New MethodEUS-guided alcohol ablation of an insulinoma
Section snippets
Materials and methods
Diagnostic evaluation for suspected insulinoma was performed with a radial echoendoscope (acoustic frequencies 5/7.5/10 MHz; Pentax Hitachi radial EG-3630UR; Pentax Co. and Hitachi Co., Tokyo, Japan). For FNA, as well as for ablation by alcohol injection, the linear-array echoendoscope (5/7.5 MHz; Pentax Hitachi longitudinal FG-34UX; Pentax Co. and Hitachi Co.) was used.
FNA was done as described by Fritscher-Ravens et al.6 Fourteen smears on glass slides were air-dried, subsequently processed
Results
We report on a 78-year-old woman (body mass index 26.3 kg/m2) who has had recurrent symptomatic episodes of hypoglycemia since September 2000. In June 2002, the patient was referred to our hospital after repeated episodes of unconsciousness at home. After glucose was administered intravenously, she recovered without neurologic defect. Relatives reported on 2 similar episodes per week for the previous several months.
Laboratory findings and the patient's history indicated the presence of an
Discussion
Insulinomas are rare and usually become symptomatic by recurrent episodes of hypoglycemia. Attempts of nonsurgical ablation of neuroendocrine and pancreatic tumors have been reported. Scott et al7 described the successful percutaneous palliative ablation of liver metastases of a malignant insulinoma. Goldberg et al8 performed a study on the feasibility and the safety of EUS-guided radiofrequency ablation in the porcine pancreas. Recently, Gan et al5 demonstrated the feasibility of ethanol
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Cited by (175)
History of the Interventional Pancreaticobiliary Endoscopy
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2024, Gastrointestinal Endoscopy Clinics of North AmericaA single-center experience on endoscopic ultrasonography-guided ethanol ablation of insulinomas
2023, PancreatologyCitation Excerpt :Ethanol can cause the degeneration and necrosis of insulinoma tissue [8]. Not only the hypoglycemia-associated symptoms were relieved in this patient, but also the serology and images were significantly improved [9]. In a study published by Mayo Clinic, 8 cases of ultrasound-guided ethanol ablation of insulinomas were reported, of which 5 patients were completely absent of hypoglycemia-related symptoms in the follow-up period of a median of 13 months (range: 5–38 months) [10].
CURRENT VIEWS ON THE TREATMENT OF INSULINOMA
2024, Problemy EndokrinologiiPancreatic Insulinoma: When Surgery Is Not an Option
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