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Exp Clin Endocrinol Diabetes 2002; 110(1): 43-49
DOI: 10.1055/s-2002-19994
Case Report

© Johann Ambrosius Barth

Renin producing neuroendocrine pancreatic carcinoma - a case report and review of the literature

P. Langer 1 , D. Bartsch 1 , B. Gerdes 1 , I. Schwetlick 2 , A. Wild 1 , B. Brehm 3 , C. Erley 3 , R. Lamberts 3
  • 1 Department of General Surgery, University Hospital, Philipps-University of Marburg, Germany
  • 2 Department of Pathology, University Hospital, Philipps-University of Marburg, Germany
  • 3 Department of Internal Medicine, University Hospital, Eberhard Karls University of Tübingen, Germany
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Publikationsverlauf

received 09 May 2001 first decision 12 July 2001

received 31 August 2001

Publikationsdatum:
07. Februar 2002 (online)

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Summary

A 44 year old male patient presented with severe hypertension. The diagnostic work-up revealed elevated levels of plasma renin activity (about 10 times the upper limit of normal) in the presence of normal plasma aldosterone levels and serum potassium concentrations. Renovascular disease was excluded by angiography. Selective renal vein sampling did not show any renin gradient. CT-scans of the abdomen demonstrated normal morphology of the kidneys and adrenals but revealed a big mass in the pancreatic corpus and tail with infiltration of the splenic vein and the presence of enlarged local lymph nodes. The endocrine nature of the pancreatic mass was further supported by a positive octreotide scintigraphy scan. Surgical removal of the tumor by left sided pancreatectomy combined with splenectomy resulted in rapid normalization of elevated renin concentrations as well as blood pressure. Histological examination of the tumor tissue revealed the presence of a neuroendocrine pancreatic carcinoma. Highly (× 70) elevated renin levels were detected by radioimmunoassay in the tumor tissue.

To our knowledge this is the first renin-producing neuroendocrine pancreatic carcinoma described in the literature. The present paper describes the case in detail and reviews the available literature on clinical symptomatology, diagnosis and treatment of renin-producing tumors.

Key words:

Renin-producing endocrine tumors - Primary reninism - Pancreatic endocrine carcinoma - Hypertension - Ectopic hormone production

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Prof. Dr. med. Regina Lamberts

Department of Internal Medicine

Division of Gastroenterology, Hepatology and Infectious Diseases

Eberhard Karls University of Tübingen

Otfried-Müller-Str. 10

D-72076 Tübingen

Germany

Telefon: +49-7071-2982722

Fax: +49-7071-292095

eMail: regina.lamberts@uni-tuebingen.de