[Usefullness of scintigraphy with somatostatin analogues in the imaging of insulinoma of the pancreas].
We present a case of a 74-years-old female with insulinoma of the pancreas. Neuroglycopenic symptoms (Whipple's triad) and a positive fast test established the diagnosis. The fast was terminated after 5 hours and 40 minutes because of neuroglycopenic symptoms with the serum glucose and insulin levels of 40 mg/dl and 34,01 microU/ml respectively. The tumor was invisible in ultrasound, abdominal CT scan and MRL The only means that enabled preoperative visualization was 111-Indium labeled octreotide scintigraphy (OctreoScan). Laparotomy was performed, and a tumor was disclosed in intraoperative ultrasonography within the head of the pancreas. The tumor of 37 mm diameter was excised. Histopatological examination revealed benign insulinoma. After surgery the symptoms alleviated completely. The patient with proper glucose levels and insulin concentration of 3,04 microU/ml was discharged in good health. This case confirms high usefulness of preoperative OctreoScan and intraoperative ultrasonography in the approach to a patient with insulinoma.
Owecki
Maciej
M
Akademia Medyczna w Poznaniu, Katedra i Klinika Endokrynologii, Przemiany Materii i Chorób Wewnetrznych. mowecki@amp.edu.pl
Czepczyriński
Rafał
R
Biczysko
Maciej
M
Stawny
Bolesław
B
Drews
Michał
M
Sowiński
Jerzy
J
D000368:Aged; D005260:Female; D006801:Humans; D007205:Indium Radioisotopes; D007340:Insulinoma / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000601:surgery; D008279:Magnetic Resonance Imaging; D016343:Monitoring, Intraoperative; D010190:Pancreatic Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000601:surgery; D011877:Radionuclide Imaging; D013004:Somatostatin / Q000031:analogs & derivatives*; D014057:Tomography, X-Ray Computed
D007205:Indium Radioisotopes; D013004:Somatostatin; C081788:pentetreotide