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已发表论文
由异位胰腺导致的罕见恶性胰岛素瘤伴多发性肝转移：3 年随访和文献回顾
Authors Liu Q, Duan JH, Zheng YM, Luo J, Cai XP, Tan HY
Received 24 October 2017
Accepted for publication 14 March 2018
Published 3 April 2018 Volume 2018:11 Pages 1813—1819
DOI https://doi.org/10.2147/OTT.S154991
Checked for plagiarism Yes
Review by Single-blind
Peer reviewers approved by Dr Andrew Yee
Peer reviewer comments 3
Editor who approved publication: Dr Carlos Vigil Gonzales
Abstract: Here, we report the
diagnosis and treatment of a very rare case of malignant insulinoma derived
from ectopic pancreas. A middle-aged woman presented with a 6-year history of
recurrent hypoglycemia with multiple lesions in liver. Admission workup
revealed elevated serum insulin and C-peptide, as well as multiple lesions in
the liver (largest being 4.3 cm), enlarged lymph nodes around the pancreas, and
a lesion (of 3.5 cm) at the proximal jejunum, as shown by contrast computed
tomography (CT). Liver biopsy showed the lesions to be well-differentiated
neuroendocrine tumors, grade G1. 68Gallium-exendin-4
positron emission tomography/CT confirmed the origin as the lesion located at
the jejunum. The combination treatment of everolimus plus long-acting
octreotide relieved symptoms and achieved a partial tumor response. Maintenance
treatment of the somatostatin analog (ie, octreotide) alone was administered.
Three years of follow-up, up to the writing of this report, showed good
survival, with the patient remaining asymptomatic and euglycemic without
disease progression. This case shows that 68Gallium-exendin-4
positron emission tomography/CT is useful for locating insulinoma, especially
for insulinoma derived from ectopic pancreas, and that everolimus plus
octreotide with maintenance somatostatin analog alone is an effective drug
strategy for treating inoperable malignant insulinoma.
Keywords: malignant insulinoma, ectopic pancreas, octreotide, everolimus, 68Gallium-exendin-4 positron emission tomography/computed tomography, 68Ga-exendin-4 PET/CT
Keywords: malignant insulinoma, ectopic pancreas, octreotide, everolimus, 68Gallium-exendin-4 positron emission tomography/computed tomography, 68Ga-exendin-4 PET/CT
