Gastrinomás

Gastrinomas are rare neuroendocrine tumors that primarily arise in the pancreas or the duodenum, though they can occur in other locations as well. These tumors are characterized by their ability to produce and secrete excessive amounts of the hormone gastrin. Gastrin's main function is to stimulate the stomach to produce hydrochloric acid (HCl), a key component of gastric acid.

The overproduction of gastrin by a gastrinoma leads to abnormally high levels of stomach acid. This condition is known as the Zollinger-Ellison syndrome. The excessive acid can cause severe and recurrent peptic ulcers in the stomach, duodenum, and even further down the small intestine. Other symptoms associated with Zollinger-Ellison syndrome include diarrhea, abdominal pain, heartburn, nausea, vomiting, and weight loss. In some cases, the prolonged high acidity can also damage the intestinal lining, leading to malabsorption of nutrients.

Gastrinomas are often part of a genetic disorder called multiple endocrine neoplasia type 1 (MEN1), which predisposes individuals to tumors in multiple endocrine glands. However, many gastrinomas occur sporadically, meaning they are not linked to MEN1. Diagnosis typically involves measuring gastrin levels in the blood. Elevated gastrin levels, especially in the presence of peptic ulcers, are highly suggestive of a gastrinoma. Further imaging techniques like CT scans, MRI, or endoscopic ultrasound are used to locate the tumor.

Treatment strategies for gastrinomas aim to control the excessive acid production and, if possible, remove the tumor. Proton pump inhibitors (PPIs) are highly effective in reducing stomach acid and alleviating ulcer symptoms. Surgical removal of the tumor is the preferred treatment when feasible, offering the potential for a cure. If the tumor cannot be completely removed or has spread, medical management focuses on controlling gastrin secretion and acid levels.