Un insulinome géant : à propos d’un cas

Abstract Islet-cell tumors are the most common neuroendocrine tumors that arise from the endocrine pancreas. They are typically benign and sporadic. Diagnosis is generally established late because clinical signs lack specificity. The insulinoma is difficult to localize since it is very small in size...

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Bibliographic Details
Published in:Annales d'endocrinologie 2009-03, Vol.70 (1), p.71-75
Main Authors: Ketari-Jamoussi, S, Debbiche-Chedly, A, Ben Dhaou, B, Boussema, F, Cherif, O, Cherif, A.R, Ben Ayed, M, Bouzaine, A, Rokbani, L
Format: Article
Language:fre
Subjects:
Endocrine tumor
Endocrinology & Metabolism
Endocrinopathies
Insulinoma
Insulinome
Internal Medicine
Pancréas endocrine. Cellules apud (pathologie)
Sciences biologiques et medicales
Sciences biologiques fondamentales et appliquees. Psychologie
Sciences medicales
Therapy
Traitement
Tumeur endocrine
Tumeurs. Hypoglycémie
Vertebres: endocrinologie
Citations: Items that this one cites
Online Access:Get full text
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Summary:Abstract Islet-cell tumors are the most common neuroendocrine tumors that arise from the endocrine pancreas. They are typically benign and sporadic. Diagnosis is generally established late because clinical signs lack specificity. The insulinoma is difficult to localize since it is very small in size, often not exceeding 2 cm. We report an exceptional case of giant insulinoma initially revealed by a pseudo-polycythemia in an 80-year-old man. He had been treated for hypertension for a few months. Routine biological investigations showed elevated hematocrit and haemoglobin, suggesting Vaquez disease. History taking revealed recent episodes of nocturnal agitation. On admission, he had reddish skin with a suspected enlarged spleen, but total blood volume was normal. Imaging studies showed a voluminous tumor located between the pancreas and the spleen. The presence of an insulinoma was confirmed on the basis of an elevated level of proinsulin at the time of an asymptomatic episode of hypoglycemia. Spleno-pancreatectomy was performed. Histopathological examination revealed a malignant, well-differentiated neuroendocrine malignant tumor.
ISSN:0003-4266
DOI:10.1016/j.ando.2008.09.005