title: EUS-guided alcohol ablation of an insulinoma.
abstract: BACKGROUND
  Surgical resection is currently considered to be the criterion standard for treatment of insulinomas. Alternative treatments, despite medication with diazoxide, are lacking. EUS-guided ethanol ablation of endocrine tumors has not been reported before.
  
  
  METHODS
  A 78-year-old woman was referred with typical symptoms of an insulinoma. Diagnosis was confirmed by laboratory findings, EUS, and EUS-guided FNA. Because of severe complications during several hypoglycemic episodes, a poor general condition, and strict refusal of surgical resection, the decision was made to ablate the insulinoma by EUS-guided alcohol injection. A total of 8 mL 95% ethanol was injected into the tumor.
  
  
  RESULTS
  The patient was discharged and exhibited no further hypoglycemic episodes, and her general condition improved rapidly. Based on clinical, morphologic, and biochemical criteria, we achieved a durable complete remission of the tumor.
  
  
  CONCLUSIONS
  EUS-guided ablation may become a minimally invasive alternative for patients with insulinomas in whom surgery is not feasible.
authors.affiliation: Department of Internal Medicine II, Klinikum Chemnitz, Flemmingstrasse 2, D-09116 Chemnitz, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Jürgensen
authors.forename: Detlef
authors.initials: D
authors.lastname: Schuppan
authors.forename: Frank
authors.initials: F
authors.lastname: Neser
authors.forename: Jan
authors.initials: J
authors.lastname: Ernstberger
authors.forename: Ulrich
authors.initials: U
authors.lastname: Junghans
authors.forename: Ulrich
authors.initials: U
authors.lastname: Stölzel
mesh_terms: D000368:Aged; D001786:Blood Glucose / Q000032:analysis; D019160:Endosonography; D000431:Ethanol / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D006946:Hyperinsulinism / Q000209:etiology; D007340:Insulinoma / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy*; D010190:Pancreatic Neoplasms / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy*
chemical_list: D001786:Blood Glucose; D000431:Ethanol