Successful preoperative localization of a small pancreatic insulinoma by diffusion-weighted MRI.
BACKGROUND
Insulinoma is the most common functioning endocrine tumor of the pancreas responsible for fasting hypoglycemia resulting from autonomous insulin hypersecretion. Most insulinomas are small and difficult to localize with conventional imaging. We successfully localized a small insulinoma in our patient using diffusion-weighted magnetic resonance imaging before surgery.


METHODS
We report the case of a female patient with a clinical suspicion of insulinoma. A preoperative MR with diffusion-weighted imaging was performed and localized a small nodule in the pancreatic tail. Treatment consisted of surgical enucleation. Histologic examination identified a neuroendocrine tumor compatible with an insulinoma.


CONCLUSIONS
Diffusion-weighted imaging can be useful in detecting and localizing small insulinomas, especially for those with no hypervascular pattern.
Anaye
Anass
A
Department of Medical Imaging, University Clinics of Brussels, Erasme Hospital, Brussels, Belgium. aanaye@ulb.ac.be
Mathieu
Anne
A
Closset
Jean
J
Bali
Maria Antonietta
MA
Metens
Thierry
T
Matos
Celso
C
D038524:Diffusion Magnetic Resonance Imaging; D005260:Female; D006801:Humans; D007340:Insulinoma / Q000000981:diagnostic imaging* / Q000601:surgery; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery; D011300:Preoperative Care / Q000379:methods; D011859:Radiography; D016896:Treatment Outcome