Migratory necrolytic erythema is seen in

Peutz-Jeghers syndrome
Sarcoidosis
Glucagonomas
Acute pancreatitis
 
Answers , Description and details

Correct Answer : Glucagonomas
Ref: Harrisons 17th edition page no 2355
Migratory necrolytic erythema is seen in  Glucagonoma
 
Glucagonoma
Most common site – tail of pancreas (extra pancreatic is very rare)
50-80% are malignant
Clinical features        – Migratory necrolytic erythema
– Glucose intolerance
– Weight loss
– Anemia
– Diarrhea
– Thromboembolism
 
Other Pancreatic endocrine tumors
 
Insulinoma
It is an endocrine tumor of beta cells.
Only 5-15% are malignant (very low malignancy potential)
Most common site of Insulinoma – distributed equally all over Pancreas
Whipple’s triad
1) Symptoms consistent with hypoglycemia
2) A low plasma glucose concentration
3) Relief of symptoms after the plasma glucose level is raised
These features are typically seen in Insulinoma.
 
Gastrinoma – Zollinger Ellison syndrome
It is a non beta cell tumor.
60-90% of the tumors are malignant
Increased Gastrin secretion will lead to gastric acid hypersecretion which in turn results in peptic
ulceration.
Most common site of gastrinoma – Duodenum
Most common symptom – abdominal pain
Most common hormone to be secreted besides gastrin – ACTH
Most common site of peptic ulcer – first part of Duodenum
Most valuable provocative test – secretin injection test
 
VIPoma
Other names – Verner Morrison syndrome, Watery diarrhea syndrome, WDHA syndrome
Pancreatic cholera
Most common site – tail of pancreas
Clinical features   – Watery diarrhea
– Hypokalemia
– Hypochlorhydria
– Metabolic acidosis
– Hypercalcemia
– Hyperglycemia
 
 
Somatostatinoma
Most common site – head of pancreas
Clinical features        – Diabetes mellitus
– Gall bladder disease
– Diarrhea
– Steatorrhea
 
 
Note:
Most common site of Insulinoma – equally distributed
Most common site of Glucagonoma – tail of pancreas
Most common site of VIPoma – tail of pancreas
Most common site of Somatostatinoma – head of pancreas
Most common site of Ca pancreas – head of pancreas
Most common site of Pseudocyst – body and tail of pancreas
Most common site of Gastrinoma – Duodenum
 
Note :
Erythema migrans is seen in Lymes disease
Granuloma annulare is seen in Diabetes mellitus
Trousseau syndrome (Migratory thrombophlebitis) is seen in Pancreatic Cancer

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