# Glucagonoma Syndrome With Necrolytic Migratory Erythema

## TL;DR

A rare pancreatic tumor caused a skin condition and diabetes, and was successfully treated with surgery.

## Contribution

This case presents an atypical presentation of necrolytic migratory erythema linked to glucagonoma syndrome.

## Key findings

- A pancreatic alpha-cell tumor was diagnosed in a 47-year-old man with skin lesions and diabetes.
- Skin lesions resolved after surgical removal of the tumor.
- The tumor was confirmed as a well-differentiated neuroendocrine tumor with low proliferation (Ki67: 1%).

## Abstract

Glucagonoma is a rare pancreatic alpha-cell tumor that leads to glucagonoma syndrome, typically characterized by necrolytic migratory erythema (NME), diabetes, weight loss, and anemia. We present the case of a 47-year-old man with a one-year history of diabetes and a relapsing pustular and scaly dermatosis. Examination revealed widespread annular erythematous plaques. Laboratory tests showed anemia, hypoalbuminemia, and hyperglycemia. Skin biopsy demonstrated epidermal necrolysis, and abdominal imaging identified a 3.1 cm tumor in the pancreatic tail. Surgical resection confirmed a well-differentiated neuroendocrine tumor (Ki67: 1%), and skin lesions resolved postoperatively. This case highlights an atypical presentation of NME and the importance of early recognition to reduce diagnostic delay in glucagonoma syndrome.