Plasma Pancreatic Hormone Levels in a Case of Somatostatinoma: Diagnostic and Therapeutic Implications*
- 1 October 1979
- journal article
- research article
- Published by The Endocrine Society in Journal of Clinical Endocrinology & Metabolism
- Vol. 49 (4), 572-579
- https://doi.org/10.1210/jcem-49-4-572
Abstract
Plasma somatostatin immunoreactivity (SIR) was elevated 40-fold in an insulin-treated diabetic with disseminated pancreatic carcinoma. The diagnosis of somatostatinoma was supported by histological and ultrastructural similarities between metastatic cells and pancreatic D cells. Under acid conditions, 75/ of the plasma SIR eluted as a 6000- to 7000-dalton protein and 25/ as synthetic somatostatin (mol wt 1600), whereasthe 20-fold elevated urine SIR consisted almost exclusively of the higher molecular weight fraction. The hypersomatostatinemia was associated with reduced basal and stimulated pancreatic hormone levels, which might reflect itsinvolvement in the steatorrhea and diabetes, and its protection against ketoacidosis. Plasma SIR rose 50/ upon insulin withdrawal and 10-foldafter tolbutamide injection and fell 30/ after diazoxide. It is concluded that an increase in plasma and urine SIR, the presence of a 6000- to 7000-dalton SIR fraction in plasma and urine, a reduction in basal and stimulated pancreatic hormone levels, and tolbutamide-induced somatostatin release can be diagnostic for a somatostatinoma. Streptozotocin reduced tumor volume, hypersomatostatinemia, and tolbutamide-induced somatostatin release, suggesting that this drug may be useful in the treatment of disseminated somatostatinoma.Keywords
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