Use of intraoperative insulin assay for the localisation of insulinoma.
BACKGROUND
The curative treatment for patients with insulinoma is the surgical removal of the tumour; however, these tumours are small and therefore their preoperative localisation using ultrasound and CT scans may be difficult.


METHODS
Intraoperative serum insulin measurements were used as an aid to the surgical management of seven unselected and consecutive presentations of insulinoma.


RESULTS
In six of the seven cases we were able to demonstrate an increase in the peripheral serum insulin concentration between 3 and 5 min after manual examination of the tumour. In addition, there was a 50% decrease in concentration 10 min after removal of the tumour.


CONCLUSIONS
We believe that intraoperative insulin measurements are of use in demonstrating the functionality of tumours localised by intraoperative ultrasound and surgical examination. In addition, they act as an indicator of the completeness of surgery post tumour excision.
Scott-Coombes
David
D
Department of Surgery, University Hospital of Wales, Heath Park, Cardiff CF14 4XW, Wales. scott.coombes@cardiffandvale.wales.nhs.uk
Eatock
Fiona
F
Henley
Robert
R
Luzio
Stephen D
SD
D014408:Biomarkers, Tumor / Q000097:blood*; D006801:Humans; D007328:Insulin / Q000097:blood*; D007340:Insulinoma / Q000097:blood / Q000175:diagnosis / Q000601:surgery*; D007430:Intraoperative Care / Q000379:methods*; D010173:Palpation; D010190:Pancreatic Neoplasms / Q000097:blood / Q000175:diagnosis / Q000601:surgery*
D014408:Biomarkers, Tumor; D007328:Insulin