A Case of Somatostatinoma of the Pancreas which was Diagnosed Preoperatively

Masayoshi Ueno, Toshifumi Kanaizumi, Kouji Emoto, Shiho Sugimori, Toyoki Kobayashi, Masami Yagi, Hideaki Shimomura*, Yoshiyuki Nakajima**, Hiroshige Nakano**

Department of Surgery, Nara Prefectural Mimuro Hospital
*Department of Pathology, Nara Prefectural Mimuro Hospital
**First Department of Surgery, Nara Medical University

We experienced a patient with a somatostatinoma of the pancreas. A 65-year-old woman, who had no clinical symptoms except impaired glucose tolerance, visited our hospital for detailed examination of the pancreas head tumor. An abdominal ultrasonogram, CT scan and celiac angiography revealed a hypervascular lesion corresponding to that of the pancreas head. As we suspected a hormone-producing tumor of the pancreas, the concentrations of somatostain, insulin, glucagon, gastrin, vasoactive intestinal polypeptide etc. in the periphreal blood were measured by immunoassay. Only somatostatin appeared in an excess amount of 50 pg/ml which was 4 times higher than the normal range (1-12 pg/ml). From those results, we were able to diagnose the case as pancreatic somatostatinoma preoperatively and pancreatoduodenectomy was performed. The resected specimen revealed a spherical tumor of the pancreas head measuring about 3 cm in diameter. This tumor was a benign islet-cell tumor histologically, and stained by anti-somatostatin antibody, not by antibodies against glucagon, insulin and vasoactive intestinal polypeptide immunohistochemically. The patient was discharged after the operation and has been well without recurrence for 8 months postoperatively. To date, only 16 patients, including ours, with somatostatinoma of the pancreas have been reported in Japan. Their clinico-pathological features were reviewed in this study.

Key words
somatostatinoma of the pancre, islet cell tumor

Reprint requests
Masayoshi Ueno Department of Surgery, Nara Prefectural Mimura Hospital
1-14-16 Sango-cho Mimuro, Ikoma-gun, Nara, 633 JAPAN

Accepted
July 10, 1996

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