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Endoscopic Localization and Tattooing of a Proinsulinoma for Minimally Invasive Resection

2011; Lippincott Williams & Wilkins; Volume: 40; Issue: 3 Linguagem: Inglês

10.1097/mpa.0b013e318205e926

1536-4828

Annabelle Rodríguez, Marcia I. Canto, Martin A. Makary,

Gastrointestinal disorders and treatments

Hypoglycemia can be common in patients using insulin injections or certain antidiabetes medications. In rare cases, hypoglycemia can be caused by a pancreatic insulinoma. We report a case of a 33-year-old woman found to have severe recurrent hypoglycemia. Diagnostic studies such as continuous glucose monitoring and a hospitalized fast provided biochemical evidence for a proinsulinoma. After abdominal multidetector contrast-enhanced computerized tomography failed to detect pancreatic abnormalities, endoscopic ultrasonography identified and localized a 9-mm pancreatic tail lesion. At the time of endoscopy, the lesion was tattooed with ultrasonographic guidance for subsequent laparoscopic visualization and curative resection.