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Updated: Aug 13, 2026

Robotic Enucleation of an Intra-Pancreatic Insulinoma in the Pancreatic Head
Published on: January 3, 2020
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
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.
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