History and exam

Key diagnostic factors

common

refractory or recurrent peptic ulcer disease

Large amounts of the hormone gastrin are produced by the tumor/s; this causes the stomach to produce too much acid, which may lead to peptic ulcers.

diarrhea

Occurs in 37% to 73% of patients.[1][2]

Other diagnostic factors

common

epigastric abdominal pain

Occurs in 70% to 100% of patients. This abdominal pain or burning, which may be localized or diffuse and is frequently relieved by food or antacids, is due to peptic ulcer disease.[1]

gastroesophageal reflux disease

Occurs in 44% of patients.[1]

uncommon

steatorrhea

Due to malabsorption of lipids as a result of pancreatic enzyme deactivation.

gastrointestinal bleed

May be associated with refractory or recurrent peptic ulcer disease.

bone pain

Patients with bone metastases may complain of low back ache in particular.

Risk factors

strong

multiple endocrine neoplasia type 1 (MEN1)

About 20% of gastrinomas are associated with MEN1. It is an autosomal dominantly inherited syndrome characterized by tumors in multiple endocrine organs, especially the parathyroid, pituitary, and pancreas. The presence of nephrocalcinosis should raise suspicion for MEN1.[13][14]

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