Glucagon-secreting pancreatic islet cell carcinoma, containing insulin and somatostatin, with hypoglycemic attack

A patient with glucagonoma syndrome and hypoglycemic attack is presented. Total pancreatectomy was performed with splenectomy and excision of the metastatic nodule in the liver. Diagnosis of glucagon-secreting A cell carcinoma of the pancreas was confirmed by hormone assays and morphological studies with light and electron microscopy. Glucagon, insulin, and somatostatin were demonstrated immunohistochemically in the tumor tissue. Multihormonal features of the endocrine pancreatic tumors are discussed.