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題 名 | Octreotide Treatment for a Malignant Islet Cell Tumor with Variable Hormone Secretion: Case Report=用Octreotide治療分泌各種荷爾蒙的惡性胰島細胞:病例報告 |
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作 者 | 吳奕宏; 林仁德; 邱正堂; 陳澤卿; 鄭隆賓; | 書刊名 | 長庚醫學 |
卷 期 | 22:4 1999.12[民88.12] |
頁 次 | 頁643-648 |
分類號 | 415.549 |
關鍵詞 | 惡性胰島細胞瘤; 胃泌素; 胰島素; Octreotide; Malignant islet cell tumor; Gastrin; Insulin; |
語 文 | 英文(English) |
中文摘要 | 胰島細胞瘤可因其細胞型態不同而分泌不同的荷爾蒙。這裡戒們報告一例70歲女 性,初期表現以消化道潰瘍症狀,稍後痊現血中胃泌素上升,且腹部電腦斷層掃瞄發現肝臟 有多處轉移性的腫瘤。患者在接受肝臟切片及胰臟尾端切除後,病理報告為惡性胰島細胞瘤。 而在手術組纖中,胃泌素組織免疫化學染色呈現陽性反應斑點。14個月後,胰島素組織免疫 化學染色也呈現陽性反應斑點。另外,低血糖的發生,及血中胃泌素和胰島素值的上升,顯 示它已經轉變成分泌多種荷爾蒙的腫瘤。病人接受每天皮下注射300μg到400μg octreotide,5天後血中胃泌素由584pg/ml下降到49.1 pg/ml,而胰島素則由90.8μIU/ml 下降到20.9μIU/ml。另外,稍後追蹤的腹部電腦斷層檢查顯示轉移至肝臟的腫瘤變小。總結, 我們發瑰一例以octreotide可有效控制的惡性胰島細胞瘤。 |
英文摘要 | It is well known that an islet cell tumor can secrete multiple hormones depending on its cell type. We report the case of a 70-year-old woman who initially presented with peptic ulcer symptoms, an elevated serum gastrin level, and multiple liver tumors. Liver biopsy and distal pancreatectomy were performed, and the pathological diagnosis was malignant islet cell tumor. Additionally, the immunohistochemical staining revealed scattered positivity for gastrin, and then also positivity for insulin 14 months later. A subsequent hypoglycemic episode and elevated serum gastrin and insulin levels suggested that the disease had developed into a condition of multiple hormone secretion. The plasma gastrin and insulin levels decreased from 584 pg/ml and 90.8 P μIU/ml to 49.1 pg/ml and 20.9 μIU/ml, respectively, 5 days after treatment with subcutaneous octreotide 100 μg every 6 to 8 hours. In addition, follow-up computed tomography showed shrinkage of the metastatic liver tumors. In conclusion, we found a case of malignant islet cell tumor with variable hormone secretion which could be effectively controlled with octreotide. |
本系統中英文摘要資訊取自各篇刊載內容。