Multifocal Insulinoma in Pancreas and Effect of Intraoperative Ultrasonography
Insulinoma is the most frequently seen functional pancreatic neuroendocrine tumor. The incidence of multifocal insulinoma is lower than 10%. Its treatment is direct or laparoscopic excision. The present case was examined with the findings of hypoglycemia and hypercalcemia, and as there was high insu...
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| Format: | Article |
| Language: | English |
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Wiley
2015-01-01
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| Series: | Case Reports in Surgery |
| Online Access: | http://dx.doi.org/10.1155/2015/375124 |
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| author | Ersin Borazan Alper Aytekin Latif Yilmaz Muhsin Elci Mehmet Salih Karaca Selim Kervancioglu Ahmet Abdulhalik Balik |
| author_facet | Ersin Borazan Alper Aytekin Latif Yilmaz Muhsin Elci Mehmet Salih Karaca Selim Kervancioglu Ahmet Abdulhalik Balik |
| author_sort | Ersin Borazan |
| collection | DOAJ |
| description | Insulinoma is the most frequently seen functional pancreatic neuroendocrine tumor. The incidence of multifocal insulinoma is lower than 10%. Its treatment is direct or laparoscopic excision. The present case was examined with the findings of hypoglycemia and hypercalcemia, and as there was high insulin and C-peptide levels the initial diagnosis was insulinoma. The case was investigated in terms of MEN 1. During preoperative screening for localization, there was one focus in the head of the pancreas in the abdominal tomography and two foci in endoscopic ultrasonography. No other focus was detected through intraoperative visual or manual palpation. However, five foci were detected during operation by intraoperative ultrasonography. The relation of masses with the main pancreatic canal was evaluated and they were excised by enucleation method. There was no recurrence during the postoperative 18-month follow-up of the patient. As a result, during treatment for insulinoma, it should be kept in mind that there might be multifocal foci. In all insulinomas, the whole pancreas should be evaluated with intraoperative ultrasonography because none of the current preoperative diagnostic methods are as sensitive as manual palpation of pancreas and intraoperative ultrasonography. The intraoperative detection of synchronous five foci in pancreas is quite a rare condition. |
| format | Article |
| id | doaj-art-30abdeb5a08c403299e129028ee6ea1e |
| institution | Kabale University |
| issn | 2090-6900 2090-6919 |
| language | English |
| publishDate | 2015-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Surgery |
| spelling | doaj-art-30abdeb5a08c403299e129028ee6ea1e2025-02-03T07:24:42ZengWileyCase Reports in Surgery2090-69002090-69192015-01-01201510.1155/2015/375124375124Multifocal Insulinoma in Pancreas and Effect of Intraoperative UltrasonographyErsin Borazan0Alper Aytekin1Latif Yilmaz2Muhsin Elci3Mehmet Salih Karaca4Selim Kervancioglu5Ahmet Abdulhalik Balik6Department of General Surgery, Gaziantep University, 27310 Gaziantep, TurkeyDepartment of General Surgery, Gaziantep University, 27310 Gaziantep, TurkeyDepartment of General Surgery, Gaziantep University, 27310 Gaziantep, TurkeyDepartment of General Surgery, Gaziantep University, 27310 Gaziantep, TurkeyDepartment of Radiology, Gaziantep University, 27310 Gaziantep, TurkeyDepartment of Radiology, Gaziantep University, 27310 Gaziantep, TurkeyDepartment of General Surgery, Gaziantep University, 27310 Gaziantep, TurkeyInsulinoma is the most frequently seen functional pancreatic neuroendocrine tumor. The incidence of multifocal insulinoma is lower than 10%. Its treatment is direct or laparoscopic excision. The present case was examined with the findings of hypoglycemia and hypercalcemia, and as there was high insulin and C-peptide levels the initial diagnosis was insulinoma. The case was investigated in terms of MEN 1. During preoperative screening for localization, there was one focus in the head of the pancreas in the abdominal tomography and two foci in endoscopic ultrasonography. No other focus was detected through intraoperative visual or manual palpation. However, five foci were detected during operation by intraoperative ultrasonography. The relation of masses with the main pancreatic canal was evaluated and they were excised by enucleation method. There was no recurrence during the postoperative 18-month follow-up of the patient. As a result, during treatment for insulinoma, it should be kept in mind that there might be multifocal foci. In all insulinomas, the whole pancreas should be evaluated with intraoperative ultrasonography because none of the current preoperative diagnostic methods are as sensitive as manual palpation of pancreas and intraoperative ultrasonography. The intraoperative detection of synchronous five foci in pancreas is quite a rare condition.http://dx.doi.org/10.1155/2015/375124 |
| spellingShingle | Ersin Borazan Alper Aytekin Latif Yilmaz Muhsin Elci Mehmet Salih Karaca Selim Kervancioglu Ahmet Abdulhalik Balik Multifocal Insulinoma in Pancreas and Effect of Intraoperative Ultrasonography Case Reports in Surgery |
| title | Multifocal Insulinoma in Pancreas and Effect of Intraoperative Ultrasonography |
| title_full | Multifocal Insulinoma in Pancreas and Effect of Intraoperative Ultrasonography |
| title_fullStr | Multifocal Insulinoma in Pancreas and Effect of Intraoperative Ultrasonography |
| title_full_unstemmed | Multifocal Insulinoma in Pancreas and Effect of Intraoperative Ultrasonography |
| title_short | Multifocal Insulinoma in Pancreas and Effect of Intraoperative Ultrasonography |
| title_sort | multifocal insulinoma in pancreas and effect of intraoperative ultrasonography |
| url | http://dx.doi.org/10.1155/2015/375124 |
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