Insulinoma-Associated Transient Hypothalamus-Pituitary-Adrenal Axis Impairment and Amelioration by Steroid Therapy and Surgical Intervention: A Case Report

胰島素腫瘤合併暫時性下視丘－腦下垂體－腎上腺軸缺損且經由類固醇和手術治療緩解－一位成人病例報告

張毓泓(Yu-Hung Chang) ； 謝明家(Ming-Chia Hsieh) ； 辛世杰(Shih-Chieh Hsin) ； 辛錫璋(Shyi-Jang Shin) ； 林昆德(Kun-Der Lin)

《The Kaohsiung Journal of Medical Sciences》 23卷10期 (2007/10) Pp. 526-530

摘要

胰島素細胞腫瘤在胰島細胞腫瘤中是最常見的功能性腫瘤。它會造成嚴重的低血糖而且通常很難在術前被定位出來。這病例報告是一年輕女性的胰島素細胞腫瘤合併暫時性下視丘－腦下垂體－腎上腺軸缺損。在經由傳統的影像學檢查失敗之後，我們成功的使用體泌素接受體閃爍攝影(somatostatin receptor scintigraphy)和選擇性動脈刺激、肝靜脈血掖採樣術(selective arterial calcium stimulation and venous sampling)方法將腫瘤定位出來。此外也成功的使用prednisolone 治療腎上腺功能不足與預防嚴重的低血糖。而她的下視丘－腦下垂體－腎上腺軸缺損與嚴重的低血糖在切除腫瘤之後就回復了。

關鍵字

下視丘－腦下垂體－腎上腺軸缺損 ； 胰島素細胞腫瘤

並列摘要

Insulinoma is the most common functional tumor among pancreatic islet cell tumors. This type of tumor is difficult to localize prior to surgery and can lead to serious hypoglycemia. This paper presents the case of a young female who suffered from insulinoma associated with transient hypothalamus-pituitary-adrenal axis impairment. To localize her insulinoma, we used two alternative testing methods, somatostatin receptor scintigraphy and selective arterial calcium stimulation with venous sampling, after a failure of conventional imaging methods. We treated her adrenal insufficiency and prevented serious hypoglycemia by giving her prednisolone. The impairment in her hypothalamus-pituitary-adrenal axis and her serious hypoglycemia recovered after excision of the tumor.

並列關鍵字

hypothalamus-pituitary-adrenal axis impairment ； insulinoma