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Malignant insulinoma in ectopic pancreatic tissue
Joakim Hennings1, Ultike Garske, Johan Botling
1Department of Surgery, Uppsala University Hospital, Uppsala, Sweden. joakim.hennings@surgsci.uu.se
Digestive Surgery
|January 25, 2006
Summary
This case study details a rare malignant insulinoma found in ectopic pancreatic tissue, presenting with hypoglycemic symptoms. Radio-guided surgery successfully removed the tumor, highlighting advanced diagnostic and surgical techniques for rare endocrine neoplasms.
Area of Science:
- Endocrinology
- Surgical Oncology
- Diagnostic Imaging
Background:
- Ectopic pancreatic tissue is rare, and malignant insulinomas are even rarer.
- The co-occurrence of these conditions presents a diagnostic and therapeutic challenge.
Observation:
- A patient presented with symptoms of hypoglycemia, elevated insulin levels, and a positive fasting test.
- Ultrasound and somatostatin receptor scintigraphy using (111)I-labelled octreotide localized an extrapancreatic mass.
Findings:
- Radio-guided surgery successfully extirpated a tumor adjacent to the ligament of Treitz.
- Histopathology confirmed the tumor as a malignant insulinoma.
- The patient's follow-up was uneventful, with close surveillance ongoing.
Implications:
- This case highlights the utility of somatostatin receptor scintigraphy in localizing rare tumors.
- Radio-guided surgery offers a precise method for resecting such lesions.
- Early and accurate diagnosis is crucial for managing malignant insulinomas in ectopic pancreatic tissue.