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Pancreatic glucagonoma with pancreatic calcification
Rahul Amreesh Gupta1, F E Udwadia, Pravin Agrawal
1Department of Surgical Gastroenterology, Jaslok Hospital and Research Centre, Mumbai, Maharashtra, India.
Summary
Glucagonoma, a rare pancreatic neuroendocrine tumor, often presents with diabetes and a distinctive rash, leading to delayed diagnosis. This case highlights glucagonoma with unusual pancreatic calcification, emphasizing diagnostic clues.
Area of Science:
- Endocrinology
- Oncology
- Gastroenterology
Background:
- Glucagonoma is a rare pancreatic neuroendocrine tumor (NET) associated with diabetes mellitus, necrolytic migratory erythema, and other symptoms.
- Diagnosis is often delayed due to misdiagnosis of the characteristic rash, typically by 7-8 years.
- Pancreatic calcifications are common in tumors, but calcification of normal pancreatic tissue is rare, often linked to ductal obstruction and pancreatitis.
Observation:
- This report details a unique case of glucagonoma presenting with coexistent pancreatic calcification.
- The patient's presentation included symptoms suggestive of glucagonoma and findings of pancreatic calcification.
Findings:
- Glucagonoma diagnosis should be considered in diabetic patients exhibiting a migratory rash.
- The presence of idiopathic focal pancreatitis may indicate an underlying pancreatic tumor.
Implications:
- Early suspicion of glucagonoma in patients with diabetes and characteristic rash can improve diagnostic timelines.
- Recognizing pancreatic calcification in the context of pancreatitis may prompt investigation for pancreatic NETs.
- This case underscores the importance of considering rare presentations of pancreatic neuroendocrine tumors.
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