Dai W, Shi Y, Cai L
Peking Union Medical College Hospital, Beijing.
Zhonghua Nei Ke Za Zhi. 1995 Mar;34(3):190-2.
Glucagonoma is a rare pancreatic tumor, necrolytic migratory erythema is its distinctive feature and it is often associated with diabetes mellitus, weight loss, anemia, hypoaminoacidemia, glossitis and stomatitis. We reported a case of glucagonoma misdiagnosed as "eczema" and "benign hepatic anginoma" for 3 years. His blood glucagon level was 1,758 ng/L. The results of abdominal B-mode ultrasonography and CT scan were negative, but selected arteriogram showed a tumor mass between the pancreatic body and tail. Before operation, treatment with octreotide and supply of amino acids were given with improvement of the skin lesion. After resection of the tumor from pancreas, necrolytic migratory erythema disapeared, but his blood level of glucagon and amino acids did not improve. It is suggested that any diabetic patient with chronic skin damage should be checked for blood glucagon level. In suspected cases, selected arteriogram will be helpful for location of the tumor. Vigorous resection of the pancreatic tumor should be done as soon as possible, even though there is already metastases.
胰高血糖素瘤是一种罕见的胰腺肿瘤，坏死性游走性红斑是其显著特征，且常伴有糖尿病、体重减轻、贫血、低氨基酸血症、舌炎和口腔炎。我们报告了一例胰高血糖素瘤被误诊为“湿疹”和“肝脏良性血管瘤”达3年之久的病例。其血液中胰高血糖素水平为1758 ng/L。腹部B超和CT扫描结果均为阴性，但选择性动脉造影显示胰体和胰尾之间有一肿瘤块。术前给予奥曲肽治疗并补充氨基酸，皮肤病变有所改善。胰腺肿瘤切除后，坏死性游走性红斑消失，但血液中胰高血糖素和氨基酸水平并未改善。建议任何有慢性皮肤损害的糖尿病患者都应检查血液中胰高血糖素水平。对于疑似病例，选择性动脉造影有助于肿瘤定位。即使已有转移，也应尽快积极切除胰腺肿瘤。
