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RESUMEN El insulinoma es un tumor poco frecuente de las células de los islotes pancreáticos, caracterizado por la proliferación de las células betas. Son tumores neuroendocrinos pancreáticos, generalmente benignos y de pequeño tamaño, caracterizados por el síndrome de hipersecreción de insulina con el desarrollo de hipoglucemia. La mayoría de estos tumores son esporádicos, solo alrededor de 15-30 % es hereditario; está asociado a enfermedades como la neoplasia endocrina múltiple tipo 1, o el síndrome de Von Hippel-Lindau. La incidencia de dicho tumor es de 3-10 casos por cada millón de habitantes. La edad media de aparición es entre 40-50 años de edad y es más frecuente en mujeres. El reconocimiento temprano y el diagnóstico adecuado de este tumor pancreático raro, son aspectos importantes pues es potencialmente curable con un tratamiento quirúrgico oportuno.
ABSTRACT Insulinoma is a rare pancreatic islet cell tumor characterized by proliferation of beta cells. They are pancreatic neuroendocrine tumors, generally benign and small in size, characterized by insulin hypersecretion syndrome with the development of hypoglycemia. Most of these tumors are sporadic, only about 15-30% are hereditary; it is associated with diseases such as multiple endocrine neoplasia type 1, or Von Hippel-Lindau syndrome. The incidence of this tumor is 3-10 cases per million inhabitants. The average age of onset is between 40-50 years of age and it is more frequent in women. Early recognition and proper diagnosis of this rare pancreatic tumor are important aspects, as it is potentially curable with timely surgical treatment.
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Adenoma, Islet Cell/surgery , Surgical Procedures, OperativeABSTRACT
Objective To validate whether the expression of human cluster of differentiation 55 (hCD55) protein in porcine islet cells could inhibit the activation of complement components in human serum. Methods Four adult pigs with WT (wild type), GTKO [α-1, 3-galactosyltransferase (GGTA1) knockout], GTKO/hCD55 and hCD55 genotypes were selected. Islet cells were isolated from WT, GTKO and GTKO/hCD55 pigs, and the purity and insulin secretion function were detected. The expression of hCD55 at the DNA, RNA and protein levels was analyzed by agarose gel electrophoresis, reverse transcription polymerase chain reaction (RT-PCR) and flow cytometry, respectively. Complement-dependent cytotoxicity assay and complement deposition assay were performed under the incubation conditions with fresh human serum. Results The purity of isolated porcine islet cells from three genotype pigs was > 75%, and the glycemic index was > 1. The expression of hCD55 messenger RNA(mRNA) and protein in GTKO/hCD55 porcine islet cells decreased the deposition of human complement component C3c and membrane-attacking complex C5b-9, and reduced the cytotoxicity. Conclusions The expression of hCD55 protein in porcine islet cells could inhibit the activation of human complement and reduce complement-mediated killing effect, indicating that hCD55 protein could exert complement protection effect on porcine islet cells. These findings provide theoretical basis for the application of hCD55 in islet xenotransplantation.
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Objective:To investigate the relationship between the expression level of circular RNA_0005414 and islet cell function in type 2 diabetes patients.Methods:A total of 110 patients with type 2 diabetes and 106 cases of normal glucose tolerance (control group) in Uygur populations, 64 cases of type 2 diabetes mellitus and 63 cases of normal glucose tolerance (control group) in Han populations were enrolled in the study. All subjects underwent oral glucose tolerance test chemistry panel. Homeostasis model assessment for insulin resistance (HOMA-IR) and β cell function (HOMA-β) were evaluated by homeostasis model as islet cell function indexes. The differentially expressed circular RNAs were screened using RNA sequencing from the peripheral blood monocytes of 5 Uygur patients with type 2 diabetes mellitus and matched controls. The expression level of a significantly up-regulated circular RNA_0005414 was detected and verified, and the relationship between the expression level of circular RNA_0005414 and islet cell function was analyzed.Results:Differential expression profiles of circular RNAs were found in Uygur type 2 diabetic patients . The expression level of circular RNA_0005414 in Uygur type 2 diabetic group was higher than that in Uygur control group ( P<0.01), the expression level of circular RNA_0005414 in Han type 2 diabetic group was higher than that in Han control group ( P<0.01), the expression level of circular RNA_0005414 in Uygur type 2 diabetes group was higher than that in Han type 2 diabetes group, but the difference was not statistically significant ( P>0.05). In the Uyghur and Han groups, Spearman correlation analysis showed that the expression level of circular RNA_0005414 was positively correlated with fasting blood glucose, 2 h plasma glucose after glucose loading, HbA 1C, total cholesterol, fasting insulin, HOMA-IR ( P<0.05) and negatively correlated with HOMA-β ( P<0.01). Partial correlation analysis showed that circular RNA_0005414 expression level was positively correlated with fasting blood glucose, HbA 1C, and HOMA-IR ( P<0.01). Multivariate linear regression analysis showed that circular RNA_0005414 was the only factor affecting HOMA-β in Uygur patients with type 2 diabetes. Conclusion:The expression level of circular RNA_0005414 was closely related to islet cell function in Uygur type 2 diabetes patients, the up-regulation of circular RNA_0005414 may be involved in the occurrence and development of type 2 diabetes in Uygur.
