Concurrent insulinoma and pancreatic adenocarcinoma: report of a rare case and review of the literature.
Pancreatic adenocarcinoma is the 5th leading cause of cancer-related death in Western countries and insulinomas are rare endocrine neoplasms of the pancreas. The concurrent appearance of pancreatic adenocarcinoma and insulinoma is very rare and to the best of our knowledge has never been reported again. Herein, we present such an occurrence in a 74-year-old man. Resection of a mass in the uncinate process of the pancreas revealed pancreatic adenocarcinoma with severe desmoplastic reaction. Two years later, due to symptomatology persistence the patient was re-examined and a new 2 cm mass in the uncinate process was found leading to surgery, which demonstrated a 2 cm endocrine islet-cell tumor. Establishing a diagnosis in patients with insulinoma is difficult and the imaging studies still have low sensitivity and specificity except for intra-operative ultrasonography, which is the most accurate method detecting 90% of these lesions.
Department of Surgery, University of Athens, Aretaieion University Hospital, 76 Vas. Sofias Ave., Athens, Greece. p_athanasopoulos@yahoo.com
Panagiotis G
PG
Athanasopoulos
George
G
Polymeneas
Dionysios
D
Dellaportas
George
G
Mastorakos
Evi
E
Kairi
Dionysios
D
Voros
D000230:Adenocarcinoma / Q000473:pathology* / Q000601:surgery; D000368:Aged; D018273:Carcinoma, Islet Cell / Q000473:pathology* / Q000601:surgery; D006801:Humans; D007340:Insulinoma / Q000473:pathology* / Q000601:surgery; D008297:Male; D016609:Neoplasms, Second Primary; D010190:Pancreatic Neoplasms / Q000473:pathology* / Q000601:surgery; D014057:Tomography, X-Ray Computed
Semin Diagn Pathol. 2000 May;17(2):91-103
10839609
Mayo Clin Proc. 1991 Jul;66(7):711-9
1677058
Endocrinol Metab Clin North Am. 1999 Sep;28(3):533-54
10500930
Ann Intern Med. 1996 Jul 1;125(1):26-34
8644985
J Am Coll Surg. 1999 Oct;189(4):368-73
10509462
CA Cancer J Clin. 2005 Jan-Feb;55(1):10-30
15661684
World J Surg. 1998 Jun;22(6):593-7; discussion 597-8
9597934
Cancer Control. 2004 Jan-Feb;11(1):23-31
14749620
Baillieres Clin Gastroenterol. 1996 Dec;10(4):645-71
9113316
Int J Urol. 2007 Jan;14(1):73-4
17199864