从非功能性胰腺神经内分泌瘤引起的恶性胰岛素瘤
Ritodhi Chatterjee1, Basim Ali1, Son H Nguyen2
1Department of Internal Medicine, Baylor College of Medicine, Houston, TX.
ACG case reports journal
|March 6, 2024
概括
罕见的胰腺神经内分泌瘤 (PNETs) 可以转化. 这种病例显示非功能性PNET (NF-PNET) 进展为恶性胰岛素瘤,导致严重的低血糖,不耐初始治疗.
科学领域:
- 内分泌学 在内分泌学.
- 在瘤学瘤学.
- 胃肠病学 胃肠病学
背景情况:
- 胰腺神经内分泌瘤 (PNET) 是一种罕见的瘤,具有功能性 (F-PNET) 和非功能性 (NF-PNET) 亚型.
- 虽然F-PNETs存在激素过分的症状,但NF-PNETs很少能转化为功能瘤.
- 恶性胰岛素瘤是一种F-PNET,在诊断时经常转移,并与预后不佳有关.
研究的目的:
- 介绍一个已知转移NF-PNET的患者,患有恶性胰岛素瘤的病例.
- 讨论管理恶性胰岛素瘤的次要低血糖症的挑战.
- 审查恶性胰岛素瘤和相关低血糖症的治疗策略.
主要方法:
- 案例报告的呈现方式.
- 对患有NF-PNET和随后的恶性胰岛素瘤的患者的临床病史,诊断和治疗进行审查.
- 讨论耐药性低血糖症的管理策略和减少瘤负担.
主要成果:
- 一名已知转移NF-PNET的患者在诊断后2年因恶性胰岛素瘤而发展出症状性低血糖症.
- 低血糖是不耐持续输注的右糖.
- 通过二氧化和肝动脉栓塞,实现了低血糖症的临时改善.
结论:
- 恶性胰岛素瘤可能由先前存在的NF-PNETs引起,呈现出严重的耐药性低血糖症.
- 管理需要一种多模式的方法,包括医疗治疗 (类固醇,体静止素类似物,氧化物) 和减少瘤负担.
- 早期识别和管理对于改善这些罕见病例的结果至关重要.
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