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The incidence of diabetes mellitus tends to increase, and clinical treatment is extremely challenging. Although drugs exert certain therapeutic effect on reducing blood glucose level, it remains impossible to achieve clinical cure of type 1 diabetes mellitus with a risk of blood glucose fluctuations. Islet cell transplantation is one of the efficacious methods to solve the problem of blood glucose fluctuation caused by insulin injection. However, there are several problems in the clinical practice of islet cell transplantation, including long time use of immunosuppressants in recipients and massive loss of pancreatic islet cells after transplantation, which limit its wide application in clinical practice. Islet cell encapsulation technology can reduce the loss of islet cells and decrease or eliminate the rejection, which is a key link to improve the survival of islet cells. In this article, the development course of islet cell encapsulation technology was briefly reviewed, the challenges in different islet cell encapsulation technologies were analyzed and subsequent research on this technology was projected, aiming to provide reference for promoting the development of islet cell.
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@#Introduction: Diabetes-associated autoantibodies (DAA) is the hallmark of T1DM and LADA which are frequently tested in young diabetes patients. It was noted that up to 10-15% of patients with initial diagnosis of T2DM also exhibit DAA. Regardless of the classification, the presence of DAA suggests an underlying islet autoimmunity which lead to progressive pancreatic β-cell failure. There is limited data reported on DAA in young diabetes patients in Malaysia. This study aims to determine the frequency of DAA positivity and its association with demographic and clinical characteristics among this cohort. Methods: A retrospective study using secondary data obtained from Allergy and Immunology Research Centre, Institute for Medical Research, Malaysia. This study included 194 diabetes patients who were diagnosed before the age of 40 years old and tested for GADA, ICA, IA2A and IAA. Results: From 194 patients, 91 (46.9%) were positive for least one of the following DAA: ICA (79, 40.7%), GADA (61, 31.4%), IA2A (37, 19.1%) and IAA (9, 4.6%). Multiple positivity was higher (73.6%) compared to single positivity. Highest combination of double positivity was ICA+GADA (54, 59.3%) and triple positivity was ICA+GADA+IA2A (25, 27.5%). Simultaneous positivity of four autoantibodies was seen in only one (1.1%) patient. ICA, GADA and IA2A were associated with age group and ethnicity (all p < 0.001). Only IA2A was associated with gender (p = 0.012). Conclusions: GADA, ICA ad IA2A are more significant in young Malaysian diabetes patients. IAA has a very low frequency in this studied population.
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Objective To investigate the effects of vitamin D3 supplementation combined with standard-ized hypoglycemic regimen on islet β cell function and macroangiopathy of T2DM patients. Methods A total of 192 patients with type 2 diabetes mellitus were selected and randomly divided into control group and observation group with 96 patients in each group. Patients in two groups were given standardized hypoglycemic regimen, and the observation group was treated with vitamin D3 supplementation in addition. The changes of the indexes of body examination, glycolipid metabolism, islet β cell function and macrovascular complications before and 6 months after treatment were compared between the two groups. Results After 6 months of treatment, BMI, SBP, TG, FBG, FINS, HbA1c and HOMA-IR decreased, while HOMA-β increased in both groups ( P<0. 05) . Compared with the control group, the serum levels of 25 ( OH) D increased, and vaspin and CRP de-creased significantly after 6 months of treatment in the observation group ( P<0. 05) . CIMT and other indicators showed no significant difference. 25 (OH) D was negatively correlated with FBG, FINS, vaspin and CRP, and positively correlated with 1PH and ISI (P<0.05). Conclusion Vitamin D3 is closely related to T2DM and its macrovascular complications, but it has not been found that vitamin D3 supplementation can further improve islet β cell function and macrovascular complications in patients with T2DM.
