Solitary hepatic gastrinoma treated with laparoscopic radiofrequency ablation

Abstract

Background: This is a case of a solitary hepatic gastrinoma in a 65-year-old male. The patient was diagnosed with Zollinger-Ellison syndrome in 1991. He had negative radiologic and surgical explorations at that time. He was maintained on proton-pump inhibitors for the next 10 years without symptoms.

Methods: A computed tomographic (CT) scan done in April 2001 demonstrated a 5-cm right hepatic lesion. Radionucleotide scanning with octreotide demonstrated intense activity in the same area in the right hepatic lobe. His serum gastrin was 317 pg/mL. He underwent laparoscopic radiofrequency ablation of the lesion.

Results: Treatment resulted in a 6-cm ablative area giving a 1-cm margin on the tumor. One- and 3-month follow-up CT scans demonstrated adequate ablation of the tumor. An octreotide scan done 3 months postoperatively did not reveal any areas of abnormal uptake.

Conclusion: We report success with laparoscopic radiofrequency ablation as an alternative to major hepatic resection in patients with a solitary hepatic gastrinoma.

Figure 1.

CT scan of patient's right hepatic tumor.

Figure 2.

Intraoperative ultrasound of tumor ablation.

Figure 3.

One month post-radiofrequency ablation CT scan demonstrating ablated lesion.

Figure 4.

Three month post-radiofrequency ablation CT scan demonstrating ablated lesion.