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A Case of Glucagonoma with Liver Metastasis: Complete Response to Dacarbazine
Author(s) -
ISOMOTO Hajime,
MIZUTA Yohei,
MATSUNAGA Keiichiro,
TOMONAGA Michio,
SHIMOKAWA Isao,
OMAGARI Katsuhisa,
TAKESHIMA Fuminao,
MURASE Kunihiko,
KOHNO Shigeru
Publication year - 1998
Publication title -
digestive endoscopy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.5
H-Index - 56
eISSN - 1443-1661
pISSN - 0915-5635
DOI - 10.1111/j.1443-1661.1998.tb00550.x
Subject(s) - medicine , hyperglucagonemia , dacarbazine , glucagonoma , hypoproteinemia , anemia , pancreatic tumor , gastroenterology , metastasis , chemotherapy , pathology , glucagon , cancer , insulin , pancreatic cancer
We report a case of glucagonoma syndrome with liver metastasis, who responded completely to dacarbazine chemotherapy. A 77‐year‐old woman complained of itching skin eruptions (diagnosed as necrolytic migratory erythema) and weight loss. She was found to have glucose intolerance, anemia, hypoproteinemia and hyperglucagonemia. Abdominal CT and celiac arteriography showed a hypervascular tumor in the pancreatic tail and a metastatic tumor in the left hepatic lobe. Immunohistochemical examination of the metastatic liver tumor obtained by laparoscopic biopsy revealed the tumor cells to be positive for glucagon. The patient was treated with 20 courses of 300 mg/day intravenous dacarbazine for 5 consecutive days followed by a 4 week drug‐free interval. No major side effects were noted. Treatment resulted in disappearance of the skin lesions and correction of anemia, glucose intolerance, hypoproteinemia and hyperglucagonemia. Follow‐up abdominal CT showed complete resolution of both the primary pancreatic tumor and the metastatic liver tumor. We suggest that dacarbazine be considered as the treatment of choice for metastatic glucagonoma.