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Extended Octreotide Suppression Test to Determine Hormone Responsiveness of Multiple Type I Gastric Carcinoid Tumors

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Abstract

A 70-year-old man was found to have at least 12 type I gastric carcinoids and microcarcinoidosis. We performed an extended octreotide suppression test to determine if the tumors were gastrin-dependent and would likely regress after antrectomy. He was given an octreotide infusion at 12.5–25 mcg/h for 86 hr followed by depot octreotide 20 mg intramuscularly every four weeks for eight months. Fasting serum gastrin and chromogranin A levels were measured, and endoscopy with biopsies was performed before and after the infusion and at five months and eight months. Total RNA was extracted for quantitation of histidine decarboxylase mRNA using real-time PCR. Fasting serum gastrin decreased from 306 pg/ml pretreatment to 31 pg/ml at the end of infusion and 115 pg/ml at eight months. Chromogranin A decreased from four to six times the upper limit of normal to normal. Tissue histidine decarboxylase mRNA decreased 50-fold. At eight months, only a few diminutive nodules were present on endoscopy. These results demonstrated that the carcinoid tumors in this patient were under neuroendocrine control and were expected to respond to antrectomy.

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References

  1. Modlin IM, Lye KD, Kidd M (2004) A 50-year analysis of 562 gastric carcinoids: small tumor or larger problem? Am J Gastroenterol 99:23–32

    Article  PubMed  Google Scholar 

  2. Kulke MH, Mayer RJ (1999) Medical progress: carcinoid tumors. N Engl J Med 340:858–868

    Article  PubMed  CAS  Google Scholar 

  3. Gilligan CJ, Lawton GP, Tang IH, et al. (1995)Gastric carcinoid tumors: the biology and therapy of an enigmatic and controversial lesion. Am J Gastroenterol 90:338–352

    PubMed  CAS  Google Scholar 

  4. Modlin IM, Lye KD, Kidd M (2003) Carcinoid tumors of the stomach. Surg Oncol 12:153–172

    Article  PubMed  Google Scholar 

  5. Borch K, Renvall H, Kullman E, et al. (1987) Gastric carcinoid associated with the syndrome of hypergastrinemic atrophic gastritis: a perspective of 11 cases. Am J Surg Pathol 11:435–444

    Article  PubMed  CAS  Google Scholar 

  6. Higham AD, Dimaline R, Varro A, et al. (1998) Octreotide suppression test predicts beneficial outcome from antrectomy in a patient with gastric carcinoid tumor. Gastroenterology 114:817–822

    Article  PubMed  CAS  Google Scholar 

  7. Sandor A, Kidd M, Lawton GP, et al. (1996) Neurohormonal modulation of rat enterochromaffin cell histamine secretion. Gastroenterology 110:1184–1192

    Article  Google Scholar 

  8. Jordan PH Jr, Barroso A, Sweeney J (2004) Gastric carcinoids in patients with hypergastrinemia. J Am Coll Surg 199:552–555

    Article  PubMed  Google Scholar 

  9. Lamberts SWJ, Lely AVD, De Herder WW, et al. (1996) Drug therapy: octreotide. N Engl J Med 334:246–254

    Article  PubMed  CAS  Google Scholar 

  10. Aurang K, Wang J, Lloyd KC (1997) Somatostatin inhibition of acid and histamine release by activation of somatostatin receptor subtype 2 receptors in rats. J Pharmacol Exp Ther 281:245–281

    PubMed  CAS  Google Scholar 

  11. Lloyd KCK, Amirmoazzami S, Friedik F, Chew P, Walsh JH (1997) Somatostatin inhibits gastrin releaser and acid secretion by activating sst2 in dogs. Am J Physiol 272(6 Pt 1):G1481–G1488

    PubMed  CAS  Google Scholar 

  12. Kolby L, Bernhardt P, Sward C, et al. (2004) Chromogranin A as a determinant of midgut carcinoid tumor volume. Regulatory Peptides 120:269–273

    Article  PubMed  CAS  Google Scholar 

  13. Thomas RM, Baybick JH, Elsayed AM, et al. (1994) Gastric carcinoids: an immunohistochemical and clinicopathological study of 104 patients. Cancer 73:2053–2058

    Article  PubMed  CAS  Google Scholar 

  14. Borch K, Stridsberg M, Burman P, et al. (1997) Basal chromogranin A and gastrin concentrations in circulation correlate to endocrine cell proliferation in type-A gastritis. Scand J Gastroenterol 32:198–202

