Tskitishvili Aleksandre, Lobjanidze Mariam, Turmanishvili Zurabi, Mamulashvili Nikoloz, Bejanishvili Tamar
Aieti Medical School, David Tvildiani Medical University, Tbilisi, GEO.
Internal Medicine, Brookdale Hospital and Medical Center, Brooklyn, USA.
Cureus. 2024 Apr 1;16(4):e57376. doi: 10.7759/cureus.57376. eCollection 2024 Apr.
Neuroendocrine tumors (NETs) are rare. When present, they often produce serotonin and are called carcinoids. Serotonin-secreting NETs can present with or without carcinoid syndrome. Although the idea of serotonin-secreting NETs potentially altering glucose metabolism is not new, data around this issue has been scarce, with only a few limited studies and case reports. We present a case where a female patient's prediabetic hemoglobin A1C levels normalized after removing serotonin-secreting NET. Before removal, the patient had locally metastatic carcinoid and serotonin-related intractable diarrhea but did not exhibit any other sign of carcinoid syndrome, including flushing, which is considered a hallmark. Therefore, in suggestive clinical contexts, this case points to the possibility of impaired glucose tolerance being an early clinical sign of carcinoid that could aid in serotonin-secreting NET diagnosis before it manifests as overt carcinoid syndrome.
神经内分泌肿瘤（NETs）较为罕见。一旦出现，它们通常会产生血清素，被称为类癌。分泌血清素的NETs可能伴有或不伴有类癌综合征。尽管分泌血清素的NETs可能改变葡萄糖代谢这一观点并不新鲜，但围绕该问题的数据却很稀少，仅有少数有限的研究和病例报告。我们报告一例病例，一名女性患者在切除分泌血清素的NET后，糖尿病前期的糖化血红蛋白水平恢复正常。在切除之前，该患者患有局部转移性类癌和与血清素相关的顽固性腹泻，但未表现出类癌综合征的任何其他体征，包括被视为典型特征的潮红。因此，在具有提示性的临床背景下，该病例表明糖耐量受损可能是类癌的早期临床体征，这有助于在分泌血清素的NETs表现为明显的类癌综合征之前进行诊断。
