A new cause of Zollinger-Ellison syndrome: Non-small cell lung cancer

Alaa Abou-Saif, Junyi Lei, Thomas J. McDonald, Subrata Chakrabarti, Irving F. Waxman, Homayoun Shojamanesh, David S. Schrump, David E. Kleiner, Fathia Gibril, Robert T. Jensen

Research output: Contribution to journalArticlepeer-review

18 Scopus citations

Abstract

Numerous epidemiologic studies suggest a relationship between lung cancer and peptic ulcer disease. Furthermore, various lung cancers synthesize and release a number of peptides such as gastrin and gastrin-releasing peptide that could cause acid hypersecretion; however, Zollinger-Ellison syndrome (ZES), because of a lung tumor, has never been described. We report such a patient for the first time. A 60-year-old man with a non-small cell lung carcinoma (large cell type) presented with diarrhea, heartburn, abdominal pain, and duodenal ulcers. Evaluation showed ZES was present (fasting hypergastrinemia, hyperchlorhydria) and control of all symptoms by omeprazole. No abdominal or cardiac tumor, the other known locations of gastrinomas causing ZES, was found on detailed tumor imaging studies. Resection of the lung tumor resulted in a decrease in gastrin levels to normal values. Plasma radioimmunoassays showed elevated gastrin, chromogranin A and normal levels of gastrin-releasing peptide, and 9 other hormones, The tumor showed similar immunocytochemical results. The characteristics of this case are compared with 100 cases of sporadic abdominal gastrinomas, and the evidence reviewed suggests why ZES should be considered in patients with lung cancer with peptic symptoms.

Original languageEnglish (US)
Pages (from-to)1271-1278
Number of pages8
JournalGastroenterology
Volume120
Issue number5
DOIs
StatePublished - 2001
Externally publishedYes

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

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