    Article  PubMed  CAS  Google Scholar 

  15. Kidd M, Modlin IM, Mane SM, et al. (2006) Q RT-PCR detection of chromogranin A: a new standard in the identification of neuroendocrine tumor disease. Ann Surg 24:273–280

    Article  Google Scholar 

  16. Janson ET, Holmberg L, Stridsberg M, et al. (1997) Carcinoid tumors: analysis of prognostic factors and survival in 301 patients from a referral center. Ann Oncol 8:685–690

    Article  PubMed  CAS  Google Scholar 

  17. Modlin IM, Gilligan C, Lawton GP, et al. (1995) Gastric carcinoids: the Yale experience. Arch Surg 130:250–256

    PubMed  CAS  Google Scholar 

  18. Ramirez AG, Roses LL, Blanco ES, et al. (1996) Multiple gastric carcinoid tumors: endoscopic management. J Clin Gastroenterol 23:76–77

    Article  Google Scholar 

  19. Ichikawa J, Tanabe S, Koizumi W, et al. (2003) Endoscopic mucosal resection in the management of gastric carcinoid tumors. Endoscopy 35:203–206

    Article  PubMed  CAS  Google Scholar 

  20. Higashino K, Lishi H, Narahara H, et al. (2004) Endoscopic resection with a two channel videoendoscope for gastric carcinoid tumors. Hepatogastroenterology 51:269–272

    PubMed  CAS  Google Scholar 

  21. Hirschowitz BI, Griffith J, Pellegrtin D, et al. (1992) Rapid regression of enterochromaffinlike cell gastric carcinoids in pernicious anemia after antrectomy. Gastroenterology 102:1409–1418

    PubMed  CAS  Google Scholar 

  22. Richards AT, Hinder RA, Harrison AC (1987) Gastric carcinoid tumors associated with hypergastrinemia and pernicious anemia—regression of tumors by antrectomy: a case report. S Afr Med J 72:51–53

    PubMed  CAS  Google Scholar 

  23. Olbe L, Lundell L, Sandler F (1988) Antrectomy in a patient with ECL-cell gastric carcinoids and pernicious anemia. Gastroenterol Int 1(suppl 1):340

    Google Scholar 

  24. Schindl M, Kaserer K, Bruno N (2001) Treatment of gastric neuroendocrine tumors: the necessity of a type-adapted treatment. Arch Surg 136:49–54

    Article  PubMed  CAS  Google Scholar 

  25. Granberg D, Wilander E, Stridsberg M, et al. (1998) Clinical symptoms, hormone profiles, and prognosis in patients with gastric carcinoids. Gut 43:223–228

    Article  PubMed  CAS  Google Scholar 

  26. Ahlman H (1999) Surgical treatment of carcinoid tumors of the stomach and small intestine. Ital J Gastroenterol Hepatol 31(suppl 2):S198–S201

    PubMed  Google Scholar 

  27. Tomassetti P, Migliori M, Caletti G, et al. (2000) Brief report: treatment of type II gastric carcinoid tumors with somatostatin analogues. N Engl J Med 343:551–554

    Article  PubMed  CAS  Google Scholar 

  28. Prommegger R, Bale R, Ensinger C, et al. (2006) Gastric carcinoid type I tumor: new diagnostic and therapeutic method. Eur J Gastroenterol Hepatol 15:705–707

    Article  Google Scholar 

  29. Fykse V, Sandvik AK, Qvigstad G, et al. (2004) Treatment of ECL cell carcinoids with octreotide LAR. Scand J Gastroenterol 31:621–628

    Article  CAS  Google Scholar 

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Authors and Affiliations

  1. Division of Gastroenterology, Hepatology, and Nutrition, Department of Medicine, State University of New York at Buffalo, Buffalo, New York, 14221, USA

    Mohammad Fayyaz, Shahid Mehboob, Valerie Andersen & Michael D. Sitrin

  2. Western New York VA Medical Center, 3495 Bailey Avenue, Room 803A, Buffalo, New York, 14221, USA

    Michael D. Sitrin

Authors
  1. Mohammad Fayyaz
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  2. Shahid Mehboob
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  3. Valerie Andersen
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  4. Michael D. Sitrin
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Correspondence to Michael D. Sitrin.

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Fayyaz, M., Mehboob, S., Andersen, V. et al. Extended Octreotide Suppression Test to Determine Hormone Responsiveness of Multiple Type I Gastric Carcinoid Tumors. Dig Dis Sci 52, 1579–1585 (2007). https://doi.org/10.1007/s10620-006-9583-5

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  • DOI: https://doi.org/10.1007/s10620-006-9583-5

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