Non-functional duodenal neuroendocrine carcinoma: a rare cause of diabetes mellitus

Endocrinology, Diabetes & Metabolism Case Reports
Chad BisambarCarron Meney

Abstract

A 40-year-old Caucasian female presented with hyperglycaemia, polyuria, polydipsia and weight loss of 6 kg over a 1-month period. There was no personal or family history of malignancy or diabetes mellitus. On examination, she was jaundiced with pale mucous membranes and capillary glucose was 23.1 mmol/L. Initial investigations showed iron deficiency anaemia and obstructive pattern of liver function tests. HbA1c was diagnostic of diabetes mellitus at 79 mmol/mol. Malignancy was suspected and CT chest, abdomen and pelvis showed significant dilatation of intra- and extra-hepatic biliary tree including pancreatic duct, with periampullary 30 mm mass lesion projecting into lumen of duodenum. Enlarged nodes were seen around the superior mesenteric artery. This was confirmed on MRI liver. Fasting gut hormones were normal except for a mildly elevated somatostatin level. Chromogranin A was elevated at 78 pmol/L with normal chromogranin B. Duodenoscopy and biopsy showed possible tubovillous adenoma with low-grade dysplasia, but subsequent endoscopic ultrasound and biopsy revealed a grade 1, well differentiated neuroendocrine tumour. The patient was started on insulin, transfused to Hb >8 g/dL and Whipple's pancreatico-duodenectomy was und...Continue Reading

References

Feb 6, 2003·Cancer·Irvin M ModlinMark Kidd
Oct 29, 2005·Best Practice & Research. Clinical Gastroenterology·K Martin HoffmannRobert T Jensen
Apr 16, 2013·Best Practice & Research. Clinical Gastroenterology·Dermot O'TooleRobert T Jensen
Dec 18, 2013·Clinical Endoscopy·Sang Ho KimJong Sun Rew
Jan 31, 2018·HeartRhythm Case Reports·T Jared Bunch

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