GLUCAGONOMA

From Big Medical Encyclopedia

GLUCAGONOMA (a glucagon + - oma) — a malignant tumor, coming from alpha cells of the insular device of a pancreas.

In the world literature several cases of G. among which only in three it is given detailed kliniko-morfol, the description [Mac-Gavren (M. H. McGavran) with sotr are described., 1966; Yosinaga (T. Joshinaga) with sotr., 1966; S. L. Lightman with sotr., 1974]. The etiology and pathogeny are not clear.

Is located in various parts of a pancreas, plentifully the vaskulyarizirovana also is closely connected with vessels. The sizes of a tumor of 4 — 10 cm in dia., the form is various — from spherical to wrong, the 50th Mr.

Gistol can reach weight, G.'s structure is various. Cells of a tumor usually pleomorfna, with existence of a big kernel and one big kernel. Histochemical they give positive reactions to an argirofilnost, chrome-hematoxylin-phloxine, paraaminobenzaldehyde, reaction about aldehyde-fuchsin negative. The submicroscopy finds considerably the bigger size of alpha cells in a tumor in comparison with normal gland.

Cosecretes a significant amount glucagon (see).

It is clinically shown by a diabetes mellitus (see. diabetes mellitus ), which arises at early stages of tumoral process and it is characterized by absence of ketoacidosis and a hypoglycemia. Disappearance of nipples of language (the so-called varnished language) is characteristic.

Diagnosis is based on a wedge, data and laboratory researches (definition of a sugar content in blood and urine, a glucagon in blood). In view of bystry emergence of metastasises scanning of a pancreas, arteriography of the truncus celiacus system, a puncture biopsy of a tumor, sometimes a diagnostic laparotomy matters.

Treatment operational. For compensation of diabetes appoint insulins therapy).

The forecast after operation doubtful.


Bibliography Church R. E. a. Crane W. A. A cutaneous syndrome associated with islet-cell carcinoma of the pancreas, Brit. J. Derm., v. 79, p. 284, 1967; Lightman S. L. a. Bloom S. R. Cure of insulin-dependent diabetes mellitus by removal of a glucagonoma, Brit. med. J., v. l, p. 367, 1966; M e G a v r a n M. of H. a. o. A glucagon-secreting alpha-cell carcinoma of the pancreas, New Engl. J. Med., v. 274, p. 1408, 1966; Joshinaga T. o. Pancreatic A-ccll tumor associated with severe diabetes mellitus, Diabetes, v. 15, p. 709, 1966.

A. G. Mazowiecki.

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