Please wait a minute...
J Zhejiang Univ (Med Sci)  2017, Vol. 46 Issue (6): 662-665    DOI: 10.3785/j.issn.1008-9292.2017.12.14
A case of insulinoma complicated with secondary adrenal insufficiency
LI Yao(),CHEN Hui*()
Department of Endocrinology, the Second Hospital of Lanzhou University, Lanzhou 730030, China
Download: HTML( 6 )   PDF(985KB)
Export: BibTeX | EndNote (RIS)      


A middle-aged male patient with recurrent hypoglycemia was diagnosed as insulinoma according to the symptoms and the laboratory tests. Laboratory tests also showed low cortisol and adrenocortico-tropic hormone (ACTH) levels, therefore adrenal insufficiency was diagnosed and hydrocortisone was given. The hormone replacement therapy was terminated after surgery, and ACTH and cortisol levels returned to normal.

Key wordsInsulinoma/surgery      Hypoglycemia      Adrenal insufficiency/complications      Case reports     
Received: 22 June 2017      Published: 25 December 2017
CLC:  R58  
Corresponding Authors: CHEN Hui     E-mail:;
Cite this article:

LI Yao,CHEN Hui. A case of insulinoma complicated with secondary adrenal insufficiency. J Zhejiang Univ (Med Sci), 2017, 46(6): 662-665.

