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Occult Abdominal Para-Aortic Ectopic Insulinoma Localized by 18F-NOTA-Exendin-4 PET/CT
Yan Wan1, Hao Wang2, Lijuan Feng2
1Department of Nuclear Medicine, Jiujiang City Key Laboratory of Cell Therapy, JiuJiang NO. 1 People's Hospital, Jiujiang, Jiangxi, China.
Abstract:
Solitary ectopic insulinomas without concurrent pancreatic or gastrointestinal lesions are exceedingly rare. We report the 18F-NOTA-exendin-4 PET/CT findings of a solitary ectopic insulinoma in a 68-year-old woman with a 10-year history of recurrent hypoglycemic syncope. Endogenous hyperinsulinemia was confirmed, but conventional imaging and laparoscopic pancreatic exploration were negative. PET/CT revealed a solitary intense focus in the para-abdominal aortic region. Surgical resection confirmed a solitary ectopic insulinoma, and postoperative hypoglycemia resolved. This case highlights the value of 18F-NOTA-exendin-4 PET/CT in identifying occult solitary ectopic insulinomas when conventional imaging and surgical exploration are unrevealing, enabling curative resection.
