Fenkci S M, Fidan Yaylali G, Sermez Y, Akdam H, Sabir N, Kiraç S
Pamukkale University, School of Medicine, Departments of Endocrinology and Metabolism, Pamukkale University Hospital, Kinikli, Denizli, Turkey.
Endocr Relat Cancer. 2005 Jun;12(2):449-54. doi: 10.1677/erc.1.00957.
A 44-year-old woman was diagnosed with type II diabetes in 1998 and 1 year later she developed necrolytic migratory erythema, which is a specific skin lesion of glucagonoma. During the clinical investigation, a nodular 6 cm mass in the distal pancreatic region and multiple cystic liver metastases were found. She was operated on, and glucagonoma was detected and the long-acting, repeatable, octreotide treatment was started. 3 years after resection of a pancreatic glucagonoma she presented to a hospital emergency department with diabetic ketoacidosis. Hepatic multiple cystic metastases were visualized by computed tomography. During hospitalization she developed severe pulmonary embolism and deep-venous thrombosis of the lower extremities. Indium-labeled octeotide scintigraphy showed multiple cystic lesions in the liver with additional lesions in the iliocecal region, which had not been visualized by computed tomography. Despite somatostatin therapy the tumor had expanded in the liver. Arterial chemoembolization was performed but 6 months later she died.
一名44岁女性于1998年被诊断为II型糖尿病，1年后出现坏死性游走性红斑，这是一种胰高血糖素瘤的特异性皮肤病变。在临床检查期间，发现胰腺远端区域有一个6厘米的结节状肿块以及多处肝囊性转移灶。她接受了手术，检测出患有胰高血糖素瘤，并开始使用长效、可重复的奥曲肽进行治疗。胰腺胰高血糖素瘤切除术后3年，她因糖尿病酮症酸中毒入住医院急诊科。通过计算机断层扫描可见肝脏多处囊性转移灶。住院期间，她发生了严重的肺栓塞和下肢深静脉血栓形成。铟标记的奥曲肽闪烁扫描显示肝脏有多处囊性病变，回盲部还有其他病变，这些病变计算机断层扫描未能显示。尽管进行了生长抑素治疗，肿瘤仍在肝脏中增大。进行了动脉化疗栓塞，但6个月后她去世了。
