinemia; Ovarian Neoplasms; Syndrome

Topics: Adult; Cystadenoma; Female; Gastrins; Humans; Ovarian Neoplasms; Secretory Rate; Zollinger-Ellison Syndrome

Forty-five cases of mucinous tumors of the ovary were studied for argyrophilia. Argyrophil cells were identified in seven of the 22 cystadenomas (32%), five of the 11 borderline tumors (45%), and two of the 12 carcinomas (17%). These 14 tumors and two additional mucinous tumors known to contain argyrophil cells were studied further by immunohistochemical methods for the localization of calcitonin, gastrin, somatostatin, adrenocorticotropin (ACTH), serotonin, neurotensin, and lysozyme. Serotonin immuno-reactivity was identified in 15 of the 16 cases. Among the peptide hormones, there was a high frequency of positivity for ACTH, gastrin, and somatostatin. Despite the demonstration of reactivity for these hormones, there was no clinical evidence of syndromes of hormone excess in the patients. Lysozyme was present in all but one of the benign and borderline tumors, but was not identified in the carcinomas. Lysozyme was also found in normal and neoplastic gastric and endocervical epithelium, indicating that its presence is not useful in differentiating gastrointestinal and müllerian-type epithelium. The results of this study confirm the previously recognized intestinal characteristics of the epithelium of many mucinous tumors, but also raise the question whether the simple, uniformly mucinous epithelium that is most common within these tumors and is generally regarded as endocervical in type may occasionally be gastric in nature.

Topics: Adrenocorticotropic Hormone; Calcitonin; Cystadenocarcinoma; Cystadenoma; Endothelium; Female; Gastrins; Humans; Immunoenzyme Techniques; Muramidase; Neurotensin; Ovarian Neoplasms; Serotonin; Silver; Somatostatin; Staining and Labeling

We report a patient with abdominal pain, diarrhea, and edema of the small intestine all of which disappeared after resection of an ovarian mucinous cystadenoma of borderline malignancy. Preoperatively, the serum gastrin level was high and it decreased to normal afterwards; subsequent immunohistochemical studies of the tumor revealed cytoplasmic hormone granules containing gastrin-like immunoreactivity. We believe that the symptoms in our patient were the result of an ectopic ovarian gastrin-producing tumor.

Topics: Adult; Cystadenoma; Female; Gastrins; Hormones, Ectopic; Humans; Ovarian Neoplasms

Topics: Adult; Aged; Cholecystokinin; Cystadenocarcinoma; Cystadenoma; Enkephalins; Female; Gastrins; Gastrointestinal Hormones; Glucagon; Humans; Middle Aged; Neurotensin; Ovarian Neoplasms; Somatostatin

Techniques for evaluating ectopic gastrin production associated with the Zollinger-Ellison syndrome are described. The site of gastrin production in this example was a mucinous cystadenoma of the ovary confirmed by immunoperoxidase localization of gastrin within the ovarian tumor cells and by radioimmunoassay of the tumor's gastrin content. These methods, localizing the source of ectopic gastrin, permitted conservative management of the ulcer diathesis with surgical resection of the mucinous cystadenoma. After oophorectomy the patient's serum gastrin level returned to normal, and the ulcer diathesis ceased.

Topics: Cystadenoma; Female; Gastrins; Hormones, Ectopic; Humans; Middle Aged; Ovarian Neoplasms; Ovary; Radioimmunoassay; Zollinger-Ellison Syndrome

Angiographic findings in one giant cell carcinoma, one cystadenocarcinoma, one poorly vascularized mucinous cystadenocarcinoma, as well as in two avascular (gastrin- and glucagon-producing) islet-cell tumors of the pancreas are described. Two hypervascularized islet-cell tumors are presented for comparison and a case of tumorous chronic pancreatitis in a child is reported because ot its rarity. The aggressiveness of the giant cell carcinoma of the pancreas was demonstrated by its expansive growth. In the case of cystadenocarcinoma angiography revealed the tumor with hepatic metastases not diagnosed at explorative laparotomy. The relative hypovascularity in the case of mucinous cystadenocarcinoma was unusual. Both avascular islet-cell tumors simulated a pancreatic pseudocyst and the final diagnosis was made only by immunoassay. Chronic pancreatitis in a child presented with marked hypervascularization.

Topics: Adenoma, Islet Cell; Adult; Aged; Angiography; Carcinoma; Celiac Artery; Chronic Disease; Contrast Media; Cystadenoma; Diagnosis, Differential; Female; Gastrins; Glucagon; Hepatic Artery; Humans; Male; Middle Aged; Pancreatic Cyst; Pancreatic Neoplasms; Pancreatitis; Zollinger-Ellison Syndrome

Topics: Cystadenoma; Female; Gastrins; Humans; Middle Aged; Ovarian Neoplasms; Radioimmunoassay; Zollinger-Ellison Syndrome