Division of Diabetes, Endocrinology and Rheumatology, Japanese Red Cross Kyoto Daini Hospital, Kyoto 602-8026, Japan.
Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto 602-8566, Japan.
Endocr J. 2024 Aug 8;71(8):809-815. doi: 10.1507/endocrj.EJ24-0142. Epub 2024 May 31.
When a neuroendocrine tumor with abundant blood flow is located in the pancreatic tail, it is difficult to distinguish it from accessory spleen. The patient was a 71-year-old woman who was admitted with impaired consciousness and hypoglycemia, raising suspicion of insulinoma. The selective arterial calcium injection test suggested a lesion in the pancreatic tail. Contrast-enhanced computed tomography and magnetic resonance imaging (MRI) showed a mass in the splenic hilum; however, its continuity with the pancreas was unclear. Contrast-enhanced MRI using super paramagnetic iron oxide (SPIO) showed no SPIO uptake in the splenic hilar mass. SPIO contrast-enhanced MRI is considered useful for differentiating pancreatic endocrine tumors from paraspleen tumors.
当血流丰富的神经内分泌肿瘤位于胰尾时，很难将其与副脾区分开来。该患者为 71 岁女性，因意识障碍和低血糖入院，疑诊为胰岛素瘤。选择性动脉钙注射试验提示胰尾有病变。增强 CT 和磁共振成像（MRI）显示脾门有肿块，但与胰腺的连续性不明确。超顺磁氧化铁（SPIO）增强 MRI 显示脾门肿块内无 SPIO 摄取。SPIO 增强 MRI 被认为有助于区分胰腺内分泌肿瘤和副脾肿瘤。
