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胰岛素瘤的术前检测:两例病例报告。

Preoperative detection of insulinomas: two case reports.

作者信息

Ozkaya Mesut, Yuzbasioglu Mehmet Fatih, Koruk Irfan, Cakal Erman, Sahin Mustafa, Cakal Basak

机构信息

Department of General Surgery, Sutcu Ymam University Medical Faculty, Kahramanmaras, Turkey.

出版信息

Cases J. 2008 Nov 29;1(1):362. doi: 10.1186/1757-1626-1-362.

DOI:10.1186/1757-1626-1-362
PMID:19040758
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC2633341/
Abstract

BACKGROUND

Insulinoma is the most common endocrine tumor of the pancreas. Accurate preoperative detection and localization of insulinomas is essential for the appropriate selection of candidates for surgery. We present two cases with benign pancreatic insulinoma.

CASE PRESENTATION

Preoperative evaluation for patients with suspected insulinomas has been controversial. Endoscopic ultrasonography (EUS) has a sensitivity of 95% in well skilled operators and well tolerated preoperative imaging method.

CONCLUSION

We have detected the insulinomas with EUS before surgery in our patients but other imaging modalities did not help us for localization of them. Patients have been asymptomatic postoperatively with no hypoglycemia on repeat fasting. We reviewed here the different modalities for preoperative localization of insulinoma.

摘要

背景

胰岛素瘤是胰腺最常见的内分泌肿瘤。准确的术前检测和定位胰岛素瘤对于合适的手术候选者选择至关重要。我们展示两例良性胰腺胰岛素瘤病例。

病例报告

疑似胰岛素瘤患者的术前评估一直存在争议。内镜超声检查(EUS)在技术熟练的操作者中灵敏度为95%,是耐受性良好的术前成像方法。

结论

我们在患者手术前通过EUS检测到了胰岛素瘤,但其他成像方式对其定位并无帮助。患者术后无症状,再次禁食时无低血糖情况。我们在此回顾胰岛素瘤术前定位的不同方式。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e946/2633341/4b522fa6e078/1757-1626-1-362-2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e946/2633341/53abc3d5c422/1757-1626-1-362-1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e946/2633341/4b522fa6e078/1757-1626-1-362-2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e946/2633341/53abc3d5c422/1757-1626-1-362-1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e946/2633341/4b522fa6e078/1757-1626-1-362-2.jpg

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引用本文的文献

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J Clin Diagn Res. 2014 Sep;8(9):FD05-6. doi: 10.7860/JCDR/2014/8694.4782. Epub 2014 Sep 20.
2
Co-existence of insulinoma and diabetes: A case report.胰岛素瘤与糖尿病并存:一例报告。
Oncol Lett. 2014 Oct;8(4):1697-1700. doi: 10.3892/ol.2014.2338. Epub 2014 Jul 10.
3
Metastatic insulinoma in a patient with type 2 diabetes mellitus: case report and review of the literature.2 型糖尿病患者转移性胰岛素瘤:病例报告及文献复习。

本文引用的文献

1
Pancreatic insulinomas: diagnosis and surgical treatment of 74 patients.胰腺胰岛素瘤:74例患者的诊断与外科治疗
Hepatobiliary Pancreat Dis Int. 2002 Aug;1(3):458-61.
2
CT, endoscopic sonography, and a combined protocol for preoperative evaluation of pancreatic insulinomas.CT、内镜超声检查以及用于胰腺胰岛素瘤术前评估的联合方案。
AJR Am J Roentgenol. 2003 Oct;181(4):987-92. doi: 10.2214/ajr.181.4.1810987.
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Preoperative detection of pancreatic insulinomas on multiphasic helical CT.多期螺旋CT对胰腺胰岛素瘤的术前检测
Int J Endocrinol. 2011;2011:124078. doi: 10.1155/2011/124078. Epub 2011 Feb 10.
AJR Am J Roentgenol. 2003 Sep;181(3):775-80. doi: 10.2214/ajr.181.3.1810775.
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What preoperative assessment is necessary for insulinomas? Calculating the degree of waste: analysis of 29 cases.胰岛素瘤的术前评估需要什么?计算浪费程度:29例分析。
Chir Ital. 2002 Sep-Oct;54(5):597-604.
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Islet cell tumors of the pancreas: the medical oncologist's perspective.胰腺胰岛细胞瘤:肿瘤内科医生的观点
Surg Clin North Am. 2001 Jun;81(3):527-42. doi: 10.1016/s0039-6109(05)70141-9.
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Natural history of a proinsulin-secreting insulinoma: from symptomatic hypoglycemia to clinical diabetes.
J Clin Endocrinol Metab. 2000 Oct;85(10):3628-30. doi: 10.1210/jcem.85.10.6892.
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Role of EUS in the preoperative localization of insulinomas compared with spiral CT.与螺旋CT相比,超声内镜在胰岛素瘤术前定位中的作用
Gastrointest Endosc. 2000 May;51(5):552-5. doi: 10.1016/s0016-5107(00)70288-4.
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Hypoglycemia in adults.
Diabetes Metab. 1999 Dec;25(6):477-90.
9
Preoperative localization of insulinomas is not necessary.胰岛素瘤的术前定位并非必要。
J Am Coll Surg. 1999 Oct;189(4):368-73. doi: 10.1016/s1072-7515(99)00163-5.
10
Noninvasive imaging of insulinomas and gastrinomas with endoscopic ultrasonography and somatostatin receptor scintigraphy.胰岛素瘤和胃泌素瘤的内镜超声检查及生长抑素受体闪烁显像无创成像
Surgery. 1998 Dec;124(6):1134-43; discussion 1143-4. doi: 10.1067/msy.1998.93109.