Zografos George N, Stathopoulou Alexandra, Mitropapas George, Karoubalis John, Kontogeorgos George, Kaltsas Gregory, Piaditis George, Papastratis George I
Third Department of Surgery, Athens General Hospital, Athens, 115 27, Greece.
Hormones (Athens). 2005 Apr-Jun;4(2):111-6.
We report a case of an insulinoma that was not identified on either Computerized Tomography (CT) scan and Magnetic Resonance Imaging (MRI). Endoscopic ultrasonography (EUS) revealed a small insulinoma located at the body of the pancreas, which was histologically confirmed. The patient underwent a laparotomy but no tumour was identified either on palpation or with intra-operative ultrasound (IOUS). Subsequently, a further EUS was performed and after the tumour was identified was injected with blue dye. The patient then underwent a second exploratory laparotomy and a tumour at the posterior aspect of the pancreas close to the left side of the portal vein was identified and was successfully excised. Histology confirmed the presence of an endocrine tumour staining for chromogranin A and insulin. The patient had an uneventful postoperative recovery and has developed no further episodes of hypoglycemia 3 years after surgery.
我们报告一例胰岛素瘤，在计算机断层扫描（CT）和磁共振成像（MRI）上均未发现。内镜超声检查（EUS）发现胰腺体部有一个小的胰岛素瘤，经组织学证实。患者接受了剖腹手术，但触诊或术中超声（IOUS）均未发现肿瘤。随后，再次进行EUS，在发现肿瘤后注射了蓝色染料。患者接着接受了第二次探查性剖腹手术，发现胰腺后侧靠近门静脉左侧有一个肿瘤，并成功切除。组织学证实存在一种对嗜铬粒蛋白A和胰岛素染色的内分泌肿瘤。患者术后恢复顺利，术后3年未再发生低血糖发作。
