Pancreatic insulinoma combined with glucagon positive cell: A case report
Pancreatic insulinoma combined with glucagon positive cell: A case report作者机构：Department of Surgery Asahi General Hospital Department of Surgery Kanto Medical Center NTT EC Department of Pathology Asahi General Hospital
出 版 物：《World Journal of Gastrointestinal Surgery》 (世界胃肠外科杂志（英文版）（电子版）)
年 卷 期：2013年第5卷第3期
页 面：68-72页
学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学]
主 题：Hypoglycemia Insulinoma Pancreas Neuroendocrine tumor Glucagon
摘 要：We present a 70-year-old man who was referred for surgery with uncontrollable hypoglycemia. Ultrasonography and abdominal contrast computed tomography revealed a hypervascular tumor of 1 cm in diameter in the pancreatic tail. With a diagnosis of insulinoma, we performed a distal pancreatectomy. The patient showed a good postoperative course without any complications. The patient s early morning fasting hypoglycemia disappeared. The respective levels of C-peptide and insulin dropped from 14.9 ng/mL and 4860 μIU/mL preoperatively to 5.3 ng/mL and 553 μIU/mL after surgery. A histopathological examination demonstrated that the tumor was a pancreatic neuroendocrine tumor, grade 1. Immunostaining was negative for insulin and positive for CD56, chromogranin A, synaptophysin and glucagon. These findings suggested that the tumor was clinically an insulinoma but histopathologically a glucagonoma. Among all insulinoma cases reported between 1985 and 2010, only 5 cases were associated with independent glucagonoma. In this report, we characterize and discuss this rare type of insulinoma by describing the case we experienced in detail.
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