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Intraoperative selective arterial calcium injection test to confirm complete resection of a proinsulinoma
Proinsulinoma is a subtype of insulinoma that is surgically curable, but localization can be difficult as these tumors are typically too small to be visualized by imaging. We report the case of a 53-year-old woman referred to our hospital with dizziness and headache. Her blood glucose level was 46 m...
Autores principales: | , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9341228/ https://www.ncbi.nlm.nih.gov/pubmed/35919694 http://dx.doi.org/10.1093/jscr/rjac249 |
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author | Sakamoto, Akimasa Ogawa, Kohei Iwata, Miku Ito, Chihiro Shine, Mikiya Matsui, Takashi Nishi, Yusuke Uraoka, Mio Utsunomiya, Takeshi Nagaoka, Tomoyuki Tamura, Kei Funamizu, Naotake Inoue, Hitoshi Sakamoto, Katsunori Kurata, Mie Takada, Yasutsugu |
author_facet | Sakamoto, Akimasa Ogawa, Kohei Iwata, Miku Ito, Chihiro Shine, Mikiya Matsui, Takashi Nishi, Yusuke Uraoka, Mio Utsunomiya, Takeshi Nagaoka, Tomoyuki Tamura, Kei Funamizu, Naotake Inoue, Hitoshi Sakamoto, Katsunori Kurata, Mie Takada, Yasutsugu |
author_sort | Sakamoto, Akimasa |
collection | PubMed |
description | Proinsulinoma is a subtype of insulinoma that is surgically curable, but localization can be difficult as these tumors are typically too small to be visualized by imaging. We report the case of a 53-year-old woman referred to our hospital with dizziness and headache. Her blood glucose level was 46 mg/dl and Whipple’s triad was present. Although her immunoreactive insulin level during hypoglycemia was in the normal range (5.0 μU/ml), the proinsulin level was elevated (408 pmol/l). Imaging examinations showed no evidence of pancreatic tumor. A preoperative selective arterial calcium injection (SACI) test showed excessive insulin secretion in the splenic artery region, which localized the proinsulinoma to the body or tail of the pancreas, and laparoscopic spleen-preserving distal pancreatectomy was performed. Intraoperative SACI test performed after tumor removal did not show excessive insulin secretion. The intraoperative SACI test appears to be useful for localization and for confirming complete resection of proinsulinoma. |
format | Online Article Text |
id | pubmed-9341228 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-93412282022-08-01 Intraoperative selective arterial calcium injection test to confirm complete resection of a proinsulinoma Sakamoto, Akimasa Ogawa, Kohei Iwata, Miku Ito, Chihiro Shine, Mikiya Matsui, Takashi Nishi, Yusuke Uraoka, Mio Utsunomiya, Takeshi Nagaoka, Tomoyuki Tamura, Kei Funamizu, Naotake Inoue, Hitoshi Sakamoto, Katsunori Kurata, Mie Takada, Yasutsugu J Surg Case Rep Case Report Proinsulinoma is a subtype of insulinoma that is surgically curable, but localization can be difficult as these tumors are typically too small to be visualized by imaging. We report the case of a 53-year-old woman referred to our hospital with dizziness and headache. Her blood glucose level was 46 mg/dl and Whipple’s triad was present. Although her immunoreactive insulin level during hypoglycemia was in the normal range (5.0 μU/ml), the proinsulin level was elevated (408 pmol/l). Imaging examinations showed no evidence of pancreatic tumor. A preoperative selective arterial calcium injection (SACI) test showed excessive insulin secretion in the splenic artery region, which localized the proinsulinoma to the body or tail of the pancreas, and laparoscopic spleen-preserving distal pancreatectomy was performed. Intraoperative SACI test performed after tumor removal did not show excessive insulin secretion. The intraoperative SACI test appears to be useful for localization and for confirming complete resection of proinsulinoma. Oxford University Press 2022-07-30 /pmc/articles/PMC9341228/ /pubmed/35919694 http://dx.doi.org/10.1093/jscr/rjac249 Text en Published by Oxford University Press and JSCR Publishing Ltd. All rights reserved. © The Author(s) 2022. https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Case Report Sakamoto, Akimasa Ogawa, Kohei Iwata, Miku Ito, Chihiro Shine, Mikiya Matsui, Takashi Nishi, Yusuke Uraoka, Mio Utsunomiya, Takeshi Nagaoka, Tomoyuki Tamura, Kei Funamizu, Naotake Inoue, Hitoshi Sakamoto, Katsunori Kurata, Mie Takada, Yasutsugu Intraoperative selective arterial calcium injection test to confirm complete resection of a proinsulinoma |
title | Intraoperative selective arterial calcium injection test to confirm complete resection of a proinsulinoma |
title_full | Intraoperative selective arterial calcium injection test to confirm complete resection of a proinsulinoma |
title_fullStr | Intraoperative selective arterial calcium injection test to confirm complete resection of a proinsulinoma |
title_full_unstemmed | Intraoperative selective arterial calcium injection test to confirm complete resection of a proinsulinoma |
title_short | Intraoperative selective arterial calcium injection test to confirm complete resection of a proinsulinoma |
title_sort | intraoperative selective arterial calcium injection test to confirm complete resection of a proinsulinoma |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9341228/ https://www.ncbi.nlm.nih.gov/pubmed/35919694 http://dx.doi.org/10.1093/jscr/rjac249 |
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