Most Common Site of Glucagonoma
Glucagonomas are most commonly located in the body and tail (distal pancreas) of the pancreas. 1
Anatomical Distribution
The distal pancreas (body and tail) represents the predominant location for glucagonomas, which distinguishes them from other pancreatic neoplasms:
- Glucagonomas are predominantly located in the body or tail of the pancreas, as documented in multiple case series and clinical reports 2
- This distal location contrasts sharply with ductal adenocarcinomas, where 80-90% occur in the pancreatic head 3
- The tail of the pancreas specifically is cited as the most common site in clinical case presentations 4
Surgical Implications Based on Location
The anatomical distribution directly determines the surgical approach:
- For glucagonomas in the tail (most common site): distal pancreatectomy with splenectomy and resection of peripancreatic lymph nodes is recommended 1, 5
- For the less common head location: pancreatoduodenectomy (Whipple procedure) with peripancreatic lymph node resection is required 3, 1
- Small peripheral glucagonomas (<2 cm) may be candidates for enucleation or local excision with lymph node dissection, though this is uncommon given most glucagonomas are malignant 1
Critical Clinical Context
Splenectomy is mandatory for glucagonomas (unlike insulinomas where spleen preservation may be attempted), because these tumors are typically malignant with regional lymph node involvement requiring adequate oncologic resection 5
Perioperative anticoagulation should be considered due to the hypercoagulable state associated with glucagonoma syndrome, which increases the risk of venous thrombosis and pulmonary emboli 1, 5
Answer: D. Body and tail; distal pancreas