Insulinoma Presenting with Tinnitus and Hearing Impairment

胰島素瘤以耳鳴及聽力障礙表現

莊世旻(Shih-Ming Chuang) ； 林君璐(Jiun-Lu Lin) ； 蔡崇鑫(Chung-Hsin Tsai) ； 梁清香(Ching-Hsiang Leung) ； 簡銘男(Ming-Nan Chien)

《台灣癌症醫學雜誌》 27卷6期 (2011/12) Pp. 257-262

https://doi.org/10.6323/JoCRP.2011.27.6.3

摘要

目的：介紹胰島素瘤以耳鳴及聽力喪失來表現。方法：一57歲男性以表現耳鳴，聽力喪失和頭暈，因反覆低血糖症狀合併低血糖及C-胜肽濃度上升，內生性高胰島素血症高度懷疑，住院中72小時禁食測試及影像學檢查確定診斷，並對病灶加以定位。結果：72小時禁食測試為陽性，符合內生性高胰島素血症，電腦斷層與核磁共振影像皆診斷單顆胰島素瘤位於胰臟頭部，經病灶摘除術（enucleation）手術後，耳鳴及暈眩症狀改善。結論：不明原因之耳鳴及聽力障礙病有前庭功能異常者如有反覆低血糖之現象，宜考慮諸如胰島素瘤等內生性高胰島素血症之可能。

關鍵字

胰島素瘤 ； 聽覺功能障礙 ； 耳鳴 ； 聽力喪失

並列摘要

Objective: To describe a case of insulinoma presenting with tinnitus and hearing loss. Case Report: A 57-year-old man presented with tinnitus, hearing loss and dizziness. Endogenous hyperinsulinemia was suspected because of episodic hypoglycemic symptoms associated with low plasma glucose and elevated C-peptide. In-hospital 72-hour fasting and advanced image confirmed the diagnosis and localized the lesion. Results: The positive finding of the 72-hour fasting test was consistent with endogenous hyperinsulinemia. Computed tomography (CT) and magnetic resonance imaging (MRI) revealed a pancreatic head tumor. Surgical enucleation was performed. After surgery, all the auditory symptoms resolved. Conclusions: Endogenous hyperinsulinemia should be suspected if recurrent tinnitus and hearing loss are simultaneously associated with hypoglycemic episodes.

並列關鍵字

insulinoma ； auditory disorder ； tinnitus ； hearing loss