Ulcerogenic tumors of the duodenum

Spontaneous achlorhydria with atrophic gastritis in the Zollinger-Ellison syndrome

This case report describes the occurrence of spontaneous, persistent achlorhydria in a patient with markedly raised basal acid secretion and diarrhoea for over two years (Zollinger-Ellison syndrome). Achlorhydria was due to the rapid development of severe atrophic gastritis in a gastric mucosa that had previously shown markedly increased numbers of parietal cells.

A gastric factor in the pathogenesis of the Zollinger-Ellison syndrome

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Carcinoid-islet cell tumors of the duodenum

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SYSTEMIC EFFECTS OF NON-ENDOCRINE TUMOURS

Tumours of non-endocrine origin may exert deleterious effects by elaborating active principles which disturb body regulation. Systemic manifestations are fairly common with neoplasms of the lung, kidney, gastro-intestinal tract and thymus. The secretion of these tumours may have a known chemical structure (serotonin), may present hormone-like action (parathormone, antidiuretic hormone, insulinoid), or have well-defined biological properties (erythropoietin, gastrin-like principle). Tumours may stimulate endocrine glands by an unknown mechanism, producing disorders such as Cushing's syndrome, hypercalcemia, gynecomastia and hypoglycemia. Thymomas may be associated with autoimmune diseases. Tumours may extensively utilize or excrete some metabolite (glucose) or electrolyte (Na or K). Awareness of the systemic effects of various neoplasms may lead to an early diagnosis and proper treatment of these manifestations.

TUMOR OF THE DUODENUM REMOVED IN THE COURSE OF PARTIAL GASTRECTOMY FOR DUODENAL ULCER

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