Summary
Gastrointestinal hemorrhage from left-sided portal hypertension and gastric varices is an unusual presentation for islet cell carcinoma of the pancreas. Islet cell tumors of the pancreas themselves are rare. They present in a variety of ways. Those that elaborate functional hormones cause specific neuroendocrine syndromes. Nonfunctional tumors characteristically present later with symptoms of metastatic disease or as a result of local enlargement. We present a case of islet cell carcinoma of the pancreas presenting with recurrent gastrointestinal bleeding from gastric varices and review the literature for this rare presentation. We emphasize the importance of a careful initial diagnostic work-up that may enable curative surgery.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Kent RB, Van Heerden JA, Weiland LH: Nonfunctioning islet cell tumors. Ann Surg 193 (2):185–190, 1981
Broder LE, Carter SK: Pancreatic islet cell carcinoma. I. Clinical features of 52 patients. Ann Intern Med 79(1):101–107, 1973
Eckhauser FE, Cheung PS, Vinik AI, Strodel WE, Lloyd RV, Thompson NW: Nonfunctioning malignant neuroendocrine tumors of the pancreas. Surgery 100(6):978–988, 1986
MacLean N, Falconer CWA, Gilmour IEW, Webb JN: Islet cell tumors of the pancreas with portal varices and gastrointestinal hemorrhage. J R Coll Surg, Edinburgh 15:206–212, 1970
Broughan TA, Leslie JD, Soto JM, Hermann RE: Pancreatic islet cell tumors. Surgery 99(6):671–678, 1986
Thompson GB, Van Heerden JA, Grant CS, Carnay JA, Ilstrup DM: Islet cell carcinomas of the pancreas: A twenty-year experience. Surgery 104(6):1011–1017, 1988
Chellappa M, Yee CK, Gill DS: Left-sided portal hypertension from malignant islet cell tumor of the pancreas: Review with a case report. J R Coll Surg, Edinburgh 31(4):251–252, 1986
Wolf JH, Long RJ, Miller FJ, Feffries GH: Pancreatic islet cell tumor presenting as bleeding gastric varices secondary to splenic vein occlusion. Am J Dig Dis 22:652–655, 1977
Gallardo-Navarra V, Phillips E, Neyfeld P, Sakwa S: Segmental portal hypertension and islet cell adenoma of the pancreas. JAMA 226(12):1466, 1973
Okuno M, Sakaguchi S, Nagayama M, Yamashita T, Sakazaki S, Yoshikawa K, Taruya E, Fukamizu A, Umeyama K: Nonfunctioning islet cell carcinoma presenting bleeding gastric varices and splenomegaly. Jpn J Surg 14(3):244–247, 1984
Madsen MS, Petersen TH, Sommer H: Segmental portal hypertension. Ann Surg 204(1):72–77, 1986
Glynn MJ: Isolated splenic vein thrombosis. Arch Surg 121(6):723–725, 1986
Sutton JP, Yarborough DY, Richards JT: Isolated splenic vein occlusion. Arch Surg 100:623–626, 1970
Bachman BA, Brady PG: Localised gastric varices; mimicry leading to endoscopic misinterpretation. Gastrointest Endosc 30(4):244–247, 1984
Bok EJ, Cho KJ, Williams DM, Brady TM, Weiss CA, Forrest ME: Venous involvement in islet cell tumors of the pancreas. AJR 142(2):319–322, 1984
Caletti G, Bolondi L, Labo G: Ultrasonic endoscopy—the gastrointestinal wall. Scand J Gastroenterol 102(suppl):5–8, 1984
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Metz, D.C., Benjamin, S.B. Islet cell carcinoma of the pancreas presenting as bleeding from isolated gastric varices. Digest Dis Sci 36, 241–244 (1991). https://doi.org/10.1007/BF01300765
Received:
Revised:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF01300765