Pinsard D, Chadenas D
Service d'Endocrinologie, CHR d'Orléans la Source, France.
Diabete Metab. 1988 Jan-Feb;14(1):43-59.
Somatostatinomas are endocrine tumors which prevailing secretion is somatostatin. They are localized in the pancreas and digestive tract or not often in tissues unusually secreting somatostatin, as bronchi. Forty three cases have been described until now. The endocrine syndrome, not very spécific and inconstant, is the result of the somatostatin hypersecretion. Diabetes mellitus, cholelithiasis, pancreatic exocrine insufficiency, gastric hypochlorhydria and anemia are the main symptoms of pancreatic somatostatinoma. On the other hand, they are not found in digestive tumors. Somatostatinomas often secrete other hormonal peptides which may change the clinical manifestations. Radioimmunoassay of plasma somatostatin (basal level and/or after stimulation by tolbutamid) is a more successful diagnostic test; but only immunocytochemistry of the tumor can proved the diagnosis. They a bad prognosis but are not a contra-indication to make a curative treatment; surgical resection and chemotherapy by streptozotocin and 5 FU are the two treatments.