Budmiger H, Bühler H, Häcki W, Stamm B, Streuli R, Ammann R
Gastroenterology. 1987 Mar;92(3):800-4. doi: 10.1016/0016-5085(87)90036-9.
We describe a patient with a small somatostatinoma of the papilla of Vater without clinical evidence for diabetes mellitus, diarrhea, steatorrhea, or cholelithiasis, showing normal plasma basal levels for somatostatinlike immunoreactivity. The diagnosis was based on histologic and immunohistochemical analysis of tumor tissue and hypersomatostatinemia induced by the calcium-pentagastrin test. Before removal of the tumor both diagnostic tests recommended for the detection of a somatostatinoma, a tolbutamide test and a calcium-pentagastrin test, were performed. Whereas the calcium-pentagastrin test provoked a markedly elevated plasma somatostatin level in association with a depressed plasma neurotensin level, the tolbutamide test surprisingly did not. After removal of the tumor the calcium-pentagastrin test no longer induced hypersomatostatinemia. Further studies are needed to determine whether the calcium-pentagastrin test is a more reliable diagnostic test than the tolbutamide test in somatostatinomas with normal plasma basal levels.
我们描述了一名患有 Vater 乳头小生长抑素瘤的患者，该患者无糖尿病、腹泻、脂肪泻或胆石症的临床证据，血浆生长抑素样免疫反应性的基础水平正常。诊断基于肿瘤组织的组织学和免疫组织化学分析以及由五肽胃泌素钙试验诱导的高生长抑素血症。在切除肿瘤之前，进行了两种推荐用于检测生长抑素瘤的诊断试验，即甲苯磺丁脲试验和五肽胃泌素钙试验。五肽胃泌素钙试验可使血浆生长抑素水平显著升高，同时血浆神经降压素水平降低，而甲苯磺丁脲试验出人意料地未出现这种情况。切除肿瘤后，五肽胃泌素钙试验不再诱导高生长抑素血症。需要进一步研究以确定在血浆基础水平正常的生长抑素瘤中，五肽胃泌素钙试验是否比甲苯磺丁脲试验更可靠。
