Erdogan Askin, Kose Fatih, Akkaya Hampar, Bascil Tutuncu Neslihan, Ozyilkan Ozgur
Departments of Gastroenterology, Baskent University, Ankara, Turkey.
J Gastrointest Cancer. 2010 Dec;41(4):272-4. doi: 10.1007/s12029-010-9157-9.
A 51-year-old female was admitted to emergency unit with sudden loss of consciousness. Her blood glucose level from fingertip was 33 mg/dl, and insulin level was 55 (normal range, 4-17 IU). Abdominal ultrasonography revealed pancreatic mass with diffuse liver metastases. Biopsy of liver metastases showed differentiated neuroendocrine carcinoma.
Diazoxide and chemotherapy stabilized her glucose level for more than 4 months. However, the disease showed progression, and death occurred 8 months later.
In conclusion, this case may suggest that biologic behavior may differ from histological behavior in insulinoma and platin-based systemic chemotherapy may provide some benefit in patients those who had diazoxide- and octreotide-resistant tumors.
一名51岁女性因突然意识丧失被收入急诊科。指尖血糖水平为33mg/dl，胰岛素水平为55（正常范围4-17IU）。腹部超声显示胰腺肿物伴肝脏弥漫性转移。肝脏转移灶活检显示为分化型神经内分泌癌。
二氮嗪和化疗使她的血糖水平稳定了4个多月。然而，疾病仍进展，8个月后死亡。
总之，该病例可能提示胰岛素瘤的生物学行为可能与组织学行为不同，基于铂类的全身化疗可能对二氮嗪和奥曲肽耐药的肿瘤患者有益。
