Pancreatic alpha cell tumors: Case report and review of the literature

Abstract

The authors thank Mrs. Nancy Carlson for her technical assistance in electron microscopy, Ms. Rose O'Reilly for preparation of the manuscript, and Dr. Carl Hoar for performing the surgical exploration.Accepted for publication May 2, 1979. secreting islet cell carcinoma and describe the use of streptozotocin, which induced complete remission of the clinical syndrome, reversion of the biochemical abnormalities toward normal, and objective decrease in size of the hepatic metastases. Case ReportA 61-year-old woman with known diabetes mellitus was controlled on diet and oral agents since the initial diagnosis in 1965. In 1977, the control of the diabetes was erratic and the patient was admitted for evaluation and insulin regulation. She had had a 50-lb. weight loss as part of the exacerbation of the diabetes, and she required 40 units of NPH insulin to regulate the blood sugar at that hospitalization. Six month later the patient was readmitted with an intensely pruritic rash, and at that point she gave a history of intermittent pruritis and rash dating back to January 1975. The rash was erythematous and appeared initially in the perineum, buttocks, ankles, and inframammary area (Figs. IA, B, C, D, E). It had been treated with a variety of topical medicaments including cortico-steroids. The rash was intermittent, passing through periods of exacerbation and remission not related specifically to topical therapy and leading to residual hyperpigmentation. The cutaneous lesions were considered characteristic of migratory necrotizing erythema, and, therefore, the patient underwent further diagnostic studies including abdominal ultrasound and pancreatic angiography.