Endoscopic ultrasound-guided fine-needle aspiration biopsy (EUS-FNA) in insulinomas: Indications and clinical relevance in a single investigator cohort of 47 patients

Kann, Peter Herbert; Moll, Roland; Bartsch, Detlef K.; Pfützner, A; Forst, Thomas; Tamagno, Gianluca; Goebel, Joachim; Fourkiotis, Verena; Bergmann, Simona; Collienne, Maike

doi:10.1007/s12020-016-1179-z

Cited by 15 publications

(9 citation statements)

References 24 publications

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“…EUS is reported to have excellent sensitivity (85-95%) (8,9). In the study of Kann et al, 10 insulinoma patients underwent FNAB with EUS and the diagnostic accuracy of FNAB was observed to be 70% (10). In the present case, after localization of the lesion with EUS, insulin wash-out from FNAB was performed at the same session.…”

Section: Discussionmentioning

confidence: 49%

Insulin Washout in Fine-Needle Aspiration Fluid for Preoperative Diagnosis of Suspicious Lesion in Patients with Insulinoma: A Case Report

Kocabaş¹,

Karaköse²,

Can³

et al. 2019

Turk J Endocrinol Metab

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Section: Discussionmentioning

confidence: 49%

Insulin Washout in Fine-Needle Aspiration Fluid for Preoperative Diagnosis of Suspicious Lesion in Patients with Insulinoma: A Case Report

Kocabaş¹,

Karaköse²,

Can³

et al. 2019

Turk J Endocrinol Metab

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“…On EUS, they are quite characteristic, with most tumors homogeneously hypoechoic (rarely isoechoic), rounded in shape, and with distinct margins. [ 11 ] Tissue sampling by EUS-guided fine needle aspiration biopsy (FNA) establishes a definitive diagnosis pre-operatively but required only in inconclusive cases,[ 12 ] unlike our case. PET-CT imaging with Ga68-DOTANOC/DOTATATE, molecules having a high affinity to somatostatin receptors, can localize most of the tumors missed on anatomic imaging[ 13 ] and to detect metastasis.…”

Section: Discussionmentioning

confidence: 99%

Unusual presentation of an insulinoma in an elderly male patient

Adarsh

Salman

Kumar

et al. 2021

Journal of Postgraduate Medicine

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Insulinoma is a rare neuroendocrine tumor originating from hypersecreting beta-cells of islets of Langerhans in the pancreas. We report a case of 72-year-old male, with chronic alcohol abuse, presenting with atypical features like refractory recurrent secondary generalized seizures and behavioral disturbances with increased irritability, initially mistreated as alcohol withdrawal. Detailed history, particularly the relationship of the symptoms with food intake, made us think of other causes of seizures. Fasting biochemical investigations and localizing studies helped clinch the diagnosis. The tumor was localized with the help of endoscopic ultrasonography and whole-body Ga68-DOTANOC PET-CT. The patient was treated conservatively with diazoxide and is doing well on follow-up. The present case report emphasizes the importance of detailed clinical history, more so in atypically presenting cases of refractory seizures. Insulinoma can be medically managed despite surgery being the gold standard curative treatment.

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“…EUS is one of the most accurate diagnostic techniques and provides additional information on lymph nodes, the possibility of a biopsy or fine-needle aspiration and a sensitivity of 94%. [1][2][3]49 It is limited by operatordependent quality, its invasiveness and a reduced visualization of the pancreatic tail. 50 27.8% of the reported women received an EUS with a false-negative rate of 20.0% (Table 1).…”

Section: Imaging and Localizationmentioning

confidence: 99%

Insulinoma in pregnancy (a case presentation and systematic review of the literature)

et al. 2021

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Insulinomas are rare, benign and functional tumors that coincidentally may become overt during pregnancy or in the post-partum period. As the general symptoms of a pregnancy might cover the clinical presentation, diagnosing remains challenging. We present one additional case of a post-partum insulinoma, combined with a systematic review of the literature to sum up relevant details in diagnosis and treatment. A systematic request of Pubmed/Medline was conducted using the following terms: “insulinoma AND pregnancy” and “insulinoma” for a second request of ClinicalTrials.gov. All publications concerning pregnant or post-partum women with insulinoma were included. Thirty-six cases could be identified for analysis. Each publication was reviewed for demographic, diagnostic and therapeutic data. The most frequent clinical signs were unconsciousness and neurological symptoms. 64.9% were diagnosed during early pregnancy and 35.1% post-partum. 91.9% underwent surgery with a third resected during pregnancy without severe influence on fetal or maternal outcome. Three patients died of metastatic disease or misdiagnosing, two of them miscarried. Insulinoma in pregnancy is rare but should be considered in case of unclear hyperinsulinemic hypoglycemia. Surgery can be performed during the second trimester or post-partum with promising outcome.

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Endoscopic ultrasound-guided fine-needle aspiration biopsy (EUS-FNA) in insulinomas: Indications and clinical relevance in a single investigator cohort of 47 patients

Cited by 15 publications

References 24 publications

Insulin Washout in Fine-Needle Aspiration Fluid for Preoperative Diagnosis of Suspicious Lesion in Patients with Insulinoma: A Case Report

Insulin Washout in Fine-Needle Aspiration Fluid for Preoperative Diagnosis of Suspicious Lesion in Patients with Insulinoma: A Case Report

Unusual presentation of an insulinoma in an elderly male patient

Insulinoma in pregnancy (a case presentation and systematic review of the literature)

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