Malabu Usman H, Gowda Durgesh, Tan Yong Mong
Department of Endocrinology and Diabetes, James Cook University & Townsville Hospital, 100 Angus Smith Drive, Douglas, QLD 4814, Australia.
Case Rep Endocrinol. 2013;2013:926385. doi: 10.1155/2013/926385. Epub 2013 Dec 22.
The aim was to report an unusual case of insulinoma presenting with long-standing depression and primary testicular failure. We describe a 34-year-old male with clinical, laboratory, and radiologic data consistent with islet cell tumor and seminiferous tubule failure primary hypogonadism. The literature is reviewed relative to the component of this syndrome, and a possible association is discussed. The subject was investigated for a long-standing history of depression requiring medical attention because of mental confusion and slurred speech and was found to have an insulinoma. He was diagnosed with primary gonadal failure and physical examination showed no evidence of dysmorphic features. Chromosomal analysis revealed normal 46 XY and testicular biopsy showed Sertoli cell only syndrome (SCOS). Biochemistry revealed endogenous hyperinsulinism and histology confirmed an islet cell tumor. He remained euglycemic postoperatively and on followup. From this report, we emphasize drawing clinicians' attention to the possibility of an association between insulinoma and primary testicular failure and suggest consideration of this diagnosis in patients with hypergonadotropic hypogonadism who may present with infertility.
目的是报告一例罕见的胰岛素瘤病例，该病例伴有长期抑郁和原发性睾丸功能衰竭。我们描述了一名34岁男性，其临床、实验室和放射学数据与胰岛细胞瘤和生精小管衰竭原发性性腺功能减退相符。回顾了关于该综合征组成部分的文献，并讨论了可能的关联。该患者因长期抑郁病史接受调查，因其精神错乱和言语含糊需就医，结果发现患有胰岛素瘤。他被诊断为原发性性腺功能衰竭，体格检查未发现畸形特征。染色体分析显示46 XY正常，睾丸活检显示仅有支持细胞综合征（SCOS）。生化检查显示内源性高胰岛素血症，组织学证实为胰岛细胞瘤。术后及随访期间他血糖保持正常。通过本报告，我们强调提醒临床医生注意胰岛素瘤与原发性睾丸功能衰竭之间关联的可能性，并建议对可能出现不孕的高促性腺激素性性腺功能减退患者考虑这一诊断。
