Clinical History:
74-year old male with a history of diabetes mellitus complaining of weight
loss and diarrhea.
Discussion:
Glucagonoma is a rare tumor originating from the alpha cells of the pancreas.
The tumor is named after the hormone it secretes- glucagon. Patients with
a glucagonoma may present with diabetes, since glucagon induces glycogenolytic
activity in the liver. Other symptoms may include weight loss, diarrhea,
glossitis, anemia, and skin manifestations. The tumor is typically hypervascular
and may have reached several cm. in diameter at the time of diagnosis.
Glucagonoma may also be associated with MEN syndrome. Finally, the large
majority of glucagonomas undergo malignant transformation and may metastasize
to the liver.
Octreotide (111-InDTPA D Phe Octreotide) is a somatostatin analog which
competes with somatostatin binding to the somatostatin receptors. These
receptors are found in normal tissues as well as in a variety of tumors1.
Endocrine pancreatic tumors arising from the islet cells of the pancreas
express somatostatin receptors and therefore may be visualized using octreotide
scintigraphy 2.
Diagnosis:
Glucagonoma
References:
- Reubi JC, Kvols L, Krenning EP, Lamberts SWJ. Distribution
of Somatostatin Receptors in Normal and Tumor Tissue. Metabolism1990;
39:78-81.
- Krenning EP, Kwekkeboom DJ, Pauwels S, Kvols LK, Reubi
JC. Somatostatin Receptor Scintigraphy. In: Nuclear Medicine Annual
1995. New York, Raven Press, Ltd. 1995.
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