Cuvelier C, Pochet J M, Col V, Jonard P, Pauwels S, Cuvelier A
Département de Médecine Interne, Clinique Ste Elisabeth, Namur.
Acta Clin Belg. 1994;49(6):296-301. doi: 10.1080/17843286.1994.11718406.
Although the functional diagnosis of insulinoma is quite easy, its topographic diagnosis still constitutes a major challenge since conventional radiological techniques, e.g. ultrasonography, computed tomography and even selective angiography, fail to recognize the tumor in numbers of insulinomas. We report an observation of a benign insulinoma in an 81-year-old woman that escaped detection by ultrasonography and CT but was later localized by both endoscopic ultrasonography and somatostatin receptor scintigraphy. It illustrates the usefulness of such recent imaging techniques for the localization of islet cell tumors that escaped detection by ultrasonography and CT. Moreover, in our elderly patient who refused surgical intervention, hypoglycemia was corrected by octreotide administration emphasizing the predictive value of 111In-pentetreotide scintigraphy on the subsequent response to octreotide therapy in patients in whom the optimal treatment (surgical resection) is not possible.
尽管胰岛素瘤的功能诊断相当容易，但其定位诊断仍然是一项重大挑战，因为传统的放射学技术，如超声检查、计算机断层扫描甚至选择性血管造影，在许多胰岛素瘤病例中都无法识别肿瘤。我们报告了一例81岁女性的良性胰岛素瘤，该肿瘤在超声检查和CT检查中均未被发现，但后来通过内镜超声检查和生长抑素受体闪烁显像得以定位。这说明了这些最新成像技术对于定位那些超声检查和CT检查未能发现的胰岛细胞瘤的有用性。此外，在我们这位拒绝手术干预的老年患者中，通过使用奥曲肽纠正了低血糖，这强调了铟-111喷替肽闪烁显像对于那些无法进行最佳治疗（手术切除）的患者对奥曲肽治疗后续反应的预测价值。
