Glucagonoma occurring as a large cystic abdominal mass

We have described a 77-year-old woman with a 14 x 15 cm cystic mass arising from the head of pancreas. The serum glucagon level was elevated, and electron microscopy revealed large numbers of alpha granules within the tumor cells. Glucagonoma syndrome should be considered in the differential diagnosis of a large abdominal mass even if skin rash is minimal.