Arteriographic demonstration of pancreatic tumor in the Zollinger-Ellison syndrome.

The gastrointestinal manifestations of the Zollinger-Ellison syndrome are well known, but to our knowledge direct radiologic demonstration of the pancreatic tumor has not been previously described. The case reported here is that of a patient with a clinical diagnosis of Zollinger-Ellison syndrome in whom the diagnosis of isletcell carcinoma was made by selective angiography prior to surgery. Case Report A 55-year-old white man was treated for a peptic ulcer from 1963 until 1965 when a clinical diagnosis of Zollinger-Ellison syndrome was first made on the basis of gastric analysis values typical of this condition. In 1966 the patient's symptoms became refractory to anticholinergic therapy. Radiologic examinations had demonstrated gastric hypersecretion, an ulcer of the duodenal bulb, questionable ulceration of the third part of the duodenum, and prominent mucosal folds in the stomach, duodenum, and proximal jejunum. A few punctate calcifications had been noted in the body of the pancreas. There was no clea...