{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T21:33:39Z","timestamp":1790372019725,"version":"4.1.0"},"reference-count":22,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"11","license":[{"start":{"date-parts":[[2014,1,1]],"date-time":"2014-01-01T00:00:00Z","timestamp":1388534400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2014,8,21]],"date-time":"2014-08-21T00:00:00Z","timestamp":1408579200000},"content-version":"vor","delay-in-days":232,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/3.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2014,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>INTRODUCTION:<\/jats:title>\n                    <jats:p>Zollinger-Ellison syndrome (ZES) is caused by uninhibited secretion of gastrin from a gastrinoma. Gastrinomas most commonly arise within the wall of the duodenum followed by the pancreas. Primary lymph node gastrinomas have also been reported in the literature. This is a case of ZES where preoperative localization revealed a gastrinoma in a solitary portacaval lymph node, presumed to be a primary lymph node gastrinoma.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>PRESENTATION OF CASE:<\/jats:title>\n                    <jats:p>The patient is a 57 year old female diagnosed with ZES, suspected of having a primary lymph node gastrinoma. The patient underwent an exploratory laparotomy and excision of a portacaval lymph node with a frozen section which was positive for gastrinoma. Intraoperative sonography of the pancreas, upper endoscopy with transillumination of the duodenum, and a duodenotomy with bimanual examination of the duodenal wall were also performed. The patient was found to have a 4 mm duodenal mass near the pylorus, which was excised.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>DISCUSSION:<\/jats:title>\n                    <jats:p>Pathology showed that the duodenal mass was primary gastrinoma. Serum gastrin levels taken four months postoperatively were normal and the repeat octreotide scan did not show any evidence of recurrence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION:<\/jats:title>\n                    <jats:p>Primary lymph node gastrinoma is a diagnosis of exclusion. The duodenum and pancreas must be fully explored to rule out a primary gastrinoma that may be occult.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1016\/j.ijscr.2014.08.019","type":"journal-article","created":{"date-parts":[[2014,10,16]],"date-time":"2014-10-16T21:21:59Z","timestamp":1413494519000},"page":"849-852","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":5,"title":["Primary lymph node gastrinoma. A diagnosis of exclusion. A case for duodenotomy in the setting of a negative imaging for primary tumor"],"prefix":"10.1097","volume":"5","author":[{"given":"Annabelle","family":"Teng","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Haas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David Y.","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward","family":"Lung","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fadi","family":"Attiyeh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-19-20260114","doi-asserted-by":"crossref","first-page":"410","DOI":"10.1097\/01.sla.0000234802.44320.a5","article-title":"Surgery increases survival in patients with gastrinoma","volume":"244","author":"Norton","year":"2006","journal-title":"Ann Surg"},{"key":"R2-19-20260114","doi-asserted-by":"crossref","first-page":"481","DOI":"10.1007\/BF01655107","article-title":"Pathologic aspects of gastrinomas in patients with Zollinger-Ellison syndrome with and without multiple endocrine neoplasia type I","volume":"17","author":"Pipeleers-Marichal","year":"1993","journal-title":"World J Surg"},{"key":"R3-19-20260114","doi-asserted-by":"crossref","first-page":"3051","DOI":"10.1200\/JCO.2001.19.12.3051","article-title":"Prognostic value of initial fasting serum gastrin levels in patients with Zollinger-Ellison syndrome","volume":"19","author":"Berger","year":"2001","journal-title":"J Clin Oncol: Off J Am Soc Clin Oncol"},{"key":"R4-19-20260114","doi-asserted-by":"crossref","first-page":"497","DOI":"10.1046\/j.1365-2036.1996.11153000.x","article-title":"Long-term treatment with lansoprazole of patients with duodenal ulcer and basal acid output of more than 15 mmol\/h","volume":"10","author":"Hirschowitz","year":"1996","journal-title":"Aliment Pharmacol Therap"},{"key":"R5-19-20260114","doi-asserted-by":"crossref","first-page":"1637","DOI":"10.1016\/0016-5085(95)90124-8","article-title":"Determinants of metastatic rate and survival in patients with Zollinger-Ellison syndrome: a prospective long-term study","volume":"108","author":"Weber","year":"1995","journal-title":"Gastroenterology"},{"key":"R6-19-20260114","doi-asserted-by":"crossref","first-page":"833","DOI":"10.1111\/j.1477-2574.2012.00551.x","article-title":"Surgical treatment of gastrinomas: a single-centre experience","volume":"14","author":"Atema","year":"2012","journal-title":"HPB: Off J Int Hepato Pancreato Biliary Assoc"},{"key":"R8-19-20260114","doi-asserted-by":"crossref","first-page":"757","DOI":"10.1097\/01.sla.0000143252.02142.3e","article-title":"Resolved and unresolved controversies in the surgical management of patients with Zollinger-Ellison syndrome","volume":"240","author":"Norton","year":"2004","journal-title":"Ann Surg"},{"key":"R9-19-20260114","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1097\/00000658-199001000-00002","article-title":"Gastrinoma excision for cure. 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