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Objective To investigate the protective effect of FLPNF and the improvement of glucose-stimulated insulin secretion against dexamethasone-induced apoptosis of islet cells. Methods INS-1 cells were treated with oligopeptide FLPNF and dexamethasone, either separately or in combination. Proliferation of INS-1 cells in each group was assessed with CCK-8 assay and the insulin secretion stimulated by glucose was detected by ELISA. The apoptotic condition of the cells was observed and assessed with TUNEL and the apoptosis rate of each group was detected using flow cytometry. The expression of major target protein molecules related to apoptosis and Glut2 was detected by Western blotting analysis. Results Dexamethasone inhibited the growth of INS-1 cells in the group treated with dexamethasone. Cell damage was obvious with observable nuclear shrinkage and nuclear rupture. In addition, apoptosis rate was found to be 40.6％±2.4％. The expression of the apoptosis-related protein Bcl-2 and Glut2 was significantly reduced, whereas that of Bax and caspase-3 was significantly increased. After the combined treatment of oligopeptide FLPNF and dexamethasone, the results were reversed, and the apoptosis rate declined to 27.2％±2.0％ (P ＜ 0.001), cell morphology was improved, and the expression of apoptosis-related protein molecules of islet cells and protein Glut2 was significantly improved. Conclusion FLPNF has the ability of protecting islet cells from dexamethasone-induced apoptosis and improving the glucose-stimulated insulin secretion of islet cells.
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Autoimmune diabetes is a heterogeneous disease which can arise at any age. Subjects with adult-onset autoimmune diabetes who do not necessitate insulin-therapy for at least 6 months after diagnosis are demarcated as having latent autoimmune diabetes in adults (LADA). This condition is more heterogeneous than young-onset autoimmune diabetes and shares clinical and metabolic characteristics with both type 2 and type 1 diabetes. Patients with LADA are considered by having highly variable β-cell destruction, different degrees of insulin resistance and heterogeneous titre and pattern of islet autoantibody, suggesting different pathophysiological pathways partially explaining the heterogeneous phenotypes of LADA. To date the heterogeneity of LADA does not allow to establish a priori treatment algorithm and no specific guidelines for LADA therapy are available. These subjects are mostly treated as affected by type 2 diabetes, a factor that might lead to the progression to insulin-dependency quickly. A personalised medicine approach is necessary to attain optimal metabolic control and preserve β-cell function to decrease the risk of long-term diabetes complications. Recent data concerning the use of oral antidiabetic agents as dipeptidyl peptidase 4 inhibitors and glucagon-like peptide 1 receptor agonists indicate up-and-coming results in term of protect C-peptide levels and improving glycaemic control. This review summarises current knowledge on LADA, emphasising controversies regarding its pathophysiology and clinical features. Moreover, we discuss data available about novel therapeutic approaches that can be considered for prevention of β-cell loss in LADA.
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Adult , Humans , Autoantibodies , C-Peptide , Diabetes Complications , Diabetes Mellitus, Type 1 , Diabetes Mellitus, Type 2 , Diagnosis , Dipeptidyl-Peptidase IV Inhibitors , Glucagon-Like Peptide 1 , Hypoglycemic Agents , Insulin , Insulin Resistance , Islets of Langerhans , Phenotype , Population CharacteristicsABSTRACT
Objective To investigate the protective effect and mechanism of serum containing Euonymus fortunei on the rat pancreatic islet cells. Methods Forty male SD rats were randomly divided into 5 groups (n=8 in each group), including the control group (normal rat islet cells were cultured with normal rat serum), ischemic preconditioning group (abdominal aorta was blocked first and then re-opened before the pancreas was obtained, and the pancreatic islet cells were cultured with normal rat serum), Euonymus fortunei treatment group (normal rat islet cells were cultured with rat serum containing Euonymus fortunei), Euonymus fortunei group and blank group (normal rats were administered orally with Euonymus fortunei extract or distilled water for the preparation of rat serum). Diphenylthiocarbazone (DTZ) staining was utilized to observe and calculate the quantity of islets. Acridine orange (AO)/propidium iodide (PI) staining was adopted to calculate the survival rate of islet cells. The insulin release experiment was performed to calculate the stimulation index (SI) and evaluate islet cell function. The concentration of glutathione (GSH) and nitric oxide (NO) in islet cells was detected using GSH and NO kits. The expression level of inducible nitric oxide synthase (iNOS) messenger RNA (mRNA) was quantitatively measured by reverse transcription polymerase chain reaction (RT-PCR). Results Islet cells were observed in specifically scarlet color after DTZ staining. The quantity of islet cells did not significantly differ among different groups (all P>0.05). Along with the prolongation of culture time, the activity of islet cells in each group was gradually decreased. At 72 h after isolation and culture, compared with the control group, the survival rate of the cells was significantly higher in the Euonymus fortunei treatment group (P<0.05). The insulin release test results demonstrated that compared with the control group, the SI of the ischemic preconditioning and Euonymus fortunei treatment groups was significantly increased (both P<0.05). Compared with the control group, the GSH contents of pancreatic islet cells in the ischemic preconditioning and Euonymus fortunei treatment groups were considerably enhanced, the NO content was significantly decreased, and the expression level of iNOS mRNA was significantly down-regulated (all P<0.05). Conclusions Euonymus fortunei can increase the survival rate of islet cells and enhance the function of pancreatic islets by increasing the level of GSH, down-regulating the expression of iNOS and decreasing the NO production.
