Abstract

Gastrinoma is a rare entity. It is knwon that the course of the disease is ocasionally run in very long duration even though it is malignant. Recently we experienced a case of gastrinoma which was able to be definitely diagnosed 15 years after a nonresectable operation that afforded us to observe a long natural course of the disease. The case involved a 76-year-old man. There was a previous history of undergoing a laparotomy with a diagnosis of duodenal ulcer, when a malignant tumor of the pancreatic head, multiple liver metastases, and remarkable swelling of regional lymph nodes were confirmed and only partial gastrectomy was performed because it was diagnosed as inoperable pancreatic cancer in 1982. In 1996 after clinical follow-up by CT and about 10 year interval when he had not been seen at the hospital, he has admitted because of an abdominal tumor and body weight loss. And then the patient was definitely diagnosed as gastrinoma according to the elevated serum gastrin level (1440pg/ml), pathological finding of biopsied tumor specimen and other examinations. When we encounter a patient with gastroduodenal ulcer, the diagnosis of this disease should be entertained, though it is rare.

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