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Malignant Somatostatinoma (Brief Overview and a Case Review)


Authors: M. Pešková 1;  R. Hvižď 1;  J. Dušková 2
Authors‘ workplace: 1. chirurgická klinika 1. LF UK a VFN Praha 1;  Ústav patologie 1. LF UK a VFN a Katedra patologie IPVZ Praha 2
Published in: Rozhl. Chir., 2007, roč. 86, č. 12, s. 643-647.
Category: Monothematic special - Original

Overview

Introduction:
Somatostatinoma is a rare, slowly growing tumor with malignity potential, most commonly located in the pancreas or duodenum. By the time its diagnosis is established, it is usually large and liver metastases are present. Increased concentrations of somatostatin, produced by pancreatic D cells or by intestinal mucosa, inihibit secretion of a number of GIT hormones, endocrine and exocrine pancreatic secretion. The clinical findings include symptoms of diabetes, dyspepsia, diarrhoea, steatorhoea, abdominal pain, hypochlorhydria, anemia. Sometimes, the finding is accidental.

A case review:
The authors present a case of somatostatinoma, detected accidentaly in a 72- year- old male. The tumor originated from the pancreatic head, partially spreading invasively into surrounding organs (duodenum), invading blood vessels and metastazing into peripancreatic lymphonodes. The tumor was asymptomatic and was detected as an accidental finding on ultrasound and CT abdominal examinations for the patient’s urological disorder (vesicolithiasis)

Pylorus saving hemipancreatoduodenectomy was performed and, on microscopic and subsequent immunohistochemical examination of the resecate, a well- differentiated endocrine, somatostatin- producing pancreatic carcinoma was verified.

Key words:
malignant somatostatinoma – accidental detection of the tumor – hemipancreatoduodenectomy – verification by a pathologist


Sources

1. Adam, Z., Vorlíček, J, Vaníček, J., a kol. Neuroendokrinní nádory střeva a pankreatu. In: Diagnostické a léčebné postupy u maligních chorob. Praha: Grada Publishing, s. 127–134.

2. Economopoulos, P., Christopoulos, C. Somatostatinoma syndrome, Annals of Gastroenterology, 2001, 14, 252–260.

3. Ganda, O. P., et al. „Somatostatinoma“ A somatostatin-containing tumor of the endocrine pankreas. N. Engl. J. Med., 1977, 296, 963–967.

4. Krejs, G. J., et al. Somatostatinoma syndrome. Biochemical, Morphologic and Clinical features. N. Engl. J. Med., 1979, 301, 285–292.

5. Larsson, L. I., et al. Pancreatic somatostatinoma. Clinical features and physiological implications. Lancet, 1977, 1, 666–668.

6. Vinik, A. J. Somatostatinoma. Endotext.com, August 2, 2004.

7. Vinik, A. J., Moattari, A. R. Treatment of endocrine tumors of the pancreas. Endokrinol. Metab. Clin. North Am., 1989.

8. Škrha, J., Eliáš, P., Dvořák, M., Fixa, B. Endokrinní nádory trávicího ústrojí. In: Mařatka, Z.: Gastroenterologie. Praha: Karolinum, 1999, s. 473–485.

Labels
Surgery Orthopaedics Trauma surgery
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