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This version published online on February 5, 2008
Journal of Clinical Endocrinology & Metabolism, doi:10.1210/jc.2007-2449
A more recent version of this article appeared on April 1, 2008
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Submitted on November 5, 2007
Accepted on January 28, 2008

Insulinoma and Gastrinoma Syndromes from a Single Intrapancreatic Neuroendocrine Tumor

Maya B. Lodish MD, Anathea C. Powell MD, Mones Abu-Asab MD, Craig Cochran CRNP, Petra Lenz MD, Steven K. Libutti MD, James F. Pingpank MD, Maria Tsokos MD, and Phillip Gorden MD*

National Institute of Child Health and Human Development; Surgery Branch, National Cancer Institute; Laboratory of Pathology, National Cancer Institute; Clinical Endocrinology Branch, Division of Intramural Research, National Institute of Diabetes and Digestive and Kidney Diseases

* To whom correspondence should be addressed. E-mail: PhillipG{at}intra.niddk.nih.gov.

Context: The insulinoma syndrome is marked by fasting hypoglycemia and inappropriate elevations of insulin. The gastrinoma syndrome is characterized by hypergastrinemia, ulcer disease and/or diarrhea. Rarely, insulinoma and gastrinoma coexist in the same patient simultaneously.

Objective: To determine the cause of a patient's hypoglycemic episodes and peptic ulcer disease.

Design: Clinical case report.

Setting: Clinical Research Center of the National Institutes of Health.

Patients: One patient with hypoglycemic episodes and peptic ulcer disease.

Intervention: Surgical resection of neuroendocrine tumor.

Results: The patient was found to have a single tumor co-secreting both insulin and gastrin. Resection of this single tumor was curative.

Conclusions: A single pancreatic neuroendocrine tumor may lead to the expression of both the hyperinsulinemic and hypergastrinemic syndromes.
Key words: Insulinoma • gastrinoma • MEN1






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