Migratory stomatitis (ectopic geographic tongue) on the floor of the mouth.

similar to a collection of flowers (Fig.2). They were marked by intense glucagon immunostaining. The findingswere consistentwith the recently recognized entity GCA. Mutation analysis of the tissue samples for MEN1, VHL, and p27 genes was unsuccessful because of the poor preservation of DNA within the pancreatic tissue. GCA and GCA-like entities have rarely been reported. In GCA there is no solitary pancreatic tumor but rather diffuse enlargement of the islets of Langerhans, resulting in glucagon hypersecretion. The lack of a detectable solid pancreatic tumor in an NME patient with a grossly elevated glucagon level suggests the possibility of GCA. Hypersecretion of the catabolic glucagon and secondary complications such as bacterial sepsis might lead to a fatal outcome in GCA patients, highlighting the paradox of an essentially benign endocrine neoplasm with a devastating outcome.