Pancreatic islet cell carcinoma presenting with concurrent Cushing's and Zollinger-Ellison syndromes: Case series and literature review Review uri icon

Overview

MeSH Major

  • Carcinoma, Islet Cell
  • Cushing Syndrome
  • Pancreatic Neoplasms
  • Zollinger-Ellison Syndrome

abstract

  • Cushing's syndrome and Zollinger-Ellison syndrome occur occasionally as a result of neuroendocrine cancers. The concurrence of the two syndromes has been considered to confer a poor clinical and therapeutic outcome. In this study, we are reviewing two patients with pancreatic islet cell carcinomas and with both Zollinger-Ellison and Cushing's syndromes, one followed up for more than 5 years, and the other still receiving therapy, 5 years since diagnosis. A literature review showed that surgery has limited utility as the majority of these patients had metastases at the time of diagnosis. Proton-pump inhibitors, ketoconazole, and somatostatin antagonists have a major role in controlling symptoms. Interferon and systemic chemotherapeutic agents play a role in the management of metastatic and fast-growing cases. Chemoembolization and bland embolization show encouraging results in controlling liver metastases. The latter was used effectively and more than once in the two patients presented herein. On the basis of recent molecular genetics studies, target therapy may be helpful, however, ongoing trials will define it's utility. As the data confers a worse prognosis versus other pancreatic neuroendocrine tumors, the relatively favorable outcome of the two patients reported herein may reflect the impact of multiple therapeutic modalities.

publication date

  • February 2010

Research

keywords

  • Review

Identity

Language

  • eng

Digital Object Identifier (DOI)

  • 10.1097/MEG.0b013e3283314827

PubMed ID

  • 19770666

Additional Document Info

start page

  • 246

end page

  • 52

volume

  • 22

number

  • 2