Insulinoma and gastrinoma syndromes from a single intrapancreatic neuroendocrine tumor

Context: The insulinoma syndrome is marked by fasting hypoglycemia and inappropriate elevations of insulin. The gastrinoma syndrome is characterized by hypergastrinemia, ulcer disease, and/or diarrhea. Rarely, insulinoma and gastrinoma coexist in the same patient simultaneously. Objective: Our objective was to determine the cause of a patient's hypoglycemic episodes and peptic ulcer disease. Design and Setting: This is a clinical case report from the Clinical Research Center of the National Institutes of Health. Patient and Intervention: One patient with hypoglycemic episodes and peptic ulcer disease had a surgical resection of neuroendocrine tumor. Results: The patient was found to have a single tumor cosecreting both insulin and gastrin. Resection of this single tumor was curative. Conclusions: A single pancreatic neuroendocrine tumor may lead to the expression of both the hyperinsulinemic and hypergastrinemic syndromes.