PMID- 19039643
OWN - NLM
STAT- MEDLINE
DCOM- 20090326
LR  - 20211020
IS  - 0941-1291 (Print)
IS  - 0941-1291 (Linking)
VI  - 38
IP  - 12
DP  - 2008
TI  - Cervical metastases of glucagonoma in a patient with multiple endocrine neoplasia 
      type 1: report of a case.
PG  - 1137-43
LID - 10.1007/s00595-008-3763-1 [doi]
AB  - Multiple endocrine neoplasia type 1 (MEN 1) is a syndrome characterized by tumors 
      of the parathyroid glands, pancreatic islet cells, duodenum, and pituitary gland. 
      We report a case of cervical metastases of glucagonoma with MEN 1. The patient 
      was a 34-year-old woman admitted to our hospital with epigastric pain. Her 
      medical history included two resections of prolactinoma and two upper GI 
      hemorrhages secondary to duodenal ulcers. Computed tomography (CT) showed two 
      hypervascular lesions in the tail of the pancreas and cervical ultrasound showed 
      multiple hypoechogenic ovoid images in the neck. A cervical CT scan confirmed two 
      15-mm lymph nodes in the left cervical region and 111In-DOTATOC imaging showed 
      focal abnormal somatostatin expression in the pancreatic tail and the cervical 
      nodes. The patient had asymptomatic hypoglycemic episodes, with blood sugar 
      levels as low as 30 mg/dl, which raised our suspicion of MEN 1 associated with 
      pancreatic insulinoma. Thus, we performed a distal pancreatectomy with bilateral 
      cervical dissection and parathyroid gland resection. Histopathological 
      examination revealed 12 pancreatic tumors as well as metastases in four cervical 
      lymph nodes. The resected parathyroid glands had normal structure, suggesting 
      parathyroid hyperplasia. A follow-up CT scan, 18 months after surgery, showed new 
      tumors in the head of the pancreas and in the duodenal wall. A 
      pancreatoduodenectomy was performed and histopathological examination revealed 
      nine nonfunctioning endocrine tumors in the pancreas, one tumor in the duodenal 
      wall, and metastases in two peripancreatic lymph nodes. The patient recovered 
      well and remains asymptomatic.
FAU - Butte, Jean M
AU  - Butte JM
AD  - Department of Digestive Surgery, Pontificia Universidad Catolica de Chile, 
      Marcoleta 367, Santiago, Chile.
FAU - Montero, Pablo H
AU  - Montero PH
FAU - Solar, Antonieta
AU  - Solar A
FAU - Torres, Javiera
AU  - Torres J
FAU - Olmos, Pablo R
AU  - Olmos PR
FAU - Goni, Ignacio
AU  - Goni I
FAU - Quintana, Juan C
AU  - Quintana JC
FAU - Martinez, Jorge
AU  - Martinez J
FAU - Llanos, Osvaldo
AU  - Llanos O
LA  - eng
PT  - Case Reports
PT  - Journal Article
DEP - 20081128
PL  - Japan
TA  - Surg Today
JT  - Surgery today
JID - 9204360
SB  - IM
MH  - Adult
MH  - Cholecystectomy
MH  - Duodenal Neoplasms/pathology/secondary
MH  - Female
MH  - Glucagonoma/metabolism/*pathology/surgery
MH  - Humans
MH  - Hyperplasia
MH  - Hypoglycemia/etiology
MH  - Immunohistochemistry
MH  - Lymphatic Metastasis
MH  - Multiple Endocrine Neoplasia Type 1/*pathology
MH  - Neck
MH  - Pancreatectomy
MH  - Pancreatic Neoplasms/metabolism/*pathology/surgery
MH  - Pancreaticoduodenectomy
MH  - Parathyroid Glands/pathology/surgery
MH  - Splenectomy
EDAT- 2008/11/29 09:00
MHDA- 2009/03/27 09:00
CRDT- 2008/11/29 09:00
PHST- 2007/09/11 00:00 [received]
PHST- 2008/01/09 00:00 [accepted]
PHST- 2008/11/29 09:00 [pubmed]
PHST- 2009/03/27 09:00 [medline]
PHST- 2008/11/29 09:00 [entrez]
AID - 10.1007/s00595-008-3763-1 [doi]
PST - ppublish
SO  - Surg Today. 2008;38(12):1137-43. doi: 10.1007/s00595-008-3763-1. Epub 2008 Nov 
      28.