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首页> 外文期刊>Journal of hepato-biliary-pancreatic surgery >Malignant glucagonama of the pancreas diagnoses through anemia and diabetes mellitus.
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Malignant glucagonama of the pancreas diagnoses through anemia and diabetes mellitus.

机译：胰腺恶性胰高血糖素可通过贫血和糖尿病来诊断。

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Glucagonoma of the pancreas is a rare tumor with distinct clinical manifestations, such as necrolytic migratory erythema,weight loss, anemia, diabetes mellitus, and hypoamino-acidemia. We report the case of a 68-year-old Japanese man who underwent curative resection for malignant glucagonoma of the pancreas diagnosed through anemia and diabetes mellitus. The patient had had diabetes mellitus for 20 years. Anemia was diagnosed in 1998. On admission, the hemoglobin level was 8.3g/dl, but the levels of serum iron, vitamin B12, and erythropoietin and, the number of reticulocytes were within normal limits. The levels of carcinoembryonic antigen (CEA), carbohydrate antigen (CA)19-9, and DUPAN-2 were also within normal limits, and exocrine function of the pancreas (PFD, 75%) was normal. Ultrasonography (US) revealed a hypoechoic tumor in the distal pancreas. Computed tomography (CT) demonstrated a high-density area 4 cm in diameter with calcification. The serum glucagon level was very high (2360 pg/ml), but the levels of other hormones such as somatostatin or gastrin were within normal limits, while insulin was low. Glucagonoma of the pancreas was diagnosed, and distal pancreatectomy with splenectomy was performed. Histological examination revealed a malignant endocrine tumor,which was immunohistochemically positive for chromogranin A and glucagon. Two months after the operation, the serum glucagon level had decreased to within normal limits and the hemoglobin level had increased to 10.4 g/dl. The case of glucagonoma reported here was found through diagnostic examinations of anemia and treated by surgical resection, by which the patient's anemia was largely alleviated. Therefore, we recommend checking patients who have diabetes mellitus and anemia in order to diagnose and treat glucagonoma in its early stage.
机译：胰腺胰高血糖素瘤是一种罕见的肿瘤，具有明显的临床表现，如坏死性迁徙性红斑，体重减轻，贫血，糖尿病和低氨基酸血症。我们报告了一例68岁的日本男子的病例，该男子接受了根治性切除术，用于通过贫血和糖尿病诊断出的胰腺恶性胰高血糖素瘤。该患者患有糖尿病20年。 1998年诊断为贫血。入院时血红蛋白水平为8.3g / dl，但血清铁，维生素B12和促红细胞生成素的水平以及网织红细胞的数量均在正常范围内。癌胚抗原（CEA），糖类抗原（CA）19-9和DUPAN-2的水平也在正常范围内，胰腺的外分泌功能（PFD，75％）正常。超声检查（US）显示远端胰腺有低回声性肿瘤。计算机断层扫描（CT）显示直径4厘米的高密度区域，钙化。血清胰高血糖素水平很高（2360 pg / ml），但其他激素如生长抑素或胃泌素的水平在正常范围之内，而胰岛素则较低。诊断为胰腺胰高血糖素瘤，并行胰远端切除术和脾切除术。组织学检查显示为恶性内分泌肿瘤，其对嗜铬粒蛋白A和胰高血糖素免疫组织化学阳性。术后两个月，血清胰高血糖素水平已降至正常水平，血红蛋白水平已升高至10.4 g / dl。通过对贫血的诊断检查发现了此处报道的胰高血糖素瘤病例，并通过手术切除进行了治疗，从而大大减轻了患者的贫血。因此，我们建议检查患有糖尿病和贫血的患者，以便在早期诊断和治疗胰高血糖素瘤。

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