The Kitakanto Medical Journal
Online ISSN : 1881-1191
Print ISSN : 1343-2826
ISSN-L : 1343-2826
CASE REPORTS
A Case of Insulinoma Incidentally Diagnosed after a Laparoscopic Cholecystectomy
Norifumi TakahashiToshihiro OoyaHiroshi MatsumotoKenichi TagoHisashi ShimizuYuki NumagaHiroshi IesatoTadahiro YokomoriIzumi Takeyoshi
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2011 Volume 61 Issue 1 Pages 63-68

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Abstract
A gallstone was found in a 69-year-old woman during an upper gastrointestinal tract imaging test in April 2008, and she consulted the Department of Gastroenterology at Ojiya General Hospital. Laparoscopic cholecystectomy was performed in May, and symptoms of a hypoglycemic attack were seen postoperatively. Therefore, she received a detailed examination. The Turner index was elevated at 535. Enhanced computed tomography (CT) showed a 0.5-cm hypervascular lesion in the pancreatic tail. An insulinoma was strongly suspected. Percutaneous transhepatic portal venous sampling (PTPVS) showed a rapid rise in insulin concentration in the splenic vein from a point 1/3 distal to a point 1/3 proximal. Dynamic CT showed a 1.5-cm hypervascular lesion in the pancreatic tail. Angiography and endoscopic retrograde pancreatography revealed no abnormalities. Enucleation of the tumor was performed in July. Pathological examination revealed an islet cell tumor (typical case). Immunohistochemical staining for insulin, glucagon, somatostatin, and synaptophysin was performed. Insulin and synaptophysin were positive. The patient has had no recurrence in the 28 months after surgery.
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© 2011 The Kitakanto Medical Society
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