URL:     OR



关键词: 胰岛素瘤/外科学,  低血糖症,  肾上腺功能减退/并发症,  病例报告 
Fig 1 Abdominal enhanced CT before surgery
Fig 2 Pathological examination of the specimen during operation
[1]   RENO C M , LITVIN M , CLARK A L et al. Defective counterregulation and hypoglycemia unawareness in diabetes:mechanisms and emerging treatments[J]. Endocrinol Metab Clin North Am, 2013, 42 (1): 15- 38
doi: 10.1016/j.ecl.2012.11.005
[2]   LIU H , PENG C , ZHANG S et al. Strategy for the surgical management of insulinomas:analysis of 52 cases[J]. Dig Surg, 2007, 24 (6): 463- 470
doi: 10.1159/000111822
[3]   DE FEO P , PERRIELLO G , TORLONE E et al. Contribution of cortisol to glucose counterregulation in humans[J]. Am J Physiol, 1989, 257 (1 Pt 1): E35- E42
[4]   TANG H Y , GARCIA J M . Association between insulinoma and adrenal insufficiency:a case report and review of the literature[J]. Pancreas, 2010, 39 (4): 544- 546
doi: 10.1097/MPA.0b013e3181c07117
[5]   MATHUR S , BOPARAI J , MEDIWALA S N et al. Reversible adrenal insufficiency in three patients with post-roux-en-Y gastric bypass noninsulinoma pancreatogenous hypoglycemia syndrome[J]. J Investig Med High Impact Case Rep, 2014, 2 (1): 2324709614526992
[6]   DAVIS M R , SHAMOON H . Deficient counterregulatory hormone responses during hypoglycemia in a patient with insulinoma[J]. J Clin Endocrinol Metab, 1991, 72 (4): 788- 792
doi: 10.1210/jcem-72-4-788
[7]   CHANG Y H , HSIEH M C , HSIN S C et al. Insulinoma-associated transient hypothalamus-pituitary-adrenal axis impairment and amelioration by steroid therapy and surgical intervention:a case report[J]. Kaohsiung J Med Sci, 2007, 23 (10): 526- 530
doi: 10.1016/S1607-551X(08)70011-1
[8]   KAFFEL N , CHAKROUN E , DAMMAK M et al. Paradoxal growth hormone and cortisol response to hypoglycemia caused by endogenous hyperinsulinemia:a case report[J]. Ann Endocrinol (Paris), 2007, 68 (2-3): 204- 207
doi: 10.1016/j.ando.2007.02.007
[9]   DEROSA M A , CRYER P E . Hypoglycemia and the sympathoadrenal system:neurogenic symptoms are largely the result of sympathetic neural, rather than adrenomedullary, activation[J]. Am J Physiol Endocrinol Metab, 2004, 287 (1): E32- E41
doi: 10.1152/ajpendo.00539.2003
[10]   SONG Z , ROUTH V H . Recurrent hypoglycemia reduces the glucose sensitivity of glucose-inhibited neurons in the ventromedial hypothalamus nucleus[J]. Am J Physiol Regul Integr Comp Physiol, 2006, 291 (5): R1283- R1287
doi: 10.1152/ajpregu.00148.2006
[1] ZHOU Haijin, XIA Ping, HU Xingyue. A case of neuromyelitis optica spectrum disorders complicated with systemic lupus erythematosus and thymoma[J]. J Zhejiang Univ (Med Sci), 2018, 47(1): 71-74.
[2] FANG Bing, QIAN Cong, JIANG Dingyao, XU Jing, YU Jun, CHEN Xianyi, XU Liang, CHEN Gao, ZHANG Jianmin. Hypoglossal canal dural arteriovenous fistulas treated with transvenous embolization:report of two cases and literature review[J]. J Zhejiang Univ (Med Sci), 2017, 46(4): 445-448.
[3] WEN Hong, CHEN Lu, YAN Kai, HE Jing. Prenatal diagnosis of Joubert syndrome:one case report and literature review[J]. J Zhejiang Univ (Med Sci), 2017, 46(3): 274-278.
[4] CHEN Yonghua,LIANG Li,FANG Yanlan,WANG Chunlin,LI Linfa,JIANG Tian'an. Iodine 131 joint radio frequency ablation treatment for child with hyperthyroidism goiter: one case report[J]. J Zhejiang Univ (Med Sci), 2017, 46(1): 89-91.
[5] SHEN Zhixin, GAO Enfang, WENG Wenqing, LUO Weiling. Hereditary vitreous degeneration muddy: report of ten cases[J]. J Zhejiang Univ (Med Sci), 2016, 45(6): 636-640.
[6] HE Zhan, DING Fang, RONG Jiandong, GAN Yongli. A case of idiopathic hypertrophic cranial pachymeningitis presenting as chronic subdural hematoma[J]. J Zhejiang Univ (Med Sci), 2016, 45(5): 540-543.
[7] OU Changjiang, WANG Shenghu, CHEN Yili, MO Jun, ZHAO Xuequn. Microvascular decompression for hemifacial spasm induced by vertebral artery dissecting aneurysm: one case report[J]. J Zhejiang Univ (Med Sci), 2016, 45(5): 536-539.
[8] DING Xia, LI Yan, CUI Yiyi, SHEN Yingying, GU Jianzhong, GUO Yong. Fibromyalgia syndrome after comprehensive treatment of breast cancer: a case report[J]. J Zhejiang Univ (Med Sci), 2016, 45(4): 429-431.
[9] MAO Lingna, GUO Qingqu, WANG Guifeng, SONG Zhenya. A case of neurofibromatosis complicated with small bowel obstruction[J]. J Zhejiang Univ (Med Sci), 2016, 45(3): 297-301.
[10] LU Pei-ying, GU Wei, PANG Xiao-hong, SHAN Peng-fei. A rare case of Silver-Russell syndrome in adult and literature review[J]. J Zhejiang Univ (Med Sci), 2015, 44(3): 335-338.
[11] FANG Xing, XU Zi-qi, LUO Ben-yan, YUAN Huai-wu, ZHU Xiong-chao, YUAN Yuan. Carotid artery dissection with Horner syndrome as main manifestation:a case report[J]. J Zhejiang Univ (Med Sci), 2015, 44(2): 229-232.
[12] HE Zhan, DING Fang, RONG Jian-dong, ZHU Guang-yao. Pure spinal epidural cavernous hemangioma:report of one case[J]. J Zhejiang Univ (Med Sci), 2015, 44(2): 233-235.
[13] LI Jiang,et al. Surgical treatment combined with oral administration of indomethacin for eosinophilic granuloma of the skull: report of a pediatric case[J]. J Zhejiang Univ (Med Sci), 2014, 43(4): 501-503.