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Updated: May 30, 2026

Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas
Published on: January 17, 2018
A case of a giant glucagonoma with parathyroid hormone-related peptide secretion showing an inconsistent postsurgical
Kiyokazu Shirai1, Izumi Inoue, Jun Kato
1The Second Department of Internal Medicine, Wakayama Medical University, Japan. spk449q9@voice.ocn.ne.jp
Abstract:
A 53-year-old woman was admitted because of a giant pancreatic tumor. Hypercalcemia and a high serum parathyroid hormone-related peptide (PTHrP) level were observed. A hypoglycemic attack occurred during pancreatectomy, and the surgical specimen revealed a PTHrP-secreting glucagonoma. Liver metastases developed 1 and 5.5 years later, and bone metastases appeared 6 years after surgery. Her serum PTHrP concentrations remained normal after surgery, despite re-elevation of the serum glucagon concentration after recurrence. The clinical course of this case illustrates the process of development of neuroendocrine tumors secreting two or more hormones.
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