King N K K, Siriwardana H P P, Coyne J D, Siriwardena A K
Dept. of Histopathology, University Hospital of South Manchester, Withington, Manchester, UK.
Scand J Gastroenterol. 2003 Jun;38(6):678-80. doi: 10.1080/00365520310001950.
Insulinoma is a rare tumour, the main symptoms of which are related to hypoglycaemia. Generalized pruritus has been described in association with the multiple endocrine neoplasia syndrome (MEN II or Sipple's syndrome) as a paraneoplastic phenomenon. Further, pruritus is known to be part of the paraneoplastic syndrome in other solid tumours. This case describes a patient presenting with symptoms of Whipple's triad (hypoglycaemic symptoms during fasting, low fasting blood sugar levels and symptoms relieved by intravenous dextrose). Magnetic resonance scanning and selective mesenteric angiography demonstrated a probable pancreatic neuroendocrine tumour. Pituitary fossa imaging and endocrine profile excluded the MEN I syndrome. Symptoms resolved after surgical removal of the tumour. Histology confirmed a pancreatic neuroendocrine tumour. The association between pruritus and insulinoma appears to be a novel paraneoplastic phenomenon.
胰岛素瘤是一种罕见肿瘤，其主要症状与低血糖有关。全身性瘙痒已被描述为与多发性内分泌肿瘤综合征（MEN II 或西普尔综合征）相关的副肿瘤现象。此外，瘙痒已知是其他实体瘤副肿瘤综合征的一部分。本病例描述了一名出现惠普尔三联征症状（禁食期间低血糖症状、空腹血糖水平低以及静脉注射葡萄糖后症状缓解）的患者。磁共振扫描和选择性肠系膜血管造影显示可能为胰腺神经内分泌肿瘤。垂体窝成像和内分泌检查排除了MEN I综合征。肿瘤手术切除后症状消失。组织学证实为胰腺神经内分泌肿瘤。瘙痒与胰岛素瘤之间的关联似乎是一种新的副肿瘤现象。
