Document Detail


Role of endoscopic ultrasonography in the localization of insulinomas and gastrinomas.
MedLine Citation:
PMID:  7985098     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: We have previously found selective venous sampling to be the most sensitive method to localize otherwise occult functioning endocrine tumors. However, recently we have used endoscopic ultrasonography (EUS) as the initial and in some cases the only localization study in the preoperative evaluation of proven insulinomas and of selected cases of gastrinoma. METHODS: All patients referred between April 1993 and April 1994 with a subsequently confirmed diagnosis of organic hyperinsulinism or Zollinger-Ellison syndrome (ZES) underwent EUS. Ten patients with insulinomas and six with gastrinomas were studied. Only one patient with ZES had multiple endocrine neoplasia type I. Patients with negative EUS findings had additional localization procedures including angiography and arterial stimulation tests. All but one patient underwent surgical exploration. RESULTS: Solitary insulinomas were found in all 10 patients. EUS correctly identified and localized the insulinoma in seven (70%) of 10 patients but failed to identify two pedunculated insulinomas that were easily found at exploration. Because of an incomplete examination, a single insulinoma was not detected within the parenchyma. The EUS examination correctly excluded the pancreatic gastrinomas in five patients. The sixth patient, who had multiple endocrine neoplasia type I, had two 0.5 cm tumors in the head. CONCLUSIONS: EUS is a sensitive and cost-effective technique for localization of insulinomas and may be the only study needed. In patients with ZES a negative pancreatic result suggests the likelihood of a duodenal or other extrapancreatic tumor.
Authors:
N W Thompson; P F Czako; L L Fritts; R Bude; R Bansal; T T Nostrant; J M Scheiman
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Surgery     Volume:  116     ISSN:  0039-6060     ISO Abbreviation:  Surgery     Publication Date:  1994 Dec 
Date Detail:
Created Date:  1995-01-05     Completed Date:  1995-01-05     Revised Date:  2010-03-24    
Medline Journal Info:
Nlm Unique ID:  0417347     Medline TA:  Surgery     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1131-8     Citation Subset:  AIM; IM    
Affiliation:
Department of Surgery, University of Michigan Medical Center, Ann Arbor.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Endoscopy
Female
Gastrinoma / ultrasonography*
Humans
Insulinoma / ultrasonography*
Male
Middle Aged
Multiple Endocrine Neoplasia Type 1 / ultrasonography
Pancreatic Neoplasms / ultrasonography*
Zollinger-Ellison Syndrome / ultrasonography

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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