Laparoscopic Distal Pancreatectomy for an ACTH Secreting Pancreatic Neuroendocrine Tumor

2015 ◽  
Vol 2 (4) ◽  
Author(s):  
Camille L. Stewart ◽  
Christopher Raeburn ◽  
Barish H. Edil
Keyword(s):  
Neuroendocrine Tumor ◽  
Distal Pancreatectomy ◽  
Pancreatic Neuroendocrine Tumor ◽  
Laparoscopic Distal Pancreatectomy ◽  
Acth Secreting

scholarly journals A Case Report: Insulinoma in a Military Pilot Detected by 68Ga-Dotatate PET/CT

2020 ◽  
Vol 185 (9-10) ◽  
pp. e1887-e1890
Author(s):  
Lisa D Larose ◽  
Penny J Vroman ◽  
Sierra R Musick ◽  
Alexis A Beauvais
Keyword(s):  
Neuroendocrine Tumor ◽  
Air Force ◽  
Imaging Modality ◽  
Pancreatic Neuroendocrine Tumor ◽  
Altered Mental Status ◽  
Laparoscopic Distal Pancreatectomy ◽  
Nuclear Medicine Imaging ◽  
Pancreatic Lesion ◽  
Pet Ct ◽  
Initial Imaging

Abstract A 37-year-old active duty male Air Force instructor pilot, with no prior medical history, was found unresponsive at his home after awakening with symptoms of altered mental status when the Emergency Medical Service (EMS) was called. The patient was found to be hypoglycemic with a glucose of 37 mg/dL. The patient recovered after administration of a dextrose bolus. Further investigation revealed that over the last several years, the patient exhibited symptoms of lightheadedness and tremors if fasted greater than 3 hours. Further clinical workup strongly suggested the presence of a neuroendocrine tumor. Initial imaging studies to include a multiphasic dedicated pancreatic computed tomography (CT) scan did not demonstrate a pancreatic lesion. However, the utilization of an innovative new nuclear medicine imaging modality, a 68Ga-Dotatate PET/CT, clearly demonstrated a 19 × 16 mm lesion of the distal pancreatic tail, which guided surgical resection. He underwent a robotic-assisted laparoscopic distal pancreatectomy, pathologically characterized as an insulinoma. The patient’s symptoms immediately resolved with no recurrence over the next 6 months. The pilot was granted a waiver, returning him to his flying duties. The 68Ga-Dotatate PET/CT enabled the identification of an otherwise occult pancreatic neuroendocrine tumor ultimately leading to this patient’s definitive cure and the salvage of this military asset’s aviation career.

scholarly journals Laparoscopic distal pancreatectomy in 16 years girl with insulinoma

2017 ◽  
Vol 10 (3) ◽  
pp. 26-32
Author(s):  
Yury Y. Sokolov ◽  
Mariya A. Melikyan ◽  
Sergey A. Karpachev ◽  
Vladimir R. Druzhinin ◽  
Ekaterina A. Tashirova ◽  
...  
Keyword(s):  
Distal Pancreatectomy ◽  
Molecular Genetic ◽  
Multislice Ct ◽  
Pancreatic Neuroendocrine Tumor ◽  
Laparoscopic Distal Pancreatectomy ◽  
Molecular Genetic Analysis ◽  
Tumor Removal ◽  
Contrast Enhanced ◽  
Immunohistochemical Studies ◽  
Radiological Methods

We present a clinical case of insulinoma in 16 years-old girl. The patient complained about episodes of loss of consciousness, followed by retrograde amnesia and accompanied by weakness and dizziness. The patient was transferred to the Department of Endocrinology, where hypoglycemia was detected (2.0-2.5 mmol/l). Topical diagnosis of insulinoma was evidentiated with the help of radiological methods - multislice CT and contrast-enhanced MRI, which revealed an oval tumor 12x10 mm. The molecular genetic analysis of MEN1 gene was performed – no mutations were revealed. Prescribed Proglikem (diazoxide) therapy (100 mg / day) on pre-operative period was effective, patient`s glycemia values stabilized. Further the laparoscopic distal pancreatectomy with tumor removal was performed. After the surgery we achieved stable euglycemia. On microscopic and immunohistochemical studies pancreatic neuroendocrine tumor G1 was confirmed. The discussion presents data on the epidemiology, diagnosis and surgical treatment of insulinomas in children and adults.