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Objective To investigate the clinical efficacy of entecavir in the treatment of hepatitis B cirrhosis associated with hepatic diabetes. Methods 78 cases of hepatitis B Hepatic Cirrhosis with diabetes were selectedfrom June 2015 to December 2016, and randomly divided into study group (n=39) and control group (n=39). The study group were treated with entecavir, the control group were treated with adefovir dipivoxil. Two groups of patients with hepatitis B cirrhosis combined with hepatic diabetes were treated continuously for 48 weeks, the changes of FPG, HOMA-β, beta and HOMA-IR were recorded. Results There was no significant difference between the two groups in the treatment of FPG, HOMA-β, and HOMA-IR. After treatment, the two groups of FPG and HOMA-IR decreased significantly compared with before treatment, while HOMA-β was significantly higher than before treatment, but the changes of the above indexes in the study group were better than those in the control group (P<0.05). Conclusion Entecavir combined with hypoglycemic agents can achieve more ideal blood glucose control effect in patients with hepatitis B cirrhosis combined with hepatic diabetes..
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Objective To investigate the clinical efficacy of entecavir in the treatment of hepatitis B cirrhosis associated with hepatic diabetes. Methods 78 cases of hepatitis B Hepatic Cirrhosis with diabetes were selectedfrom June 2015 to December 2016, and randomly divided into study group (n=39) and control group (n=39). The study group were treated with entecavir, the control group were treated with adefovir dipivoxil. Two groups of patients with hepatitis B cirrhosis combined with hepatic diabetes were treated continuously for 48 weeks, the changes of FPG, HOMA-β, beta and HOMA-IR were recorded. Results There was no significant difference between the two groups in the treatment of FPG, HOMA-β, and HOMA-IR. After treatment, the two groups of FPG and HOMA-IR decreased significantly compared with before treatment, while HOMA-β was significantly higher than before treatment, but the changes of the above indexes in the study group were better than those in the control group (P<0.05). Conclusion Entecavir combined with hypoglycemic agents can achieve more ideal blood glucose control effect in patients with hepatitis B cirrhosis combined with hepatic diabetes..
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We report the case of a 75-year-old man who was admitted to the hospital with symptoms of severe hypoglycemia. He had a history of solitary fibrous tumor diagnosed by Pathology after its complete surgical resection eight years before. The laboratory examination reported hypoglycemia with inhibited Insulin secretion. A computed tomography of the thorax revealed a large solid heterogeneous mass in the left hemithorax. Solitary fibrous tumor is a rare neoplasm. The association of solitary fibrous tumor and paraneoplastic hypoglycemia is known as Doege-Potter syndrome and occurs in less than 5% of all solitary fibrous tumors.
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Humans , Male , Female , Aged , Paraneoplastic Syndromes/etiology , Solitary Fibrous Tumor, Pleural/complications , Hypoglycemia/etiology , Paraneoplastic Syndromes/diagnostic imaging , Tomography, X-Ray Computed , Solitary Fibrous Tumor, Pleural/diagnostic imaging , Hypoglycemia/diagnostic imagingABSTRACT
A patient with severe hypoglycemia due to insulin-like growth factor ( IGF)-IIsecreted by a giant solitary fibrous tumor of the pleura ( SFTP) was investigated through comprehensively reviewing his medical history and clinical records. The patient had severe hypoglycemia accompanied with significantly decreased serum insulin level. A solitary fibrous tumor of the pleura was found, and right pneumonectomy removed this giant tumor. Two years after the operation, the patient was fit and well with no further hypoglycemia episodes. Non-islet-cell tumor hypoglycemia should be considered in patients who have hypoglycemia episodes accompanied with significantly decreased serum insulin level.
