Sugimoto F, Sekiya T, Saito M, Iiai T, Suda K, Nozawa A, Nakazawa T, Ishizaki T, Ikarashi T
Department of Surgery, Koseiren-Kariwagun General Hospital, Kashiwazaki, Japan.
Surg Today. 1998;28(12):1279-82. doi: 10.1007/BF02482815.
A 59-year-old woman was hospitalized due to a 1-year history of diarrhea and weight loss. Echography and computed tomography of the abdomen revealed a 10 x 7 cm solid mass in the tail of the pancreas and gallstones, while selective celiac angiography revealed the presence of a hypervascular mass. High levels of somatostatin and calcitonin were detected in the plasma, 70 pg/ml (normal range <28 pg/ml) and 5550 pg/ml (normal range 37 +/- 8 pg/ml), respectively. This tumor was thus removed by means of a distal pancreatectomy and a splenectomy. After the pancreatic tumor was removed, the elevated levels of plasma somatostatin and calcitonin returned to the normal ranges, and the persistent diarrhea also dramatically disappeared. A postoperative immunohistochemical study showed the tumor cells to be diffusely positive for somatostatin and calcitonin. These results clearly indicate this patient to be a case of calcitonin-producing pancreatic somatostatinoma.
一名59岁女性因腹泻和体重减轻1年病史入院。腹部超声和计算机断层扫描显示胰腺尾部有一个10×7厘米的实性肿块及胆结石，而选择性腹腔动脉造影显示有一个高血管性肿块。血浆中检测到高水平的生长抑素和降钙素，分别为70 pg/ml（正常范围<28 pg/ml）和5550 pg/ml（正常范围37±8 pg/ml）。因此通过远端胰腺切除术和脾切除术切除了该肿瘤。胰腺肿瘤切除后，血浆生长抑素和降钙素水平升高恢复到正常范围，持续腹泻也显著消失。术后免疫组化研究显示肿瘤细胞生长抑素和降钙素弥漫性阳性。这些结果清楚地表明该患者是一例产生降钙素的胰腺生长抑素瘤。
