Pathology · Neoplasia (Classification, Carcinogenesis, Tumor Markers, Paraneoplastic)

A 58-year-old woman with new-onset diabetes presents with a migrating, erythematous, scaly rash on the perineum and groin, glossitis, and weight loss. A pancreatic mass is identified. Which tumor is most likely responsible?

  • A Insulinoma
  • B Glucagonoma
  • C Gastrinoma
  • D Somatostatinoma
Correct answer: B. Glucagonoma

Explanation

Necrolytic migratory erythema is the characteristic paraneoplastic rash of glucagonoma, an alpha-cell pancreatic neuroendocrine tumor. It presents with dermatitis, diabetes, depression, and deep vein thrombosis. Insulinoma causes hypoglycemia. Gastrinoma causes Zollinger-Ellison syndrome. Somatostatinoma causes diabetes, cholelithiasis, and steatorrhea.

Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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