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Pancreatic ductal carcinoma accounts for 85％-90％ in pancreatic cancer, followed by the pancreatic cellendocrine tumors and pancreatic acinar cell carcinoma.In addition, mesenchymal cell carcinoma of pancreas is rare, and a mixed pancreatic cancer from 3 cells carcinoma is extremely rare.And pancreatic cancer always assume hypovascular tumor,spontaneous rupture of pancreatic cancer is rarely reported.A patient with a mixed duct-acinar-islet cell tumor of pancreas was admitted to the Second Affiliated Hospital of Harbin Medical University in June 2014, and underwent emergent operation of intraabdominal bleeding due to spontaneous rupture of tumor.The follow-up was done up to January 20, 2015.The patient died of intraabdominal widespread implantation metastasis of pancreatic cancer.A mixed duct-acinar-islet cell tumor of pancreas is extremely rare and easy to metastasis and diffusion of tumor with a rapid disease progression and a poor prognosis of patient,while operation is the key to terminate deterioration of the condition, and is the last line of defense to save lives.
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Objective To investigate the diagnosis and surgical treatment of functional insulinomas.Methods One hundred and thirty two patients from January 2002 to May 2013 were retrospectively reviewed who was confirmed as functional insulinomas by pathology.Results There were 43 males and 89 females.56 cases were located in the head of pancreas,76 body and tail of pancreas.69 patients underwent open enucleation,48 patients had Laparoscopic surgery,5 patients underwent distal pancreatectomy,9 patients had Laparoscopic distal pancreatectomy,1 patients had pancreaticoduodenectomy.The difference of variant imaging examination in Checking insulinomas was statistical significant(P ＜0.01).Laparoscopic treatment of insulinomas was at least as safe as open treatment.Conclusions Imaging examination could improve the accuracy of preoperative diagnosis of insulinomas.Surgery was the most effective methods to cure insulinomas and Laparoscopic surgery was becoming increasingly popular in treating insulinomas.
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Objective To discuss and improve the scheme of circulating fluid replacement in the polyuria stage after simultaneous islet cell-renal transplantation.Methods Nursing data of 26 patients after simultaneous islet cell-renal transplantation during the polyuria stage were analyzed retrospectively,the impact on spend-and-tax circulating fluid replacement on the outcome after surgery was observed.Results In 26 patients,3 case suffered graft function recovery delay,23 patients' renal function recovered smoothly without water-electrolyte and acid base disorders in period of diuresis,compared with the 16 cases with traditional fluid replacement in the same time,serum creatinine (SCr),blood urea nitrogen (BUN) and blood glucose (BG) decreased significantly in 72 h.Conclusions Using spend-and-tax fluid replacement can reduce postoperative complications such as water-electrolyte and acid-base disorders in simultaneous islet cell-renal transplantation patients,and promote the functional recovery of transplanted islet cells and kidney.
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Objective To investigate the clinical value of intraoperative ultrasound guided precise positioning and enucleation of the functional islet cell tumor.Methods The clinical data of 20 patients with functional islet cell tumor who were admitted to the First Affiliated Hospital of Xinjiang Medical University from January 2005 to December 2011 were retrospectively analyzed.The method of precise positioning,surgical approach and prognosis of the patients were reviewed.Results The accurate rates of computed tomography (CT),magnetic resonance imaging (MRI) and transabdominal B ultrasound in detecting the position of the functional islet cell tumors were 12/18,2/6 and 7/13,respectively,and the diameters of the tumors were (1.7 ±0.8)cm,(1.3 ±0.2)cm and (1.9 ±0.9)cm,respectively.The accurate rates of arterial stimulation venous sampling and pancreatic perfusion CT imaging were 100％,and the diameters of the tumor detected were (0.7 ± 0.3) cm and (0.9 ± 0.4) cm.The accurate rate of intraoperative B ultrasound examination was 14/14,and the diameter of the tumor was (1.5 ± 0.6)cm.Routine surgery was carried out on 6 patients,and 2 patients were complicated with grade C pancreatic fistula,and 1 was complicated with grade A pancreatic fistula.Fourteen patients received precise enucleation of islet cell tumor,and 4 patients were complicated with grade A pancreatic fistula.Twenty patients were followed up.The general condition of the patients was good till April 2012,and no death,tumor recurrence and metastasis were detected.Conclusions Combination of pre-and intraoperative imaging positioning could precisely locate functional islet cell tumor.If the distance between the tumor and main pancreatic duct is above 3 mm,precise enucleation of the islet cell tumor should be considered.
