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Related Experiment Videos

Occult functioning insulinomas: which localizing studies are indicated?

J A van Heerden1, C S Grant, P F Czako

  • 1Department of Surgery, Mayo Clinic, Rochester, Minn. 55905.

Surgery
|December 1, 1992
PubMed
Summary
This summary is machine-generated.

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Occult insulinomas, tumors with unknown locations, can be successfully managed surgically. Extensive preoperative imaging is not cost-effective for these rare pancreatic neuroendocrine tumors.

Area of Science:

  • Endocrinology
  • Surgical Oncology
  • Gastroenterology

Background:

  • Occult insulinoma is a biochemically confirmed tumor with an indeterminate surgical site.
  • The utility of preoperative radiologic localization for these tumors is debated.

Purpose of the Study:

  • To evaluate the efficacy of surgical management for occult insulinomas.
  • To determine the necessity of extensive preoperative radiologic investigations.

Main Methods:

  • Retrospective review of 65 patients with sporadic insulinomas treated surgically from 1980-1990.
  • Analysis of preoperative localization studies and intraoperative ultrasonography findings.
  • Assessment of surgical outcomes for benign and malignant insulinomas.

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Main Results:

  • Twenty patients (31%) had true occult insulinomas.
  • Nineteen patients with benign insulinomas underwent successful surgical removal (enucleation or distal pancreatectomy).
  • One patient had malignant insulinoma with liver metastases.

Conclusions:

  • High surgical success rates for occult insulinomas suggest extensive preoperative imaging is not indicated.
  • Surgical exploration combined with intraoperative ultrasonography is effective for locating and removing these tumors.
  • Avoiding unnecessary preoperative radiology improves cost-effectiveness in managing occult insulinomas.