ECEESPE2025 ePoster Presentations Diabetes and Insulin (245 abstracts)
Unusual case of pancreatic neoplasm revealed by insulin initiation in a diabetic patient
Dhoha Ben Salah 1 , Oumaima Dimassi 1 , Khouloud Boujelben 1 , Nada Hassairi 1 , Faten Haj Kacem Akid 1 , Nadia Charfi 1 , Mouna Mnif 1 , Mohamed Abid 1 , Mouna Elleuch 1 & Nabila Rekik Majdoub 1
1Department of Endocrinology Hedi Chaker Hospital, Sfax, Tunisia
JOINT2454
Introduction: Pancreatic cancer ranks 12th among the most common malignancies, with type 2 diabetes mellitus (T2DM) increasing the risk by 1.8 times. Paraneoplastic dermatomyositis is a well-documented mode of presentation.
Case Report: We report the case of a 64-year-old female patient with a family history of T2DM and papillary thyroid carcinoma in her two daughters. She had been diagnosed with diabetes three years prior and was managed with oral antidiabetic. She presented with spontaneous ketoacidosis, necessitating the initiation of human insulin therapy. Within 24 hours of the first insulin injection, she developed non-pruritic, ill-defined erythematous plaques on the thighs (injections were administered in the arms) and subsequently on the anterior forearms. Suspecting insulin allergy, insulin therapy was discontinued for 15 days, and oral antidiabetic agents were resumed. However, the progressive worsening of the cutaneous lesions raised suspicion of paraneoplastic dermatomyositis. An abdominal CT scan revealed an intrapancreatic tumor at the cephalo-isthmic junction, measuring 25 × 18 mm. She underwent chemotherapy followed by Cephalic duodenopancreatectomy. Histopathological examination confirmed a moderately differentiated ductal adenocarcinoma. Following surgery, insulin therapy was reintroduced, leading to complete resolution of the cutaneous lesions.
Discussion and Conclusion: Pancreatic adenocarcinomas are frequently associated with dermatomyositis, with an incidence at least three times higher than in the general population. The association with worsening diabetes should prompt clinicians to consider an underlying pancreatic malignancy.
Volume 110
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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