A Case of Duct-islet Cell Carcinoma of the Pancreas Showing Somatostatinoma Syndrome

Hitoshi Takeuchi, Ryuji Tamura, Ken Tuchiya, Yasuhiro Yunoki, Koji Tanakaya, Yoshimasa Yasui and Eiji Konaga

Iwakuni National Hospital

Somatostatinoma is still extremely rare, though reports of this tumor have increased in number owing to development of RIA of plasma somatostatin, immunohistochemistry, and so on. We experienced a case of combined pancreas tumor of duct cell carcinoma and somatostatin-producing islet cell carcinoma. The patient was 62-year-old female who was referred to our hospital for nausea, back pain, diarrhea, and weight loss. She also had a history of cholecytectomy for the gallbladder stone. Ultrasonography and CT scanning of the abdomen showed a tumor 7cm in size, surrounded by lateral segment of the liver, the stomach, and the pancreas. The tumor was resected, because no distant metastases were found. The pathological specimen showed the combined tumor of duct cell carcinoma and islet cell carcinoma. Immunohistochemical study revealed somatostatin positive cells in islet cell carcinoma. The level of plasma somatostatin decreased from 46pg/ml to 21pg/ml and diarrhea ceased after the resection. From these results, we concluded that the symptom was caused by hypersecretion of somatostatin produced by the tumor.

Key words
pancreas tumor, somatosatin, somatostatinoma syndrome

Reprint requests
Hitoshi Takeuchi Department of Surgery, Iwakuni National Hospital 2-5-1 Kuroiso-cho, Iwakuni, 740-8510 JAPAN

Accepted
February 24, 1999

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