Gastrinoma before Zollinger and Ellison.

BACKGROUND: The 1955 landmark publication by Zollinger and Ellison characterized the gastrinoma syndrome and presented a hypothesis for the pancreatic endocrine origin of the gastric hypersecretion and dramatic ulcer diathesis.

METHODS: A detailed review of the literature was conducted to ascertain the clinical and pathologic spectrum of gastrinoma reported prior to the definition of the Zollinger-Ellison syndrome.

RESULTS: In addition to the 2 patients presented by Zollinger and Ellison, 6 published reports of gastrinoma patients were referenced in their manuscript. An additional 6 patients were described by the 5 discussants of the presented paper. Thorough review of the literature has yielded 4, and possibly 6, additional cases of gastrinoma published between 1908 and 1952.

CONCLUSION: Despite experience with a sizeable number of gastrinoma patients, it was left to Zollinger and Ellison to define the association between the islet cell tumor, its peptide hormone, and the clinical manifestations of severe gastric hypersecretion. Their seminal contribution served as the defining moment for the field of gastrointestinal endocrinology.