Spontaneous Remission of Zollinger-Ellison Syndrome

IN 1955 Zollinger and Ellison described a syndrome consisting of gastric hypersecretion and a fulminating and intractable peptic ulcer diathesis associated with islet cell tumors of the pancreas.¹ Since this original description, the syndrome has been expanded to include the additional features of diarrhea,² steatorrhea,³ and hypokalemia.⁴ It is now recognized that the clinical picture may be variable in its presentation with some patients developing a fulminant ulcer diathesis and others a severe diarrhea with or without peptic ulceration.² Diarrhea occurs in one third of the patients with ulcer and is the only symptom in 10% of the recorded cases.⁵ The pathogenesis of the basal gastric hypersecretion is postulated to be parietal cell stimulation by a gastrin-like substance elaborated in nonbeta islet tumor cells of the pancreas. A substance, capable of stimulating gastric secretion in pouch preparations, has been isolated from both primary tumors and metastatic tissue.^5,6 The assault of