Case Report
Copyright ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Jul 27, 2018; 10(7): 517-522
Published online Jul 27, 2018. doi: 10.4254/wjh.v10.i7.517
Large primary hepatic gastrinoma in young patient treated with trisegmentectomy: A case report and review of the literature
Leonardo Zumerkorn Pipek, Yuri Justi Jardim, Gustavo Heluani Antunes de Mesquita, Fernanda Nii, Kayo Augusto de Almeida Medeiros, Bárbara Justo Carvalho, Diego Ramos Martines, Leandro Ryuchi Iuamoto, Daniel Reis Waisberg, Luiz Augusto Carneiro D’Albuquerque, Alberto Meyer, Wellington Andraus
Leonardo Zumerkorn Pipek, Yuri Justi Jardim, Gustavo Heluani Antunes de Mesquita, Fernanda Nii, Kayo Augusto de Almeida Medeiros, Bárbara Justo Carvalho, Diego Ramos Martines, Leandro Ryuchi Iuamoto, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo 05403, Brazil
Yuri Justi Jardim, Program in Global Surgery and Social Change, Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA 02115, United States
Daniel Reis Waisberg, Luiz Augusto Carneiro D’Albuquerque, Alberto Meyer, Wellington Andraus, Departamento de Gastroenterologia, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo 05403, Brazil
Author contributions: Pipek LZ, Jardim YJ, Mesquita GHA, and Martines DR wrote the article; Nii F, Medeiros KAA, and Carvalho BJ performed the literature search; Waisberg DR and D’Albuquerque LAC identified the case and revised the manuscript for important intellectual content; Iuamoto LR, Andraus W, and Meyer A reviewed the final version of the article.
Informed consent statement: Written informed consent and permission to write this manuscript was obtained from the patient of this case report.
Conflict-of-interest statement: No potential conflicts of interest relevant to this article were reported.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Leonardo Zumerkorn Pipek, MBBS, Faculdade de Medicina FMUSP, Universidade de São Paulo, Av Dr Arnaldo 455, São Paulo 05403, Brazil. leonardo.pipek@fm.usp.br
Telephone: +55-11-30617000 Fax: +55-11-30617000
Received: March 28, 2018
Peer-review started: March 29, 2018
First decision: April 23, 2018
Revised: April 25, 2018
Accepted: May 30, 2018
Article in press: May 31, 2018
Published online: July 27, 2018
Abstract

Primary hepatic gastrinoma is a rare disease, with fewer than 40 cases reported in the medical literature. Because it is located in an organ in which metastases are common, its diagnosis is difficult. We report a case of a 19 years old male patient with a history of gastric ulcers since the age of nine. Following gastric surgery, an antrectomy and a vagotomy, there was some alleviation of symptoms. Subsequently, the patient reported various intermittent episodes of diarrhea, diffuse abdominal pain, and vomiting. The patient underwent tomography, which revealed the presence of a hepatic mass measuring 19.5 cm × 12.5 cm × 17 cm. Primary hepatic gastrinoma was diagnosed based on laboratory examinations that indicated hypergastrinemia and a positron emission tomography/magnetic resonance study with somatostatin analogue that confirmed the liver as the primary site. After hepatic trisegmentectomy (II, III, IV, V, VIII), the patient’s symptoms improved. The case is notable for the presence of a rare tumor with uncommon dimensions.

Keywords: Gastrinoma, Primary hepatic gastrinoma, Zollinger-Ellison syndrome, Hepatic trisegmentectomy, Gastric surgery

Core tip: Primary hepatic gastrinoma is a very rare disease. Due to its location in an organ in which metastases are common, its diagnosis is difficult. We report a case of a 19 years old male patient with a history of gastric ulcers since the age of nine. Hypergastrinemia and a PET/MR study with somatostatin analogue confirmed that the liver was the primary site. After hepatic trisegmentectomy, the patient’s symptoms improved. The case is notable for the presence of a rare tumor with uncommon dimensions.