Primary lymph node gastrinoma: 2 cases and a review of the literature.

INTRODUCTION: Gastrinoma is a rare tumour of the diffuse neuroendocrine system with the primary invariability located within the duodenum or pancreas. Numerous authors have described gastrinoma apparently isolated to peripancreatic lymph nodes, following exhaustive radiological and operative localisation and examination.

METHOD: Two cases of apparent primary lymph node gastrinoma seen in our institution are presented, along with a literature review including 58 other presented cases.

RESULTS: On prolonged follow-up up to 131 months, 34 patients have remained in remission supporting the diagnosis of primary lymph node gastrinoma. Occult primary disease, usually in the form of microduodenal tumours, have become evident in the remaining 24 cases.

CONCLUSION: The existence of primary lymph node gastrinoma is supported by many presented case studies, but long-term follow-up of all patients should occur in the expectation that occult primary disease will become apparent in some.