Pancreatic alpha cell tumors that secrete glucagon have stimulated considerable interest recently. They have been associated with a striking and distinctive clinical syndrome characterized by the skin rash of necrolytic migratory erythema, weight loss, glucose intolerance, anemia, stomatitis, and hepatic metastases in most cases
(1). Streptozocin has been used with sporadic, though not consistent, success. Efficacy for dimethyltriazenoimidazole carboxamide (DTIC) in this disease has been suggested in a single previous case report (2). We report here a rather remarkable response to DTIC in a patient with the malignant glucagonoma syndrome.
A 43-year-old white man presented to Massachusetts General Hospital in