Diagnosis of Insulinoma by Endoscopic Ultrasonography: A Case Report

內視鏡超音波診斷胰島素瘤：一例報告

王堅連(Chien-Dar Wang) ； 王朝欣(Chaur-Shine Wang) ； 李龍雄(Long-Shyong Lee) ； 張俊仁(Jun-Jen Chang) ； 廖麗瑛(Li-Ying Lao) ； 劉茂和(Mao-Ho Liu) ； 李勝煌(Sheng-Huang Lee) ； 劉正典(Jean-Dean Liu) ； 陳寶輝(Pao-Huei Chen) ； 黃文哲(Thomas W. Huang)

《中華民國消化系醫學會雜誌》 9卷3期 (1992/09) Pp. 215-219

https://doi.org/10.6557/GJTa.199209_9(3).0004

摘要

一名51歲婦女因罹患偶發性意識喪失一年而住院診治。經生化及內分泌檢查診斷為胰島素瘤，因腹部超音波及電腦斷層檢查皆無法定位，故病人拒絕接受手術治療。三年後因低血糖症狀發生頻繁，故再次住院。腹部超音波檢查，電腦斷層檢查及選擇性血管攝影檢查均在胰頭部發現可疑病灶。最後次內視鏡超音波檢查，在胰頭部清楚顯示一境界分明的2×0.8cm低回音性之腫瘤。經手術證實為胰島素瘤。證明此內視鏡超音波檢查具備極佳之解像力，為手術前定位胰島素瘤之利器之一。

關鍵字

胰島素瘤 ； 內視鏡超音波術

並列摘要

A 51-year-old woman was hospitalized for episodic loss of consciousness over a one year period. The presence of insulinoma was indicated clinically and biochemically; but conventional ultrasonography (US) and computed tomography (CT) failed to reveal a tumor, thus surgical intervention was deferred. The patient was readmitted 3 years later with an increasing frequency of hypoglycemic episodes. Conventional US showed a suspicious, small, ill-defined hypoechoic mass in the pancreatic head. CT and selective angiography revealed equivocal results. Endoscopic ultrasonography (EUS) clearly demostrated a well-demarcated, echo-free mass, measuring 2×0.8cm, in the head of the pancreas. Insulinoma was confirmed by surgical pathologic examination. These results indicate that the EUS provides a distinct advantage in pre-operative visualization of insulinomas.

並列關鍵字

Insulinoma ； Endoscopic ultrasonography