BACKGROUND: Both ectopic pancreatic tissue and malignant insulinoma are rare. We encountered the combination of these rare entities in a patient demonstrating hypoglycemic symptoms. METHOD: A patient with episodic hypoglycemia, non-suppressed serum insulin levels, positive fasting test and a positive localization on both ultrasound and somatostatin receptor scintigraphy by (111)I-labelled octreotide, was operated and investigated. RESULTS: (111)I-labelled octreotide-guided surgery was performed and a tumor adjacent to the ligament of Treitz was extirpated. Follow-up was uneventful. Histopathology revealed a malignant insulinoma. The patient is currently under close surveillance. CONCLUSION: The rare combination of an insulinoma in ectopic pancreatic tissue, where the usual diagnostic endoscopic ultrasound revealed an extrapancreatic mass, is described. This was followed by a positive somatostatin receptor scintigraphy, enabling both radio-guided surgery and future treatment of developing recurrent disease or metastases. Copyright (c) 2005 S. Karger AG, Basel.
BACKGROUND: Both ectopic pancreatic tissue and malignant insulinoma are rare. We encountered the combination of these rare entities in a patient demonstrating hypoglycemic symptoms. METHOD: A patient with episodic hypoglycemia, non-suppressed serum insulin levels, positive fasting test and a positive localization on both ultrasound and somatostatin receptor scintigraphy by (111)I-labelled octreotide, was operated and investigated. RESULTS: (111)I-labelled octreotide-guided surgery was performed and a tumor adjacent to the ligament of Treitz was extirpated. Follow-up was uneventful. Histopathology revealed a malignant insulinoma. The patient is currently under close surveillance. CONCLUSION: The rare combination of an insulinoma in ectopic pancreatic tissue, where the usual diagnostic endoscopic ultrasound revealed an extrapancreatic mass, is described. This was followed by a positive somatostatin receptor scintigraphy, enabling both radio-guided surgery and future treatment of developing recurrent disease or metastases. Copyright (c) 2005 S. Karger AG, Basel.
Authors: Irina M Cazacu; Adriana Alexandra Luzuriaga Chavez; Graciela M Nogueras Gonzalez; Adrian Saftoiu; Manoop S Bhutani Journal: Dig Dis Sci Date: 2018-11-10 Impact factor: 3.199
Authors: Alexander Betzler; Soeren T Mees; Josefine Pump; Sebastian Schölch; Carolin Zimmermann; Daniela E Aust; Jürgen Weitz; Thilo Welsch; Marius Distler Journal: BMC Surg Date: 2017-05-08 Impact factor: 2.102