ECE2022 Eposter Presentations Endocrine-Related Cancer (61 abstracts)
Hedi Chaker University Hospital, Endocrinology Department, Sfax, Tunisia
Introduction: The diagnosis of insulinomas is made biochemically. However, proper localization of insulinomas is essential before surgery. Therefore, we aimed to evaluate the role of different imaging techniques in the localization of insulinomas.
Case series: This case series include 10 patients with biochemically proven insulinomas. The age, gender, results of MRI, CT, EUS, are shown in Table-1. In imaging investigations, abdominal ultrasonography (AU) was normal in the 4 patients it was performed on. Abdominal CT scan was performed in all patients and found a tumor in only 6 cases. Abdominal MRI was performed in 2 patients and found a tumor in 1 case. The tumor confirmed by MRI wasnt found by other imaging means. Endoscopic ultrasound was performed in 6 patients, was normal in 2 cases and found a tumor in 4 cases. 3 tumors were only diagnosed with endoscopic ultrasound. CT scan and endoscopic ultrasound were enough to find the localization of insulinomas in 8 patients. No lesion was identifed in 1 case. All the 9 patients with confirmed pancreatic lesion underwent surgery and a diagnosis of insulinoma was made in all patients by immunohistopathological analysis. All these patients achieved cure after surgery.
Patient | Gender/Age | Presence of tumor on AS | Presence of tumor on CT | Presence of tumor on MRI | Presence of tumor on EUS |
1 | M/18 | No | Yes | - | - |
2 | M/58 | - | No | - | Yes |
3 | F/40 | - | No | - | No |
4 | M/62 | - | No | No | Yes |
5 | M/38 | - | Yes | - | Yes |
6 | F/47 | No | Yes | - | Yes |
7 | M/28 | - | Yes | - | - |
8 | F/46 | - | Yes | - | - |
9 | F/56 | No | No | Yes | No |
10 | M/68 | No | Yes | - | - |
Conclusion: The diagnosis of insulinoma is easily confirmed biochemically. The challenge remains in its localization as no imaging procedure was enough on its own to confirm the presence of a pancreatic lesion, confirming therefore the difficulty of pre-operative investigations