A Case of Zollinger-Ellison Syndrome whose Pancreatic Tumor Produced Multiple Hormones and a Review of 48 Cases Reported in the Japanese Literature

A 46-year-old man developed a peptic ulcer disease and a diagnosis of Zollinger-Ellison Syndrome was strongly suspected following gastric acid stu-dies. Plasma gastrin level was found to be elevated. The operation revealed a pancreatic tumor localized at the pancreas tail. The resected tumor tissue was proved to contain large amounts of immunoreactive gastrin. In addition, calci-tonin, VIP and insulin were found to be present either as a result of immuno-fluorescence studies or the respective radioimmunoassays. Therefore, this was a case of a multiple hormone producing tumor of pancreas islet cell origin, and the symptoms due to gastrin hypersecretion were the main clinical features. In addition, 48 cases of Zollinger-Ellison Syndrome reported in Japanese liter-atures were reviewed. Introduction for ZES, and the number of reported cases is increasing (Wilson, 1973). Recently, Zollinger-Ellison Syndrome (ZES) is a secretin and calcium infusion tests are prove