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Intraoperative gamma probe detection of insulinoma in an elderly patient with pancreatic cystic lesions.

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Rosière, Alain [UCL] Ernst, Yves J. [UCL] Roelants, Véronique [UCL] Vander Borght, Thierry [UCL] Michel, Luc [UCL] Donckier, Julian [UCL]

Insulinoma is a rare endocrine tumour in the elderly. We report the case of an 81-year-old woman suffering from grand mal seizures. Insulinoma was suspected because plasma glucose and insulin levels were 1.5 mmol/l and 80.4 pmol/l, respectively. A pancreatic computerized tomography (CT) scan, magnetic resonance imaging (MRI) and arteriography were normal but (111)In-DTPA-octreotide scintigraphy detected a hotspot in the pancreatic tail. Intraoperative pancreatic ultrasonography and palpation were non-contributory due to multiple pancreatic cysts and nodular lesions. However, a gamma-detecting probe localized a small tumour, labelled preoperatively with (111)In-DTPA-octreotide. Intraoperative insulin measurements in portal venous blood confirmed the successful removal of an insulinoma that was 6 mm in diameter histologically. Pancreatic cystic lesions increase with age and make the intraoperative localization of the insulinoma difficult. Intraoperative gamma probe detection of the tumour labelled with (111)In-DTPA-octreotide might therefore constitute a useful surgical tool.

Document type Article de périodique (Journal article) – Article de recherche
Access type Accès restreint
Publication date 2002
Journal information "Clinical Endocrinology" - Vol. 57, no. 4, p. 547-549 (2002)
Peer reviewed yes
Publisher Wiley-Blackwell Publishing Ltd. ((United Kingdom) Oxford)
issn 0300-0664
e-issn 1365-2265
Publication status Publié
Affiliations UCL - MD/MINT - Département de médecine interne
UCL - (MGD) Service de médecine nucléaire
UCL - (MGD) Service de chirurgie
UCL - (MGD) Service de médecine interne générale - endocrinologie
UCL - (SLuc) Service de médecine nucléaire
UCL - MD/CHIR - Département de chirurgie
MESH Subject Aged ; Aged, 80 and over ; Female ; Humans ; Indium Radioisotopes - diagnostic use ; Insulinoma - radionuclide imaging - surgery ; Intraoperative Period ; Octreotide - analogs & derivatives - diagnostic use ; Pancreatic Cyst - diagnosis ; Pancreatic Neoplasms - radionuclide imaging - surgery ; Pentetic Acid - analogs & derivatives - diagnostic use ; Radiopharmaceuticals - diagnostic use
Links
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Bibliographic reference Rosière, Alain ; Ernst, Yves J. ; Roelants, Véronique ; Vander Borght, Thierry ; Michel, Luc ; et. al. Intraoperative gamma probe detection of insulinoma in an elderly patient with pancreatic cystic lesions.. In: Clinical Endocrinology, Vol. 57, no. 4, p. 547-549 (2002)
Permanent URL http://hdl.handle.net/2078.1/9254