A case of a giant glucagonoma with parathyroid hormone-related peptide secretion showing an inconsistent postsurgical endocrine status

Intern Med. 2011;50(16):1689-94. doi: 10.2169/internalmedicine.50.5357. Epub 2011 Aug 15.


A 53-year-old woman was admitted because of a giant pancreatic tumor. Hypercalcemia and a high serum parathyroid hormone-related peptide (PTHrP) level were observed. A hypoglycemic attack occurred during pancreatectomy, and the surgical specimen revealed a PTHrP-secreting glucagonoma. Liver metastases developed 1 and 5.5 years later, and bone metastases appeared 6 years after surgery. Her serum PTHrP concentrations remained normal after surgery, despite re-elevation of the serum glucagon concentration after recurrence. The clinical course of this case illustrates the process of development of neuroendocrine tumors secreting two or more hormones.

Publication types

  • Case Reports

MeSH terms

  • Bone Neoplasms / diagnosis
  • Bone Neoplasms / metabolism
  • Bone Neoplasms / secondary
  • Female
  • Glucagon / metabolism
  • Glucagonoma / diagnosis
  • Glucagonoma / metabolism*
  • Glucagonoma / surgery*
  • Humans
  • Liver Neoplasms / diagnosis
  • Liver Neoplasms / metabolism
  • Liver Neoplasms / secondary
  • Middle Aged
  • Pancreatic Neoplasms / diagnosis
  • Pancreatic Neoplasms / metabolism*
  • Pancreatic Neoplasms / surgery*
  • Parathyroid Hormone-Related Protein / metabolism*
  • Postoperative Period


  • Parathyroid Hormone-Related Protein
  • Glucagon