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A case of multiple glucagonomas with no clinical manifestations of excess glucagon despite hyperglucagonemia

Herein we report the case of a patient with multiple glucagonomas that have been precisely described with endoscopic ultrasound. A 36‐year‐old woman was referred to our hospital for computed tomography investigation of multiple pancreatic masses. Physical examination was unremarkable; on contrast‐en...

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Autores principales: Amano, Shogo, Suenaga, Shigeyuki, Hamamoto, Kaori, Yada, Shoko, Tsuyama, Takanori, Shinoda, Shuhei, Tanaka, Yuya, Takemoto, Yoshihiro, Harada, Eijiro, Tanabe, Katsuya, Asahara, Shunichiro, Hoshii, Kazunobu, Takami, Taro
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10043567/
https://www.ncbi.nlm.nih.gov/pubmed/36998346
http://dx.doi.org/10.1002/deo2.230
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author Amano, Shogo
Suenaga, Shigeyuki
Hamamoto, Kaori
Yada, Shoko
Tsuyama, Takanori
Shinoda, Shuhei
Tanaka, Yuya
Takemoto, Yoshihiro
Harada, Eijiro
Tanabe, Katsuya
Asahara, Shunichiro
Hoshii, Kazunobu
Takami, Taro
author_facet Amano, Shogo
Suenaga, Shigeyuki
Hamamoto, Kaori
Yada, Shoko
Tsuyama, Takanori
Shinoda, Shuhei
Tanaka, Yuya
Takemoto, Yoshihiro
Harada, Eijiro
Tanabe, Katsuya
Asahara, Shunichiro
Hoshii, Kazunobu
Takami, Taro
author_sort Amano, Shogo
collection PubMed
description Herein we report the case of a patient with multiple glucagonomas that have been precisely described with endoscopic ultrasound. A 36‐year‐old woman was referred to our hospital for computed tomography investigation of multiple pancreatic masses. Physical examination was unremarkable; on contrast‐enhanced computed tomography, mass lesions were evident in the head, body, and tail of the pancreas. The mass in the pancreatic head was poorly demarcated and exhibited a faint contrast effect, the one in the pancreatic body was a cystic lesion, and the one in the pancreatic tail was hypervascular. Blood investigations showed that serum glucagon was abnormally high at 7670 pg/ml; glucose tolerance was not impaired. There was no family history that suggested multiple endocrine neoplasia type 1 or von Hippel‐Lindau disease. Endoscopic ultrasound revealed that there were additional masses, which were scattered isoechoic to hyperechoic lesions a few millimeters in size. Ultrasound‐guided fine needle biopsy of the lesion in the pancreatic tail resulted in a diagnosis of a neuroendocrine tumor. Based on these pathologic findings, we performed a total pancreatectomy. A large number of nodules with tumor cells were evident in all cut surfaces of the surgical specimen. Immunostaining was positive for chromogranin A and glucagon, and glucagonoma was therefore diagnosed. It is conceivable that attenuated glucagon action could have contributed to the development of the multiple glucagonomas.
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spelling pubmed-100435672023-03-29 A case of multiple glucagonomas with no clinical manifestations of excess glucagon despite hyperglucagonemia Amano, Shogo Suenaga, Shigeyuki Hamamoto, Kaori Yada, Shoko Tsuyama, Takanori Shinoda, Shuhei Tanaka, Yuya Takemoto, Yoshihiro Harada, Eijiro Tanabe, Katsuya Asahara, Shunichiro Hoshii, Kazunobu Takami, Taro DEN Open Case Reports Herein we report the case of a patient with multiple glucagonomas that have been precisely described with endoscopic ultrasound. A 36‐year‐old woman was referred to our hospital for computed tomography investigation of multiple pancreatic masses. Physical examination was unremarkable; on contrast‐enhanced computed tomography, mass lesions were evident in the head, body, and tail of the pancreas. The mass in the pancreatic head was poorly demarcated and exhibited a faint contrast effect, the one in the pancreatic body was a cystic lesion, and the one in the pancreatic tail was hypervascular. Blood investigations showed that serum glucagon was abnormally high at 7670 pg/ml; glucose tolerance was not impaired. There was no family history that suggested multiple endocrine neoplasia type 1 or von Hippel‐Lindau disease. Endoscopic ultrasound revealed that there were additional masses, which were scattered isoechoic to hyperechoic lesions a few millimeters in size. Ultrasound‐guided fine needle biopsy of the lesion in the pancreatic tail resulted in a diagnosis of a neuroendocrine tumor. Based on these pathologic findings, we performed a total pancreatectomy. A large number of nodules with tumor cells were evident in all cut surfaces of the surgical specimen. Immunostaining was positive for chromogranin A and glucagon, and glucagonoma was therefore diagnosed. It is conceivable that attenuated glucagon action could have contributed to the development of the multiple glucagonomas. John Wiley and Sons Inc. 2023-03-27 /pmc/articles/PMC10043567/ /pubmed/36998346 http://dx.doi.org/10.1002/deo2.230 Text en © 2023 The Authors. DEN Open published by John Wiley & Sons Australia, Ltd on behalf of Japan Gastroenterological Endoscopy Society. https://creativecommons.org/licenses/by/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Reports
Amano, Shogo
Suenaga, Shigeyuki
Hamamoto, Kaori
Yada, Shoko
Tsuyama, Takanori
Shinoda, Shuhei
Tanaka, Yuya
Takemoto, Yoshihiro
Harada, Eijiro
Tanabe, Katsuya
Asahara, Shunichiro
Hoshii, Kazunobu
Takami, Taro
A case of multiple glucagonomas with no clinical manifestations of excess glucagon despite hyperglucagonemia
title A case of multiple glucagonomas with no clinical manifestations of excess glucagon despite hyperglucagonemia
title_full A case of multiple glucagonomas with no clinical manifestations of excess glucagon despite hyperglucagonemia
title_fullStr A case of multiple glucagonomas with no clinical manifestations of excess glucagon despite hyperglucagonemia
title_full_unstemmed A case of multiple glucagonomas with no clinical manifestations of excess glucagon despite hyperglucagonemia
title_short A case of multiple glucagonomas with no clinical manifestations of excess glucagon despite hyperglucagonemia
title_sort case of multiple glucagonomas with no clinical manifestations of excess glucagon despite hyperglucagonemia
topic Case Reports
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10043567/
https://www.ncbi.nlm.nih.gov/pubmed/36998346
http://dx.doi.org/10.1002/deo2.230
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