Merck Manual

Please confirm that you are not located inside the Russian Federation

honeypot link



Minhhuyen Nguyen

, MD, Fox Chase Cancer Center, Temple University

Reviewed/Revised Mar 2021 | Modified Sep 2022
Topic Resources

A glucagonoma is a tumor of the pancreas Pancreas The pancreas is an organ that contains two types of glandular tissue: Pancreatic acini Islets of Langerhans (See also Overview of the Digestive System.) The acini produce digestive enzymes.... read more Pancreas that produces the hormone glucagon, which raises the level of sugar (glucose) in the blood and causes a distinctive rash.

  • These tumors arise from cells in the pancreas that produce glucagon.

  • Symptoms are similar to those caused by diabetes, including weight loss and excessive urination.

  • Diagnosis includes blood and imaging tests.

  • Treatment is surgery and sometimes chemotherapy.

Glucagon is a hormone normally secreted by the pancreas when blood glucose levels fall. Glucagon simulates the liver to break down stored carbohydrates to increase blood glucose. Glucagonomas are a type of pancreatic endocrine tumor Overview of Pancreatic Endocrine Tumors The pancreas is an organ located in the upper part of the abdomen. It produces digestive juices that are secreted into the digestive tract. The pancreas also produces insulin, which helps control... read more . About 80% of glucagonomas are cancerous (malignant). However, they grow slowly, and many people survive for 15 years or more after the diagnosis. The average age at which symptoms begin is 50. About 80% of people with glucagonomas are women. A few people have multiple endocrine neoplasia Multiple Endocrine Neoplasia Syndromes (MEN) Multiple endocrine neoplasia syndromes are rare, inherited disorders in which several endocrine glands develop noncancerous (benign) or cancerous (malignant) tumors or grow excessively without... read more Multiple Endocrine Neoplasia Syndromes (MEN) .

The Pancreas

Symptoms of Glucagonoma

High levels of glucagon in the blood cause the same symptoms as diabetes Diabetes Mellitus (DM) Diabetes mellitus is a disorder in which the body does not produce enough or respond normally to insulin, causing blood sugar (glucose) levels to be abnormally high. Urination and thirst are... read more , such as weight loss and frequent, excessive urination. In addition, 90% of people have the very distinctive features of a chronic brownish red rash (called necrolytic migratory erythema) and a smooth, shiny, bright red-orange tongue. The mouth also may have cracks at the corners. The rash, which causes scaling, starts in the groin and moves to the buttocks, forearms, hands, feet, and legs.

Diagnosis of Glucagonoma

Treatment of Glucagonoma

  • Surgical removal

  • Sometimes chemotherapy

  • Octreotide

Ideally, the tumor is surgically removed, which eliminates all symptoms. However, if removal is not possible or if the tumor has spread, chemotherapy may reduce the levels of glucagon and lessen the symptoms. However, chemotherapy does not improve survival.

The drug octreotide can be used to reduce glucagon levels, may clear up the rash, and may restore appetite, facilitating weight gain. But octreotide may elevate the levels of glucose in the blood even more.

Zinc taken by mouth, applied in an ointment, or given by vein (intravenously) may be used to treat the rash. Sometimes the rash is treated with intravenous amino acids or fatty acids.

Drugs Mentioned In This Article

Generic Name Select Brand Names
baqsimi, GlucaGen, Glucagon, Gvoke, Gvoke HypoPen, Gvoke PFS
Bynfezia, Mycapssa, Sandostatin, Sandostatin LAR
quiz link

Test your knowledge

Take a Quiz!