Eledrisi Mohsen S, Stuart Charles A, Alshanti Mohammad
Department of Internal Medicine, Division of Endocrinology and Metabolism, University of Texas Medical Branch, Galveston, Texas 77555, USA.
Endocr Pract. 2002 Mar-Apr;8(2):109-12. doi: 10.4158/EP.8.2.109.
To describe a patient with tuberous sclerosis who, on initial assessment, had neurologic symptoms, which were ultimately found to be caused by an insulinoma.
We present a case report with clinical, laboratory, and radiologic data. The literature is reviewed relative to tuberous sclerosis and islet cell tumors, and a possible association is discussed.
A 43-year-old man with a history of tuberous sclerosis required medical attention because of mental confusion and slurred speech and was found to have hypoglycemia. Neuroradiologic imaging showed no new lesions to account for his symptoms. His physical examination was striking for a large abdominal mass, which showed increased uptake on octreotide scanning. After surgical resection, the mass measured 21 cm and was found to be an insulinoma. Blood glucose values were normal postoperatively and on follow-up, and the patient had no recurrence of the symptoms.
From this report, we emphasize two findings. First, we draw clinicians' attention to the possibility of an association between islet cell tumors and tuberous sclerosis and suggest consideration of this diagnosis in patients with tuberous sclerosis who have new or worsening neurologic symptoms. Second, the insulinoma we describe is, to our knowledge, the largest to be reported thus far in the literature.
描述一名结节性硬化症患者，其在初次评估时出现神经系统症状，最终发现是由胰岛素瘤引起的。
我们呈现一份包含临床、实验室和放射学数据的病例报告。回顾了与结节性硬化症和胰岛细胞瘤相关的文献，并讨论了可能的关联。
一名有结节性硬化症病史的43岁男性因精神错乱和言语不清而就医，发现有低血糖症。神经放射学成像未显示可解释其症状的新病变。他的体格检查因腹部有一个大肿块而引人注目，该肿块在奥曲肽扫描中摄取增加。手术切除后，肿块大小为21厘米，发现是胰岛素瘤。术后及随访期间血糖值正常，患者症状未复发。
从本报告中，我们强调两个发现。第一，我们提请临床医生注意胰岛细胞瘤与结节性硬化症之间存在关联的可能性，并建议对有新的或恶化的神经系统症状的结节性硬化症患者考虑这一诊断。第二，据我们所知，我们描述的胰岛素瘤是迄今为止文献中报道的最大的一例。
