Report on a patient with watery diarrhoea syndrome caused by a pancreatic tumour containing neurotensin, enkephalin and calcitonin.

A patient with water diarrhoea syndrome (WDS) is described. A pancreatic tumour was found containing many cells with immunoreactivity to enkephalin and neurotensin, a few with immunoreactivity to calcitonin but none to vasoactive intestinal peptide (VIP). High levels of calcitonin, neurotensin, VIP and pancreatic polypeptide (PP) were present in plasma as measured by radioimmunoassay. After removal of the tumour, the plasma levels of the first three peptides returned to normal and the WDS disappeared. On the other hand, plasma PP did not change. No specific symptoms could be attributed to the new spectrum of peptides found in the tumour. This is the first report of a pancreatic tumour containing high levels of neurotensin.