[Bihormonal apudoma of the pancreas]

A pancreatic tumor that displayed bihormonal activity is described: the tumor elaborated insulin, resulting in a hyperinsulinism syndrome (spontaneous hypoglycemia) as well as a second hormone, apparently gastrin or a gastrin-like polypeptide, which led to the development of Zollinger-Ellison syndrome. The presence of these two syndromes complicated both the diagnosis and treatment of the disease. A histologic examination using an argyrophilic (Grimelius) reaction confirmed that the tumor had originated from endocrine cells of the gastrointestinal tract and was a bihormonal apudoma of the pancreas.