A Case Report of Asymptomatic Malignant Microglucagonoma

Kouichi Toda, Shigeo Souda, Hirofumi Sueki, Takuya Momiyama, Touru Kuratani, Kazuo Yamabe

Department of Surgery, Nissei Hospital

We experienced an asymptomatic microglucagonoma which had been reported only twice in Japan. A 74-year-old woman was diagnosed as having advanced gastric cancer with cholelithiasis and was admitted to our hospital. There were no clinical features which suggested glucagonoma except for diabetes mellitus and no pancreatic tumor was found by CT scanning. The resected specimens after total gastrectomy, distal pancreatectomy with splenectomy and cholecystectomy revealed no pancreatic tumors. But many tumor granules smaller than 5 mm in diameter were found histopathologically and they were thought to be malignant. The tumors were diagnosed immunocytochemically as glucagonomas. Six months after the operation, the patient died from peritonitis carcinomatosa of gastric cancer. At autopsy, we found many microglucagonomas smaller than 5 mm in diameter only in the pancreas. Including this case, 52 cases of glucagonoma have been reported in Japan. This case revealed for the first time that some microglucagonomas are malignant and the need for therapy of the microglucagonomas like those in this case is suggested.

Key words
malignant microglucagonoma, gastric cancer, double cancer

Reprint requests
Kouichi Toda Department of Surgery, Nissei Hospital
6-3-8 Itachibori, Nishi-ku, Osaka, 550 JAPAN

Accepted
September 4, 1991

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