2007 Volume 40 Issue 5 Pages 634-638
A 24-year-old man undergoing enucleation of an asymptomatic pancreatic endocrine tumor 4 years earlier and brought to the hospital with very low blood glucose (31mg/dl) was found in computed tomography to have six hypervascular tumors in the pancreatic tail, suggesting multiple insulinomas. Arterial stimulation venous sampling showed the dominant lesion for the endocrine tumors to be localized in the splenic artery. Under a diagnosis of multiple insulinomas of the pancreatic tail, we conducted spleen-preserving distal pancreatectomy. Immunohistochemical examination of pancreatic hormones indicated that almost all tumors were positive for insulin and negative for glucagons, but two other tumors were glucagons-positive and insulinnegative. He has remained well without recurrence or hypoglycemic attack for one year.
