title: [Endoscopic ultrasound-guided ethanol ablation: an alternative option for the treatment of pancreatic insulinoma].
abstract: Endoscopic ultrasound is the most accurate imaging modality for the diagnosis of pancreatic cancer, and endoscopic ultrasound-guided fine needle injection has already been used for palliative interventions. Surgical resection is currently the standard treatment for pancreatic insulinoma. Medical treatment may be necessary for symptomatic patients with unresectable disease. Case reports have been published about the success of endoscopic ultrasound-guided alcoholic ablation, but it has not been reported previously in Hungarian literature. The authors present the history of an 83-year-old woman who was evaluated because of repeated hypoglycemic coma occurring during the night. Endosonographic image and laboratory findings (elevated serum insulin and chromogranin A) revealed pancreatic insulinoma. Because of severe comorbidities and high risk of surgical resection, the decision was made to ablate the insulinoma by endoscopic ultrasound-guided alcohol injection. A total of 3 mL 95% ethanol was injected into the tumor. Despite the discontinuation of the diazoxide therapy the hypoglycemic episodes disappeared. This case history confirms that endoscopic ultrasound-guided alcoholic ablation is a novel, minimal invasive alternative treatment for patients with pancreatic neuroendocrine tumors in whom surgery is not feasible.
authors.affiliation: Szegedi Tudományegyetem, Általános Orvostudományi Kar I. Belgyógyászati Klinika Szeged Korányi fasor 8-10. 6720.
authors.forename: Renáta
authors.initials: R
authors.lastname: Bor
authors.affiliation: Szegedi Tudományegyetem, Általános Orvostudományi Kar I. Belgyógyászati Klinika Szeged Korányi fasor 8-10. 6720.
authors.forename: Klaudia
authors.initials: K
authors.lastname: Farkas
authors.affiliation: Szegedi Tudományegyetem, Általános Orvostudományi Kar I. Belgyógyászati Klinika Szeged Korányi fasor 8-10. 6720.
authors.forename: Anita
authors.initials: A
authors.lastname: Bálint
authors.affiliation: Szegedi Tudományegyetem, Általános Orvostudományi Kar I. Belgyógyászati Klinika Szeged Korányi fasor 8-10. 6720.
authors.forename: Tamás
authors.initials: T
authors.lastname: Molnár
authors.affiliation: Szegedi Tudományegyetem, Általános Orvostudományi Kar I. Belgyógyászati Klinika Szeged Korányi fasor 8-10. 6720.
authors.forename: Ferenc
authors.initials: F
authors.lastname: Nagy
authors.affiliation: Szegedi Tudományegyetem, Általános Orvostudományi Kar I. Belgyógyászati Klinika Szeged Korányi fasor 8-10. 6720.
authors.forename: Zsuzsanna
authors.initials: Z
authors.lastname: Valkusz
authors.affiliation: Szegedi Tudományegyetem, Általános Orvostudományi Kar I. Belgyógyászati Klinika Szeged Korányi fasor 8-10. 6720.
authors.forename: Krisztián
authors.initials: K
authors.lastname: Sepp
authors.affiliation: Szegedi Tudományegyetem, Általános Orvostudományi Kar Patológiai Intézet Szeged.
authors.forename: László
authors.initials: L
authors.lastname: Tiszlavicz
authors.affiliation: Szegedi Tudományegyetem, Általános Orvostudományi Kar Patológiai Intézet Szeged.
authors.forename: Sándor
authors.initials: S
authors.lastname: Hamar
authors.affiliation: Szegedi Tudományegyetem, Általános Orvostudományi Kar I. Belgyógyászati Klinika Szeged Korányi fasor 8-10. 6720.
authors.forename: Zoltán
authors.initials: Z
authors.lastname: Szepes
mesh_terms: D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D016461:Chemoembolization, Therapeutic / Q000379:methods*; D003128:Coma / Q000209:etiology; D019160:Endosonography; D000431:Ethanol / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007003:Hypoglycemia / Q000150:complications / Q000209:etiology; D007267:Injections; D007340:Insulinoma / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D010190:Pancreatic Neoplasms / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D000431:Ethanol
keywords: EUS; EUS-FNI; alcoholic ablation; alkoholos ablatio; endoscopic ultrasound; endoszkópos ultrahang; insulinoma; neuroendocrine tumor; neuroendokrin tumor; pancreas cancer; pancreastumor