Faculty of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada.
Faculty of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
BMJ Case Rep. 2020 Nov 9;13(11):e236659. doi: 10.1136/bcr-2020-236659.
A 27-year-old otherwise healthy man of African descent presented to the hospital with initial symptoms of carcinoid syndrome that later evolved into symptoms of hyperinsulinemic hypoglycaemia. Investigations revealed a metastatic neuroendocrine tumour (NET), co-secreting both serotonin and insulin. Management involved a multimodal approach in an attempt to reduce tumour burden and achieve euglycaemia, which proved to be a significant challenge in the face of refractory hypoglycaemia despite the administration of multiple prohyperglycaemic agents in combination. Unfortunately, given the burden of metastatic disease and multiple medical complications that ensued, the patient passed away. This case highlights the clinical history of a NET co-secreting serotonin and insulin, the use of combination therapy in the treatment of refractory hypoglycaemia in a metastatic insulin-producing tumour and emerging therapeutic modalities in the treatment of these rare malignancies.
一位 27 岁的非洲裔健康男性，最初表现为类癌综合征症状，随后发展为高胰岛素血症性低血糖症状。检查发现转移性神经内分泌肿瘤（NET），同时分泌 5-羟色胺和胰岛素。治疗采用多模式方法，试图减轻肿瘤负担并实现血糖正常，但由于低血糖难以控制，尽管联合使用了多种升糖药物，这仍然是一个巨大的挑战。不幸的是，由于转移性疾病的负担和随之而来的多种并发症，患者去世了。本病例强调了 NET 同时分泌 5-羟色胺和胰岛素的临床病史，以及联合治疗在治疗转移性胰岛素分泌肿瘤难治性低血糖中的应用，以及这些罕见恶性肿瘤治疗中的新治疗方法。
