Gastrinoma with Local Metastatic Lymph Node Causing Zollinger–Ellison Syndrome: Pathophysiology, Imaging Features, Diagnosis, and Management
Keywords: Gastrinoma, Zollinger–Ellison Syndrome, Neuroendocrine Tumor, Ga-68 DOTATATE PET/CT Introduction Gastrinoma is a rare but clinically significant functional neuroendocrine tumor (NET) characterized by autonomous gastrin secretion, resulting in profound gastric acid hypersecretion and the development of Zollinger–Ellison syndrome (ZES) . Despite its rarity, gastrinoma remains a critical diagnosis due to its association with refractory peptic ulcer disease, chronic diarrhea, and potential metastatic spread—most commonly to regional lymph nodes and the liver. With the advent of Ga-68 DOTATATE PET/CT , the diagnostic accuracy for gastrinoma and other neuroendocrine tumors has improved dramatically, allowing precise localization of small primary lesions and metastatic lymph nodes that were previously occult on conventional imaging. This article presents a comprehensive, expert-level review of gastrinoma with a local metastatic lymph node causing Zollinger–Ellison synd...