Insulinoma with subsequent association of Zollinger-Ellison syndrome

Citation
N. Mizuno et al., Insulinoma with subsequent association of Zollinger-Ellison syndrome, INTERN MED, 40(5), 2001, pp. 386-390
Citations number
19
Categorie Soggetti
General & Internal Medicine
Journal title
INTERNAL MEDICINE
ISSN journal
09182918 → ACNP
Volume
40
Issue
5
Year of publication
2001
Pages
386 - 390
Database
ISI
SICI code
0918-2918(200105)40:5<386:IWSAOZ>2.0.ZU;2-N
Abstract
We report a patient with insulinoma associated with Zollinger-Ellison syndr ome. A 67-year-old woman was first admitted to our hospital for an abdomina l mass, Abdominal computed tomography (CT) revealed a large pancreatic tumo r, which was then diagnosed as an unresectable pancreatic adenocarcinoma, A t the age of 71, she presented symptoms of hypoglycemia, Pasting blood gluc ose was 21 mg/dl and plasma immunoreactive insulin level was 846 muU/ mi, P lasma gastrin, glucagon, vasoactive intestinal polypeptide and somatostatin levels were all normal, At the age of 73, hypoglycemic attacks occurred mo re frequently and she was admitted to our hospital. Abdominal CT scan showe d multiple liver metastases, Chemotherapy with 5-fluorouracil and doxorubic in was performed. Three months later, she had an emergency laparotomy becau se of a perforated duodenal ulcer Plasma gastrin level was 1,960 pg/ml at t hat time. Gastric hypersecretion was well controlled with a proton pump inh ibitor (lansoprazole) but she died of widespread cancer dissemination 8 yea rs after her first admission, On autopsy, histologic examination revealed a mixed acinar-endocrine carcinoma of the pancreas. Immunohistochemical stai ns were positive for insulin, gastrin, and a,antitrypsin,