A particularly aggressive combined glucagonoma and gastrinoma syndrome

Duodeno-pancreatic biochemically polyfunctional endocrine tumour is a well known entity. Usually, only one hormone is responsible for the clinical fea tures, We report a case of aggressive combined glucagonoma and gastrinoma t umour without metastases, causing respectively diabetic ketoacidosis and fu lminant peptic ulcer, and death, Occasional patients can present with clini cal features of both glucagonoma and gastrinoma. Diabetic patients exhibiti ng migratory skin lesions should be suspected of glucagonoma. In addition, a multidisciplinary approach to such patients including dermatologists, sur geons, radiologists and endoscopists is mandatory, fur J Gastroenterol Hepa tol 11:1417-1419 (C) 1999 Lippincott Williams & Wilkins.