十二指肠壁胃肠道间质瘤所致难治性低血糖症：一例报告
Refractory hypoglycemia induced by a duodenal wall gastrointestinal stromal tumor: A case report.
作者信息
Eghbali Foolad, Karami Reza
机构信息
Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, Iran.
Center of Excellence of International Federation for Surgery of Obesity, Hazrat-e-Rasool Hospital, Tehran, Iran.
出版信息
Caspian J Intern Med. 2021;12(Suppl 2):S447-S450. doi: 10.22088/cjim.12.0.447.
BACKGROUND
Tumor-associated hypoglycemia can be caused by non-islet cell tumors including gastrointestinal stromal tumor (GIST) which is a rare paraneoplastic syndrome that leads to the release of insulin-like growth factor-2 (IGF-2).
CASE PRESENTATION
We report the case of a 45-year old woman who was admitted to our hospital with refractory hypoglycemic episodes. We found normal serum insulin and c-peptide level and abdominal CT-scan showed a small duodenal wall lesion suggesting insulinoma. After tumor resection, hypoglycemia symptoms were recovered, but the pathological findings demonstrated the lesion was GIST.
CONCLUSION
In a small gastrointestinal lesion with hypoglycemic symptoms we should consider IGF-II secreting GIST in addition to insulinoma.
背景
肿瘤相关性低血糖可由非胰岛细胞瘤引起，包括胃肠道间质瘤（GIST），这是一种罕见的副肿瘤综合征，可导致胰岛素样生长因子-2（IGF-2）的释放。
病例报告
我们报告了一名45岁女性的病例，她因难治性低血糖发作入院。我们发现血清胰岛素和C肽水平正常，腹部CT扫描显示十二指肠壁有一个小病变，提示胰岛素瘤。肿瘤切除后，低血糖症状得以恢复，但病理结果显示该病变为胃肠道间质瘤。
结论
对于有低血糖症状的小胃肠道病变，除了胰岛素瘤外，我们还应考虑分泌IGF-II的胃肠道间质瘤。
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