Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents for follow-up of Type II Gastric Neuroendocrine Tumor (NET) in the setting of MEN1 syndrome and Zollinger-Ellison Syndrome (ZES). Current symptoms include [epigastric pain/heartburn/diarrhea]. Review of systems positive for hypergastrinemia-related symptoms. No evidence of metastatic disease or weight loss. Compliance with PPI therapy and octreotide analogs confirmed.
Clinical Examination Findings
General: Patient appears in no acute distress. Abdomen: Soft, non-tender, non-distended, bowel sounds normoactive. No palpable masses or organomegaly. Skin: No stigmata of MEN1 (e.g., angiofibromas, lipomas). Vitals: Stable, normotensive. EGD findings: Multiple small gastric fundic/body polyps, consistent with Type II NETs, no evidence of ulceration or bleeding.
Treatment Protocol
Plan: 1. Continue high-dose PPI therapy for ZES management. 2. Periodic endoscopic surveillance (EGD) every [6-12] months for polyp monitoring and biopsy. 3. Somatostatin analog therapy (e.g., Octreotide LAR) as indicated for tumor control. 4. Multidisciplinary team (MDT) review including Endocrinology and Surgery. 5. Monitor serum gastrin and chromogranin A levels.