Korean J Med.  2013 Mar;84(3):405-410. 10.3904/kjm.2013.84.3.405.

Prolonged Neutropenia after Sunitinib Treatment in a Patient with a Glucagonoma and Multiple Hepatic Metastases

• Moon HR
• Choi JM
• Jang DK
• Lee M

• KMID: 1833851
• DOI: http://doi.org/10.3904/kjm.2013.84.3.405

Abstract

Pancreatic neuroendocrine tumors (PNET) are rare, with approximately 2.2 in 1,000,000 people affected annually. In the classification of neuroendocrine tumors, glucagonomas are a functional PNET and comprise 1.6% of PNET. Glucagonoma syndrome is a paraneoplastic syndrome that is characterized by necrolytic migratory erythema, weight loss, anemia, and diabetes mellitus. Metastatic disease at presentation is common, but is often limited to the liver and regional lymph nodes. Sunitinib malate improves the progression-free and overall survival of PNET. This report presents a 45-year-old Asian woman with prolonged neutropenia after sunitinib treatment of a glucagonoma with multiple hepatic metastases. The severity of the neutropenia after the sunitinib treatment fluctuated from grade 1 to 4 repeatedly, with a non-febrile pattern. Ultimately, the patient did not recover from the neutropenia, even after stopping the sunitinib.

Keyword

Pancreas; Neuroendocrine tumors; Glucagonoma; Sunitinib; Neutropenia

MeSH Terms

Anemia
Asian Continental Ancestry Group
Diabetes Mellitus
Female
Glucagonoma
Humans
Indoles
Liver
Lymph Nodes
Necrolytic Migratory Erythema
Neoplasm Metastasis
Neuroectodermal Tumors, Primitive
Neuroendocrine Tumors
Neutropenia
Pancreas
Paraneoplastic Syndromes
Pyrroles
Weight Loss
Indoles
Pyrroles