scholarly journals Laparoscopic distal pancreatectomy for intrapancreatic accessory spleen: Case report

2015 ◽  
Vol 143 (3-4) ◽  
pp. 195-198 ◽  
Author(s):  
Slavko Matic ◽  
Djordje Knezevic ◽  
Igor Ignjatovic ◽  
Nikola Grubor ◽  
Vladimir Dugalic ◽  
...  
Keyword(s):  
Neuroendocrine Tumor ◽  
Distal Pancreatectomy ◽  
Histopathological Examination ◽  
Preoperative Evaluation ◽  
Accessory Spleen ◽  
Laparoscopic Distal Pancreatectomy ◽  
Pancreatic Tissue ◽  
Intrapancreatic Accessory Spleen ◽  
Pancreatic Tail ◽  
Spleen Preserving

Introduction. Accessory spleens can be found in up to 10% of the population, and their intrapancreatic occurrence is considered uncommon. When present, the intrapancreatic accessory spleen is usually found in the tail of the pancreas in about 1.7% of adult individuals. The infrequent presence of the accessory spleen in the pancreatic tissue could lead to inappropriate diagnosis and hence therapeutic approach, as they are commonly presented as a hypervascular node in the tail of the pancreas on abdominal CT and MRI, mimicking a well differentiated tumor of the pancreas or non-functioning pancreatic neuroendocrine tumor. Case Outline. We present a 70-year-old female in whom a preoperative evaluation finding was highly suggestive of a non-functioning neuroendocrine tumor of the pancreatic tail. We performed spleen preserving laparoscopic distal pancreatectomy, and histopathological examination revealed the intrapancreatic accessory spleen. Conclusion. Although infrequent, the presence of the intrapancreatic accessory spleen must be considered in the differential diagnosis of pancreatic tail tumors.

scholarly journals PROINSULIN-PREDOMINANT PANCREATIC NEUROENDOCRINE TUMOR-INDUCED HYPOGLYCEMIA AFTER ROUX-EN-Y GASTRIC BYPASS SURGERY

2019 ◽  
Vol 5 (6) ◽  
pp. e339-e343
Author(s):  
Khary Edwards ◽  
Lori de La Portilla ◽  
Faryal S. Mirza ◽  
Pooja Luthra
Keyword(s):  
Gastric Bypass ◽  
Differential Diagnosis ◽  
Case Report ◽  
Neuroendocrine Tumor ◽  
Distal Pancreatectomy ◽  
Bypass Surgery ◽  
Gastric Bypass Surgery ◽  
Pancreatic Neuroendocrine Tumor ◽  
Pertinent Literature ◽  
Recurrent Hypoglycemia

Objective: To present a case of recurrent hypoglycemia following Roux-en-Y gastric bypass (RYGB) surgery whose etiology was determined to be a proinsulin-predominant pancreatic neuroendocrine tumor (a proinsulinoma). Methods: A case report along with a brief discussion and review of the pertinent literature is presented. Results: The patient is a 62-year-old female who presented with symptomatic hypoglycemia 11 years after RYGB surgery. Initial workup revealed low insulin levels with elevated proinsulin levels. A 72-hour fast confirmed the presence of proinsulin-induced hypoglycemia secondary to a pancreatic neuroendocrine tumor (PNET). She underwent distal pancreatectomy with splenectomy and a PNET tumor was successfully removed with resolution of her symptoms. Conclusion: Hypoglycemia after RYGB surgery is a well-established syndrome. While there are several etiologies for this, PNETs (including proinsulinomas) should be considered in the differential diagnosis in this population. Proinsulinomas are an increasingly recognized cause of hypoglycemia. Proinsulin levels must always be included as part of the workup of hypoglycemia in an adult.

scholarly journals Pancreaticoduodenectomy for an acth-secreting pancreatic neuroendocrine tumor in a 12 year old: case report and literature review

HPB ◽  
2020 ◽  
Vol 22 ◽  
pp. S197-S198
Author(s):  
J.M. Creasy ◽  
J. Lim ◽  
D.L. Sudan ◽  
P.J. Allen ◽  
H.E. Rice ◽  
...  
Keyword(s):  
Case Report ◽  
Literature Review ◽  
Neuroendocrine Tumor ◽  
Pancreatic Neuroendocrine Tumor ◽  
Acth Secreting
Sign in / Sign up

Export Citation Format

Share Document