Kaohsiung Journal of Medical Sciences
Volume 23, Issue 10 , Pages 526-530, October 2007

Insulinoma-associated Transient Hypothalamus—Pituitary—Adrenal Axis Impairment and Amelioration by Steroid Therapy and Surgical Intervention: A Case Report

  • Yu-Hung Chang

      Affiliations

    • Department of Endocrinology and Metabolism, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
    • ,
  • Ming-Chia Hsieh

      Affiliations

    • Department of Endocrinology and Metabolism, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
    • Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
    • ,
  • Shih-Chieh Hsin

      Affiliations

    • Department of Endocrinology and Metabolism, Kaohsiung Municipal United Hospital, Kaohsiung, Taiwan
    • ,
  • Shyi-Jang Shin

      Affiliations

    • Department of Endocrinology and Metabolism, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
    • Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
    • ,
  • Kun-Der Lin

      Affiliations

    • Department of Endocrinology and Metabolism, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
    • Corresponding Author InformationAddress correspondence and reprint requests to: Dr Kun-Der Lin, Department of Endocrinology and Metabolism, Kaohsiung Medical University Hospital, 100 Shin-Chuan 1st Road, Kaohsiung 807, Taiwan

Received 24 November 2006; accepted 12 January 2007.

Article Outline

Insulinoma is the most common functional tumor among pancreatic islet cell tumors. This type of tumor is difficult to localize prior to surgery and can lead to serious hypoglycemia. This paper presents the case of a young female who suffered from insulinoma associated with transient hypothalamus—pituitary—adrenal axis impairment. To localize her insulinoma, we used two alternative testing methods, somatostatin receptor scintigraphy and selective arterial calcium stimulation with venous sampling, after a failure of conventional imaging methods. We treated her adrenal insufficiency and prevented serious hypoglycemia by giving her prednisolone. The impairment in her hypothalamus—pituitary—adrenal axis and her serious hypoglycemia recovered after excision of the tumor.

Key Words:  hypothalamus—pituitary—adrenal axis impairment , insulinoma

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PII: S1607-551X(08)70011-1

doi:10.1016/S1607-551X(08)70011-1

Kaohsiung Journal of Medical Sciences
Volume 23, Issue 10 , Pages 526-530, October 2007

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