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Objective To investigate the clinical,pathologic and endoscopic ultrasound characteristics of pancreatic neuroendocrine tumors (PNETs).Methods Clinical data of 24 consecutive patients of PNETs who were admitted between January 2002 and January 2011 were reviewed.Results Among these 24 patients,19 were diagnosed to have insulinomas,1 was malignant insulinoma,2 were gastrinomas,and 2 were glucagonomas.Eighteen (75％) cases of PNETs were functional PNETs,and 6 (25％) were nonfunctional PNETs.The mean age of the patients was (42 ± 14) years old ranging from 19 ～ 64 years old,and the percentage of male patient was 33.3％.The main symptoms of insulinomas were intermittent abdominal pain or discomfort,and the main manifestations of glucagonomas were weight loss,skin migratory erythema; and the main symptoms of gastrinomas were diarrhea,vomiting with large amounts of water-like liquid.The detection rate of CT was 86.7％ (13/15),and the detection rate of EUS was 100％ (15/15),but PET-CT detected only 40％ of tumors (2/5).The endoscopic ultrasound characteristics of PNETs were circular or oval hypoechoic mass,and the volume was small with clear boundary and homogeneous echo.There was no enlarged lymph node,and liquid was detected in big tumor.Twenty-two patients received operation and 2 patients did not.PNETs expressed CgA and Syn protein.All patients of PNETs were alive with 7 to 80 months follow-up.Conclusions The clinical characteristics of PNETs were unique.EUS has a high accuracy for detecting and localizing PNETs.The surgical method is similar to that of pancreatic cancer,and the prognosis is relatively good.
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Fundamento: los melanomas de coroides son considerados los tumores malignos más frecuentes en el adulto, aparece generalmente entre la sexta y séptima década de la vida y se diagnostica a través de la oftalmoscopia, la biomiscroscopia, el ultrasonido y la angiografía fluoresceínica. Su forma de presentación puede ser en su variante nodular o difusa la malignidad depende del tamaño del tumor, la localización, extensión extra escleral, tipo histológico, entre otros factores. La causa de muerte por esta enfermedad suele ocurrir por metástasis hepática. Objetivo: evitar el diagnóstico tardío del melanoma ocular. Caso clínico: se presenta el caso de una paciente femenina de 50 años de edad que acudió al centro oftalmológico del Hospital Universitario Manuel Ascunce Domenech, por disminución lenta de la agudeza visual del ojo derecho, detectándose al examen oftalmológico la presencia de una masa tumoral de color pardo que ocupaba la hemiretina superior, lo cual se corroboró con la observación de el ultrasonido ocular, por lo que se decidió proceder a la enucleación del globo ocular debido a las características del mismo. El estudio histopatológico confirmó la presencia de un melanoma de coroides de células tipo mixtas con infiltración a cuerpo ciliar. Los resultados del examen físico general, hematológico e imagenológico fueron negativos, descartándose la presencia de metástasis.
Background: choroidal melanoma is considered the most common malignant tumor in adults. It usually appears between the sixth and seventh decade of life and it is diagnosed by ophthalmoscopy, biomiscroscopy, ultrasound and fluorescein angiography. Choroidal melanoma presentation may be in its nodular or diffuse variant; malignancy depends on the size of tumor, location, extrascleral extension, histological type, among other factors. The cause of death from this disease usually occurs by hepatic metastases. Objective: to avoid late diagnosis of ocular melanoma. Case presentation: a 50-year-old-female patient presented with slow decrease of visual acuity in the right eye. The eye test detected the presence of a brown tumor mass occupying the upper hemiretina, which was corroborated with the observation of ocular ultrasound. It was decided to enucleate the eyeball due to its characteristics. Histopathological examination confirmed the presence of a choroidal melanoma of mixed cell type with ciliary body infiltration. Results of physical, hematological and imaging examination were negative, ruling out the presence of metastasis.
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Multiple endocrine neoplasia type 1 (MEN1) is an autosomal dominant inherited syndrome with characteristic clinical and radiological manifestations. Many reports on MEN1 have been published; however, no cases of radiologically diagnosed MEN1 have been reported. Therefore, we report on a radiologically diagnosed case of MEN1 with clinical symptoms of gastroduodenal ulcer.