Dinc Bulent, Sahin Cankat
Akdeniz University, Faculty of Medicine, Department of Surgery, Antalya, Turkey.
Akdeniz University, Faculty of Medicine, Department of Radiology, Antalya, Turkey.
Eurasian J Med. 2009 Apr;41(1):70-2.
We report a case of a very rare endocrine tumor of the pancreas. The patient is a 53-year-old female who has necrotizing and crusty maculopapular lesions on the upper and lower extremities and was diagnosed with bullous pemphigoid. The patient's symptoms included fatique and weight loss, and examination revealed pale sclera, angular chelitis and glossitis. Because the CA 19-9 and glucagon levels were high, and abdominal dynamic CT showed a mass in the pancreas body and metastatic lesions in the liver, the decision was made to operate. A distal pancreatectomy, splenectomy, cholecystectomy and right trisegmentectomy were performed. The histopathology of the tumor was reported as a neuroendocrine tumor, which was concordant with glucagonoma. The patient died on postoperative day 12 due to liver failure. According to the literature, when safe conditions were obtained, aggressive surgery followed by chemoterapy can increase the survival rate of these patients.
我们报告一例极为罕见的胰腺内分泌肿瘤病例。患者为一名53岁女性,其上下肢出现坏死性及结痂性斑丘疹病变,被诊断为大疱性类天疱疮。患者的症状包括疲劳和体重减轻,检查发现巩膜苍白、口角炎和舌炎。由于CA 19-9和胰高血糖素水平升高,腹部动态CT显示胰体有肿块且肝脏有转移病灶,遂决定进行手术。实施了胰体尾切除术、脾切除术、胆囊切除术和右三叶肝切除术。肿瘤的组织病理学报告为神经内分泌肿瘤,与胰高血糖素瘤相符。患者术后第12天因肝衰竭死亡。根据文献,在具备安全条件时,积极手术并辅以化疗可提高这些患者的生存率。