Utilidad de la arteriografía con inyección intraarterial selectiva de calcio en el diagnóstico del insulinoma

Palomares, Rafael; Zurera, L.J.; Gálvez, M. Ángeles; Tofé, Santiago; Canis, M.; Benito, P.

doi:10.1016/s0025-7753(02)73501-x

Cited by 5 publications

(4 citation statements)

References 10 publications

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“…In our study, the ASVS, evaluated as a functional and morphological technique, was the procedure that allowed the confirmation of pathological insulin production due to a pancreatic mass or islet hyperplasia as in nesidioblastosis. For all of this, according to our results and those published by other authors [ 1 , 2 , 5 , 11 , 13 , 16 , 20 ], we suggest the ASVS as the preoperative invasive test of choice when an insulinoma is suspected.…”

Section: Discussionsupporting

confidence: 79%

“…Previous studies have reported that conventional location techniques mainly detected tumors larger than 2 cm; intraoperative US and multislice CT progressively demonstrate increased sensitivity to detect the existence of an insulinoma [ 2 , 5 , 13 , 23 ]. The EUS is the procedure of choice recommended for some authors [ 23 ]; it allows diagnosis of 84–100% tumors located in the head or body of the pancreas, but this technique has a decreased sensitivity in lesions located in the tail of pancreas (60%) [ 7 ].…”

Section: Discussionmentioning

confidence: 99%

“…Diagnosis and treatment of these tumors are curative in most cases; preoperative localization improves the chance of cure and reduces the likelihood of complications [ 5 , 6 ]. Erroneous preoperative localization of insulinoma is estimated at 75% of cases depending on the diagnosis method [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

“…Erroneous preoperative localization of insulinoma is estimated at 75% of cases depending on the diagnosis method [ 7 ]. Preoperative localization methods include transabdominal ultrasonography (US), computed tomography (CT), magnetic resonance imaging (MRI) [ 8 ], endoscopic ultrasonography (EUS) [ 9 , 10 ], and intra-arterial calcium stimulation test with hepatic venous sampling (ASVS) [ 2 , 5 , 11 ]. Noninvasive techniques globally allow the localization of less than 80% of insulinomas.…”

Section: Introductionmentioning

confidence: 99%

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Arterial Calcium Stimulation with Hepatic Venous Sampling in the Localization Diagnosis of Endogenous Hyperinsulinism

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Alhambra-Expósito

Herrera‐Martínez

et al. 2016

International Journal of Endocrinology

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Objective. The aim of this study was to assess the utility of arterial calcium stimulation with hepatic venous sampling (ASVS) in the localization diagnosis of endogenous hyperinsulinism. Patients and Methods. A retrospective descriptive study was performed including patients with endogenous hyperinsulinism who underwent ASVS. The histopathological diagnosis in patients who underwent a surgical procedure was used as the reference for the statistical study of the accuracy of this technique. Results. 30 patients were included with endogenous hyperinsulinism and nonconclusive imaging diagnosis was included. ASVS was performed in all cases. Surgery was performed in 20 cases. Insulinoma was removed in 19 patients; the location of all cases was detected in the ASVS. All cases of endogenous hyperinsulinism had a positive result for the ASVS, with this association being statistically significant (χ 2 = 15.771; p < 0.001). A good and statistically significant agreement was obtained between histopathologic diagnosis and ASVS results (K = 0.518, p < 0.001). Conclusions. ASVS is a useful procedure in the localization diagnosis of endogenous hyperinsulinism undetected by other imaging tests. This technique allows the localization of intrapancreatic insulinomas and represents useful tool for the diagnosis and surgical management of these tumors.

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Section: Discussionsupporting

confidence: 79%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Arterial Calcium Stimulation with Hepatic Venous Sampling in the Localization Diagnosis of Endogenous Hyperinsulinism

Moreno-Moreno

Alhambra-Expósito

Herrera‐Martínez

et al. 2016

International Journal of Endocrinology

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Intraoperative gamma probe detection of lymph node recurrence of insulinoma

et al. 2005

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Insulinomas are rare endocrine tumors that are mostly sporadic, benign, and small. Preoperative radiography diagnosis may be difficult. Intraoperative palpation and ultrasound remain the gold standard for detection and planned resection. Recent studies find intraoperative gamma-probe localization as a good technique for identifying primary neuroendocrine tumors. We report a case of a 75-year-old woman with functioning lymph node recurrence of a malignant insulinoma. Spleno-pancreatectomy was performed in order to treat the malignant insulinoma. Clinical, biochemical, and radiological examination confirmed the total excision of the primary lesion. However, clinical symptoms appeared 9 months later. Octreo-scan, abdominal CT, and biochemical study showed lymph node recurrence and four hepatic metastases. Surgery was performed after two [111In-DTPA] octreotide scans. Intraoperative gamma probe detection was planned in order to localize a small latero-aortic lymph node recurrence. Intraoperative count rates were high in para-aortic tissue. Para-aortic lymphadenectomy and metastasectomy were carried out. Ex-situ count rates and histological examination confirmed the recurrence. Six months later clinical and biochemical studies and scans remain negative for recurrence. Intraoperative [111In-DTPA] octreotide gamma probe examination may be a useful tool in the surgical approach to insulinoma recurrence.

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Valoración de la utilidad del test de estimulación intraarterial con calcio en el diagnóstico de localización del hiperinsulinismo endógeno

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Alcántara

Muñoz-Villanueva

et al. 2010

Endocrinología y Nutrición

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Utilidad de la arteriografía con inyección intraarterial selectiva de calcio en el diagnóstico del insulinoma

Cited by 5 publications

References 10 publications

Arterial Calcium Stimulation with Hepatic Venous Sampling in the Localization Diagnosis of Endogenous Hyperinsulinism

Arterial Calcium Stimulation with Hepatic Venous Sampling in the Localization Diagnosis of Endogenous Hyperinsulinism

Intraoperative gamma probe detection of lymph node recurrence of insulinoma

Valoración de la utilidad del test de estimulación intraarterial con calcio en el diagnóstico de localización del hiperinsulinismo endógeno

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