Multimodality preoperative imaging of pancreatic insulinomas

McAuley, G; Delaney, Holly; Colville, J.; Lyburn, Iain; Worsley, Daniel F.; Govender, Pradeep; Torreggiani, W C

doi:10.1016/j.crad.2005.06.005

Cited by 100 publications

(106 citation statements)

References 25 publications

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“…Use of CEUS shows promise but requires validation. Detection rate of US for pancreatic NET varies widely and ranges from 0%-66% [20] . EUS is a more invasive method of imaging assessment.…”

Section: Ultrasoundmentioning

confidence: 99%

“…Rösch et al [21] reported a sensitivity of 82% and a specificity of 95% for EUS in localizing pancreatic NET lesions. In a similar study by McAuley et al [20] on insulinomas, for lesions smaller than 2 cm in diameter, EUS carried a sensitivity of 80%-90%, leading the authors to recommend EUS as a screening tool for patients with a known diagnosis of multiple endocrine neoplasia (MEN) type 1.…”

Section: Ultrasoundmentioning

confidence: 99%

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Imaging of gastroenteropancreatic neuroendocrine tumors

Tan

Tan²

2011

WJCO

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Imaging of gastroenteropancreatic neuroendocrine tumors can be broadly divided into anatomic and functional techniques. Anatomic imaging determines the local extent of the primary lesion, providing crucial information required for surgical planning. Functional imaging, not only determines the extent of metastatic disease spread, but also provides important information with regard to the biologic behavior of the tumor, allowing clinicians to decide on the most appropriate forms of treatment. We review the current literature on this subject, with emphasis on the strengths of each imaging modality.

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“…Use of CEUS shows promise but requires validation. Detection rate of US for pancreatic NET varies widely and ranges from 0%-66% [20] . EUS is a more invasive method of imaging assessment.…”

Section: Ultrasoundmentioning

confidence: 99%

Section: Ultrasoundmentioning

confidence: 99%

Imaging of gastroenteropancreatic neuroendocrine tumors

Tan

Tan²

2011

WJCO

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“…The imaging characteristics and the enhanced calcium sensitivity of this patient's tumors were typical of insulinoma [5]. In contrast, some of her endocrinological features appeared unique.…”

Section: Case Reportmentioning

confidence: 73%

“…The incidence of insulinoma is very low; four cases per one million personyears [1]. Diagnosis of insulinoma requires confirmation of hypoglycemia, evidence of inappropriate insulin secretion, and identification of a pancreatic mass by medical imaging or angiography [2][3][4][5]. The intravenous secretin injection test is useful for the diagnosis of insulinoma because of its high specificity (100%) and high sensitivity (75%) [6][7][8].…”

mentioning

confidence: 99%

A Case of Secretin-responsive Insulinoma with Low Serum C-peptide Levels

et al. 2007

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Abstract. Insulinoma is the most common cause of fasting hypoglycemia resulting from autonomous insulin hypersecretion. A 59-year-old woman who had previously had an insulinoma and had undergone a partial pancreatectomy was admitted to our hospital because of recurrence of hypoglycemia after 27 years. She had two unusual endocrinological features: 1) the serum insulin response to intravenous secretin injection was not impaired, and 2) the serum C-peptide levels and ratios of serum C-peptide to insulin were relatively low. Two pancreatic tumors were readily detectable by computed tomography (CT) and magnetic resonance imaging (MRI). The selective arterial calcium injection (SACI) test showed a hyperinsulinemic response by calcium administration to the gastroduodenal artery. A partial pancreatectomy was done and her hypoglycemia disappeared. Histology revealed that the tumors were composed of monotonous, small round cells that were positive for both insulin and cathepsin B. As previous in vitro studies have shown that C-peptide can be metabolized within human insulinoma cells by proteolytic cleavage by cathepsin B, our patient's low serum C-peptide levels might have been caused by degradation of C-peptide by cathepsin B. According to the data from the literature, the molar ratio of serum C-peptide to insulin is generally decreased in patients with insulinoma than normal subjects. This case highlights the need for careful interpretation of C-peptide levels and the intravenous secretin injection test in the diagnosis of insulinoma.

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“…The critical diagnostic criterion is the detection of an inappropriately elevated plasma insulin level under conditions of hypoglycemia. The diagnosis of insulinoma requires confirmation of the presence of hypoglycemia, with evidence of inappropriate insulin secretion and the identification of a pancreatic mass on medical imaging or angiography (2)(3)(4)(5). Insulinomas are often benign, and surgical resection is curative in most patients (6).…”

Section: Discussionmentioning

confidence: 99%

Pancreatic Insulinoma Misdiagnosed as Epilepsy for Eight Years: A Case Report and Literature Review

Zhang

et al. 2015

Intern. Med.

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A 58-year-old Chinese man presented with intermittent seizure episodes after being misdiagnosed with epilepsy for eight years. MRI revealed an abnormally strong signal in the distal pancreas. The patient was subsequently diagnosed with pancreatic insulinoma based on the histological findings, and his symptoms improved following surgical removal of the tumor. The appearance of unusual manifestations of insulinoma makes it difficult to diagnose the condition. This disorder should be included in the differential diagnosis of epilepsy and mental illness.

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Multimodality preoperative imaging of pancreatic insulinomas

Cited by 100 publications

References 25 publications

Imaging of gastroenteropancreatic neuroendocrine tumors

Imaging of gastroenteropancreatic neuroendocrine tumors

A Case of Secretin-responsive Insulinoma with Low Serum C-peptide Levels

Pancreatic Insulinoma Misdiagnosed as Epilepsy for Eight Years: A Case Report and Literature Review

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