Liaw C C, Lin J T, Chen T J
Taiwan Yi Xue Hui Za Zhi. 1989 Jul;88(7):722-5.
Although part of pancreatic endocrine tumors may be multihormonal by immunohistochemical study, the clinical manifestations are often related to hypersecretion of only one type of peptide hormone. Only a few cases have shown two or more syndromes simultaneously or transition of one type of syndrome to another with the passage of time. The case reported here is an islet cell carcinoma with liver metastases. The clinical manifestations changed from Zollinger-Ellison syndrome to hypoglycemic syndrome with the secretion of gastrin, insulin and serotonin. The immunohistochemical study confirmed multihormonal production. The elevation of growth hormone with acromegaly was also noted in this case. It remains to be seen if the excessive production of growth hormone was due to growth hormone-releasing hormone secreted by the endocrine pancreatic tumor or to the possible presence of a pituitary microadenoma as a component of the multiple endocrine neoplasia type I syndrome.
尽管通过免疫组化研究部分胰腺内分泌肿瘤可能是多激素性的，但临床表现通常仅与一种肽类激素的分泌过多有关。仅有少数病例同时表现出两种或更多综合征，或随着时间推移从一种综合征转变为另一种综合征。本文报道的病例是一例伴有肝转移的胰岛细胞癌。临床表现从卓-艾综合征转变为低血糖综合征，同时分泌胃泌素、胰岛素和5-羟色胺。免疫组化研究证实了多激素分泌。该病例还发现生长激素升高伴肢端肥大症。生长激素的过量分泌是由于胰腺内分泌肿瘤分泌生长激素释放激素，还是作为I型多发性内分泌肿瘤综合征一部分的垂体微腺瘤的可能存在，仍有待观察。
