Endocrine Abstracts

Introduction: Gastrinoma is a rare neuroendocrine tumor and associated with liver metastasis in 20–40% of cases. We present a rare case report of a patient with stable liver metastasis due to gastrinoma for more than 35 years.

Case report: A 49 year old male is currently on our regular clinic follow up for the liver metastasis due to gastrinoma. His past history includes open laparotomy and resection of gastrinoma (Proven histologically) at the age of 12. During the surgery liver metastasis was noted. He was followed up in clinic until the age of 20. Later he presented with diarrhoea at the age of 38 and was started on Omeprazole 20 mg TDS. Currently he has no symptoms. Genetic study for MEN-1 syndrome is negative. Blood tests showed raised Gastrin levels of 450 ng/l while on Omeprazole. MRI of abdomen in 2014 showed three large liver lesions with largest lesion size of 7 cm. Gallium Dotate PET scan showed all lesions are metabolically active. Compared to previous CT scan in 2006 and 2010 no change in the liver metastasis size.

Discussion and conclusion: Presence of liver metastasis with gastrinoma generally indicates poor prognosis with some studies suggests 10-year survival rate of only 10–20%. However very indolent gastrinoma with liver metastasis is rare and could be managed conservatively.