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Pancreatic neuroendocrine cell tumor secreting parathyroid hormone-related protein and gastrin: Report of a case

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Abstract

This report presents a case of pancreatic neuroendocrine cell carcinoma with multiple liver metastases secreting gastrin and parathyroid hormone-related protein (PTHrP) related to lumbar bone fracture and hypercalcemia. A 58-year-old woman visited an affiliated hospital with a chief complaint of lumbago without any evidence of trauma. She was diagnosed with hepatic dysfunction and hypercalcemia as well as multiple lumbar compression fractures without osteolytic lesions. Abdominal computed tomography (CT) showed a hypervascular mass in the pancreatic tail and multiple liver tumors. Duodenal ulcers were found with gastrointestinal endoscopy. There was a marked increase in the serum gastrin level. She was diagnosed as gastrinoma with multiple liver metastases and was admitted to the hospital. She had an increase in serum PTHrP level without the elevation of intact parathyroid hormone at the time of admission. She underwent an extended right hepatectomy in addition to a distal pancreatectomy with a regional lymphadenectomy and splenectomy. The postoperative course was uneventful, and serum gastrin and PTHrP activities reduced to normal levels. She remained symptom-free, and serum calcium, gastrin, and PTHrP levels remain within the normal ranges 19 months after surgery without adjuvant therapy.

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Authors and Affiliations

  1. Second Department of Surgery, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu, 431-3192, Japan

    Yoshifumi Morita, Takanori Sakaguchi, Kosuke Oishi, Atsushi Suzuki, Kazuhiko Fukumoto, Keisuke Inaba & Hiroyuki Konno

  2. Department of Pathology, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu, 431-3192, Japan

    Satoshi Baba

  3. Department of Radiology, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu, 431-3192, Japan

    Yasuo Takehara

  4. Department of Surgery, Iwata City Hospital, Iwata, Japan

    Shohachi Suzuki

Authors
  1. Yoshifumi Morita
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  2. Shohachi Suzuki
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  3. Takanori Sakaguchi
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  4. Kosuke Oishi
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  5. Atsushi Suzuki
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  6. Kazuhiko Fukumoto
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  7. Keisuke Inaba
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  8. Satoshi Baba
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  9. Yasuo Takehara
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  10. Hiroyuki Konno
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Morita, Y., Suzuki, S., Sakaguchi, T. et al. Pancreatic neuroendocrine cell tumor secreting parathyroid hormone-related protein and gastrin: Report of a case. Surg Today 40, 1192–1196 (2010). https://doi.org/10.1007/s00595-009-4190-7

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  • DOI: https://doi.org/10.1007/s00595-009-4190-7

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