Novel association of duodenal gastrinoma and atrophic gastritis: case report and literature review.

Objective: To describe a patient with a duodenal gastrinoma in a setting of atrophic gastritis and hypergastrinemia.Methods: We present historical features and results of laboratory and genetic evaluation in a woman with duodenal gastrinoma and hypergastrinemia due to atrophic gastritis.Results: In a 46-year-old woman with a history of stable pituitary microprolactinoma, multiple gastrointestinal symptoms developed and prompted the performance of an esophagogastroduodenoscopy in conjunction with small bowel biopsies. A 2-mm duodenal gastrin-producing neuroendocrine tumor was discovered. The tumor stained negative for serotonin and somatostatin and involved the mucosa and submucosa. Immunohistochemical staining of the gastrinoma tissue with a monoclonal antibody to the cholecystokinin-B (gastrin) receptor was negative. The patient's random serum gastrin level was elevated at 990 pg/mL. She had been taking pantoprazole for 4 weeks before that test. After pantoprazole therapy was discontinued, the serum gast...