A 59-year-old man with no prior medical his- tory presents to his physician with marked hyperglycemia, diarrhea, and weight loss. CT scan of the abdomen reveals a pancreatic mass. A trial period on an oral hypoglycemic agent has not succeeded in reducing his glucose levels. Physical examination is significant for the painful rash shown in the image. Which of the following is the most likely diagnosis?
一名59岁男性，无任何既往病史，因明显高血糖、腹泻和体重减轻就诊。腹部CT扫描显示胰腺肿块。口服降糖药的试验期未能成功降低他的血糖水平。体格检查对图像中显示的痛性皮疹有意义。下列哪一项是最可能的诊断?
(A) Glucagonoma 胰高血糖素瘤
(B) Insulinoma 胰岛素瘤
(C) Pancreatic adenocarcinoma 胰腺癌
(D) Type 1 diabetes mellitus 1型糖尿病
(E) VIPoma
答案解析：
该患者有胰高血糖素瘤的症状，这是一种罕见的分泌胰高血糖素的肿瘤，可导致高血糖、腹泻和体重减轻。 这些患者出现的高血糖症对口服降糖药无反应，因为尽管胰岛素水平升高，胰高血糖素仍会不受控制地过量产生。 胰高血糖素瘤也与坏死性游走性红斑有关，这是一种皮疹，由疼痛、瘙痒的红斑丘疹组成，起泡、糜烂和结痂。
答案解析：A
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