Saglietti G, Ferrari V, Luraschi A, Fedeli P, Gioria A, Della Vedova A, Bersi M
Divisione di Medicina, USSL 57, Ospedale, Omegna, Novara.
Recenti Prog Med. 1995 Feb;86(2):68-70.
The authors report a case of a woman affected by pancreatic insulinoma who had been suffering from recurrent and misdiagnosed hypoglycemic attacks since 3 years. The total loss of warning neurogenic symptoms replaced by sudden onset of neuroglycopenic symptoms had delayed the proper and early diagnosis because of repeated and useless cardiovascular and neurological investigations. Moreover, it is stressed how difficult is to reveal such neoplasia that, despite the severe symptoms, are usually small in size and often undetectable even with TC scan. Therefore, when clinical pattern is strongly suggestive for insulinoma the use of invasive angiography or other techniques is mandatory and often conclusive. Actually clinical data have the priority in whole diagnostic pathway.
作者报告了一例患有胰腺胰岛素瘤的女性病例，该患者自3年前起就一直遭受反复且被误诊的低血糖发作。由于反复进行无用的心血管和神经学检查，警告性神经源性症状完全消失，取而代之的是突然出现的神经低血糖症状，这延误了正确和早期的诊断。此外，文中强调了发现这种肿瘤有多困难，尽管症状严重，但这种肿瘤通常体积较小，即使通过CT扫描也常常难以检测到。因此，当临床症状强烈提示胰岛素瘤时，必须使用侵入性血管造影或其他技术，而且这些技术往往具有决定性作用。实际上，临床数据在整个诊断过程中具有优先地位。
