76-Year-Old Woman With a Bluish-Purple Lump in her Left Upper Medial Leg

A woman, aged 76 years, presented with a bluish-purple lump in her mid- to upper medial left thigh. It started initially as a flat rash, and over a 2-month period, it turned into a mass measuring 2.5 cm by 3.1 cm. Work-up, including a PET-CT scan, showed the soft tissue mass on the inner thigh to have a Standardized Uptake Value of 4; there were no other sites of disease. A biopsy of the lesion was performed.

Glucagonoma syndrome with severe erythematous rash: A rare case report

RATIONALE

Glucagonoma is a rare neuroendocrine tumor of the pancreas. Glucagonoma syndrome is often misdiagnosed as other skin lesions by clinicians due to a typical clinical sign of necrolytic migratory erythema (NME) with severe erythematous rash.

PATIENT CONCERNS

A 48-year-old female patient was admitted to our department because she presented with unclear recurrent severe erythematous rash. The patient was diagnosed as skin disease.

DIAGNOSES

Histopathologic examination revealed a pancreatic glucagonoma. Immnohistochemical staining of tumor tissue was positive for glucagon.

INTERVENTIONS

The distal pancreatectomy plus splenectomy was performed in 2017.

OUTCOMES

The skin lesions disappeared after surgery. She was followed up and showed no recurrence until now.

LESSONS

Clinicians should consider the diagnosis of glucagonoma according to the typical initial symptoms. Early diagnosis is very important to provide a better prognosis. A multidisciplinary approach is effective in patients with unresectable metastatic tumors.