What is Gastrinoma of the Pancreas?A gastrinoma is a type of endocrine tumour that secretes the hormone gastrin and originates from gastrin-secreting pancreatic cells. It usually originates from the head or neck part of the pancreas. The tumour has malignant potential and can spread to other distant parts of the body. Gastrinoma can also originate from the duodenum (first part of the small intestine) and common bile duct (a tube-like structure that collects and deliver bile from the gall bladder to the small intestine). In 50% of patients with the gastrinoma pancreas, these tumours can be cancerous and can spread to the liver and can spread to other distant parts of the body. The five-year survival rate is 20-30%. While in cases where the tumour has spread to the liver and lymph nodes, the remaining life expectancy is less than 1 year.
Disease EpidemiologyGastrinoma tumours of the pancreas account for approximately 2% of all types of pancreatic tumours. These tumours are more common in men than in women. It is more common in people aged 30-50 years.
Disease CausesUncontrolled division or multiplication of cells that produce gastrin, due to a genetic mutation, is the cause of the development of pancreatic gastrinoma. Gastrin is a hormone that increases the production of stomach acid to aid in the digestion of food.
Signs and SymptomsThe patient may suffer from the following signs and symptoms. These are
- Pain in the abdomen
- Heartburn or chest pain (indigestion)
- Unintentional weight loss
- Lose motion
- Blood with the vomiting or stool (motion)
- Bitter taste in the mouth
DiagnosisThe following diagnostic techniques and procedures can be used to make a diagnosis. These are
- Complete blood count ( CBC)
- Blood coagulation profile (for example partial thromboplastin time PTT, international normalized ratio INR)
- Serum electrolyte levels
- Liver function tests (LFTs)
- Abdominal USG, CT scan and MRI
- Immunohistochemical staining
TreatmentThe selection of suitable treatment depends upon multiple factors like the size, number, and location of the tumour. Other factors are the overall performance of the pancreas, presence or absence of the spread of the tumour to the liver, nearby lymph nodes and other distant parts of the body, presence or absence of the Liver cirrhosis, its extent, and risk involved in the case of surgery due to the extent of the cirrhosis. On behalf of the above mentioned factors there are the following treatment options;
- Resection; surgical removal of the tumour along with some healthy tissues from the surroundings of the tumour to stop the spread of cancer in the early stage of cancer.
- Radiofrequency Ablation; is a non-surgical technique to kill and stop the spread of cancer cells in cases where surgery is not a suitable option.
- Targeted immunotherapy