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©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
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
ARTICLE HIGHLIGHTS
Case characteristics
Primary hepatic gastrinoma in a 19 years old hypergastremic patient who underwent hepatic trisegmentectomy to remove the tumor.
Clinical diagnosis
Primary hepatic gastrinoma.
Differential diagnosis
Gastrointestinal tumors, MEN 1.
Laboratory diagnosis
Gastrin levels were 6709.0 pg/mL before surgery. After the procedure it was 40.5 pg/mL.
Imaging diagnosis
Computed tomography (CT) showed a voluminous heterogeneous hepatic lesion, with a neoplasic aspect and dimensions 19.5 cm × 12.5 cm × 17.0 cm.
Pathological diagnosis
Histopathological analysis of the patient’s tumor revealed a Ki-67 of 5% (G2).
Treatment
Hepatic trisegmentectomy.
Term explanation
Gastrinoma: A gastrinoma is a tumor that secretes an excess of gastrin, leading to ulceration in the duodenum, stomach, and the small intestine.
Experiences and lessons
Primary hepatic gastrinoma is a very difficult to diagnose. Meticulous examination is necessary for appropriate diagnosis and treatment.
