1990 Volume 51 Issue 3 Pages 584-588
We report a case of insulinoma associated with early gastric cancer, together with reviwe of the literature.
In a 65-year-old man complaining of abnormal behavior at empty stomach, insulinoma was suspected because his conditions satisfied the three characteristics proposed by Whipple but no definite findings indicating insulinoma was shown by another examinations. Moreover, PTPC offered only a suspicion of insulinoma at the caput pancreatis, and imaging diagnostic methods failed to vivalize it. From these findings, a possibility of ectopic insulinoma was considered, and upper intestinal series revealed an early gastric cancer. On laparotomy, insulinoma was confirmed at the caput pancreatis by ultrasonography perioperatively. We did distal gastrectomy (R2) and enucleation of insulinoma. The gastric cancer had no lymphnode matastasis and was of early one retaining within the mucous membranes. Postoperative course was uneventful.
