孤立性肝転移を伴うZollinger-Ellison症候群に対してOpen MCTを施行した１例

Recently, the symptoms related to gastric hypersecretion in patients with Zollinger-Ellison syndrome (ZES) can be well controlled with histamine receptor antagonists or proton pump inhibitors. The radical treatment for patients with ZES is complete resection of the primary and metastatic tumor. However, metastatic liver tumors from the primary region, especially those occupying the hepatic hilum, are difficult to resect completely due to neighboring important vessels such as the portal vein or hepatic artery. We report a 52-year-old man showing ZES. He had a solitary metastatic tumor near the hepatic hilum, although the primary gastrinoma could not be detected in the pancreas or duodenum even by selective arterial secretin injection test (SASI test) or various diagnostic images. Transcatheteric arterial embolization therapy for the metastatic liver tumor had not controlled the tumor growth effectively, but open microwave coagulation therapy (MCT) for the metastatic liver tumor could decrease the serum level of gastrin and the tumor size remarkably. This case indicates that the MCT is able to improve the prognosis of the patients with unresectable liver metastases of neuroendocrine tumors.