Document Detail

Malignant insulinoma arising from intrasplenic heterotopic pancreas.
MedLine Citation:
PMID:  19454827     Owner:  NLM     Status:  MEDLINE    
CONTEXT: Heterotopic pancreas is defined as ectopic pancreatic tissue without vascular or anatomic continuity with the normal pancreas. The spleen is a rare site of origin. This case report describes a patient with a malignant insulinoma which originated from an intrasplenic heterotopic pancreas. CASE REPORT: A 46-year-old man with three previous episodes of neuroglucopenic and adrenergic symptoms was referred to our hospital. A fasting test was performed and discontinued due to hypoglycemic symptoms. Preoperative studies failed to demonstrate any pancreatic lesions. However, a heterogeneous encapsulated tumor in the spleen was found on MRI. During surgery, only the splenic tumor was found, with neither vascular nor anatomical connections to the normal pancreas. Pathology reported a malignant insulinoma. Insulin and proinsulin were documented by immunohistochemistry. After one year of follow up, the patient is free of symptoms and no recurrent disease has been documented. DISCUSSION: Only seven cases of splenic heterotopic pancreas have been reported, six with cystic mucinous neoplasms. In addition, only one case of a malignant insulinoma arising from heterotopic pancreas has previously been described. This is the second case reported of an insulinoma arising from heterotopic pancreas and the first to originate from intrasplenic heterotopia.
Carmen M Hernández Cárdenas; Ismael Domínguez; Manuel Campuzano; Paulina Bezaury; María Iñiguez-Rodríguez; Armando Gamboa-Domínguez; Luis F Uscanga
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Publication Detail:
Type:  Case Reports; Journal Article     Date:  2009-05-18
Journal Detail:
Title:  JOP : Journal of the pancreas     Volume:  10     ISSN:  1590-8577     ISO Abbreviation:  JOP     Publication Date:  2009  
Date Detail:
Created Date:  2009-05-20     Completed Date:  2009-08-06     Revised Date:  2009-09-18    
Medline Journal Info:
Nlm Unique ID:  101091810     Medline TA:  JOP     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  321-3     Citation Subset:  IM    
Department of Surgery, National Institute of Medical Sciences and Nutrition Salvador Zubirán, Tlalpan, México DF, Mexico.
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MeSH Terms
Choristoma / pathology*,  surgery
Insulinoma / pathology*,  surgery
Islets of Langerhans*
Magnetic Resonance Imaging
Middle Aged
Pancreatic Neoplasms / pathology*,  surgery
Splenic Diseases / pathology*,  surgery

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