{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T15:21:03Z","timestamp":1785252063518,"version":"3.55.0"},"reference-count":42,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2004,6,16]],"date-time":"2004-06-16T00:00:00Z","timestamp":1087344000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2004,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Enterochromaffin\u2010like (ECL) tumors are documented in patients with hypergastrinemia secondary to chronic atrophic gastritis or with Zollinger\u2010Ellison syndrome and multiple endocrine neoplasia type 1 (ZES\u2010MEN\u20101). In patients with ECL tumors and atrophic gastritis, normogastrinemia after antrectomy has resulted in resolution, regression, or stabilization of ECL tumors. The natural history of ECL tumors associated with ZES\u2010MEN\u20101 following normalization of gastrin levels after gastrinoma resection has not been previously reported. The purpose of this study was to determine the course of ECL tumors in patients with ZES\u2010MEN\u20101 following normalization of serum gastrin levels after gastrinoma resection. Two patients with ZES\u2010MEN\u20101 had biopsy\u2010proven ECL tumors on endoscopic evaluation. They then underwent surgical exploration that included distal pancreatectomy, enucleation of pancreatic head tumors, duodenotomy with excision of submucosal tumors, and peripancreatic lymphadenectomy. Gastric ECL tumors larger than 1.0\u00a0cm were locally excised. Patients underwent long\u2010term follow\u2010up with biochemical and endoscopic surveillance. Normogastrinemia was achieved and sustained following gastrinoma resection in two patients with ZES\u2010MEN\u20101. Periodic endoscopic surveillance over a 6\u2010year period showed complete resolution of the ECL tumors. The development of ECL tumors associated with ZES\u2010MEN\u20101 is multifactorial. Studies identified a genetic influence on tumor growth with loss of heterozygosity at the MEN\u20101 gene locus in ECL tumors. The resolution of ECL tumors in ZES\u2010MEN\u20101 patients who are normogastrinemic indicates that an elevated gastrin level is a primary initiator for development of these tumors. Therefore both genetic defects and hypergastrinemia are causative agents. Normalization of serum gastrin levels is critical for the prevention of aggressive forms of ECL tumors.<\/jats:p>","DOI":"10.1007\/s00268-004-7345-0","type":"journal-article","created":{"date-parts":[[2004,7,9]],"date-time":"2004-07-09T17:17:10Z","timestamp":1089393430000},"page":"652-658","source":"Crossref","is-referenced-by-count":53,"title":["Regression of Type II Gastric Carcinoids in Multiple Endocrine Neoplasia Type 1\u00a0Patients with Zollinger\u2010Ellison Syndrome after Surgical Excision of All Gastrinomas"],"prefix":"10.1002","volume":"28","author":[{"given":"Melanie L.","family":"Richards","sequence":"first","affiliation":[{"name":"Department of Surgery University of Texas Health Science Center at San Antonio 7703 Floyd Curl Drive 78284 San Antonio Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Gauger","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Division of Endocrine Surgery University of Michigan Hospital 1500 E. Medical Drive 48109 Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Norman W.","family":"Thompson","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Division of Endocrine Surgery University of Michigan Hospital 1500 E. Medical Drive 48109 Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas J.","family":"Giordano","sequence":"additional","affiliation":[{"name":"Department of Pathology University of Michigan Hospital 1500 E. 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