Owecki Maciej, Czepczyriński Rafał, Biczysko Maciej, Stawny Bolesław, Drews Michał, Sowiński Jerzy
Akademia Medyczna w Poznaniu, Katedra i Klinika Endokrynologii, Przemiany Materii i Chorób Wewnetrznych.
Pol Merkur Lekarski. 2006 Jan;20(115):77-80.
We present a case of a 74-years-old female with insulinoma of the pancreas. Neuroglycopenic symptoms (Whipple's triad) and a positive fast test established the diagnosis. The fast was terminated after 5 hours and 40 minutes because of neuroglycopenic symptoms with the serum glucose and insulin levels of 40 mg/dl and 34,01 microU/ml respectively. The tumor was invisible in ultrasound, abdominal CT scan and MRL The only means that enabled preoperative visualization was 111-Indium labeled octreotide scintigraphy (OctreoScan). Laparotomy was performed, and a tumor was disclosed in intraoperative ultrasonography within the head of the pancreas. The tumor of 37 mm diameter was excised. Histopatological examination revealed benign insulinoma. After surgery the symptoms alleviated completely. The patient with proper glucose levels and insulin concentration of 3,04 microU/ml was discharged in good health. This case confirms high usefulness of preoperative OctreoScan and intraoperative ultrasonography in the approach to a patient with insulinoma.
我们报告一例74岁女性胰腺胰岛素瘤病例。神经低血糖症状（Whipple三联征）及快速血糖试验阳性确诊该病。因出现神经低血糖症状，在禁食5小时40分钟后终止禁食，此时血清葡萄糖和胰岛素水平分别为40mg/dl和34.01μU/ml。超声、腹部CT扫描及磁共振成像均未发现肿瘤。术前唯一能够实现可视化的检查手段是111铟标记奥曲肽闪烁扫描（OctreoScan）。行剖腹探查术，术中超声检查发现胰腺头部有一肿瘤。切除直径为37mm的肿瘤。组织病理学检查显示为良性胰岛素瘤。术后症状完全缓解。患者血糖水平正常，胰岛素浓度为3.04μU/ml，康复出院。该病例证实术前OctreoScan及术中超声检查对胰岛素瘤患者的诊治具有很高的应用价值。
