Rare presentation of endocrine pancreatic tumour: a case of glucagonoma without necrolytic migratory erythema?

The case of a 61-year-old woman with a probable pancreatic glucagonoma in reported. The clinical peculiarity of this case is the lack of the characteristic necrolytic migratory erythema (NME); the patient presented asthenia, weight loss and hyperglycemia. Ultrasonography, CT-scan and arterography showed a irregular pancreatic mass and secondary diffuse hepatic lesions. Fine needle aspiration cytology with immunohistochemistry and glucagon serum levels yielded to the diagnosis. Surgical treatment was not proposed because of the advanced stage of the disease; therefore, chemotherapy (streptozotocin, 5-fluorouracil) was performed. During a 16-month follow-up period the patient did not develop NME.