Laparoscopic surgery for pancreatic insulinomas: an update

Chrysanthi Aggeli, Alexander M. Nixon,Ioannis Karoumpalis, Gregory Kaltsas, George N. Zografos

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Insulinomas are the most common functioning neuroendocrine tumors of the pancreas, occurring in almost 1-4 per 1 million persons each year. In contrast to other pancreatic neuroendocrine tumors, they are usually benign and solitary at the time of diagnosis. Due to their benign nature, surgical excision is the treatment of choice, with excellent long-term results. The introduction of minimally invasive techniques in the surgical treatment of insulinoma has been gaining popularity …

Preoperative imaging and localization of small sized insulinoma with EUS-guided fine needle tattoing: a case report

George N. Zografos, Alexandra Stathopoulou, George Mitropapas, John Karoubalis, George Kontogeorgos, Gregory Kaltsas, George Piaditis, George I. Papastratis

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We report a case of an insulinoma that was not identified on either Computerized Tomography (CT) scan and Magnetic Resonance Imaging (MRI). Endoscopic ultrasonography (EUS) revealed a small insulinoma located at the body of the pancreas, which was histologically confirmed. The patient underwent a laparotomy but no tumour was identified either on palpation or with intra-operative ultrasound …

Reversal of impaired counterregulatory cortisol response following diazoxide treatment in a patient with non insulinoma pancreatogenous hypoglycemia syndrome: Case report and overview of pathogenetic mechanisms

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Pasireotide for malignant insulinoma

Amit Tirosh, Salomon M. Stemmer, Evgeny Solomonov, Eldad Elnekave, Wolfgang Saeger, Yelena Ravkin, Kobi Nir, Yeela Talmor, Ilan Shimon

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Malignant insulinoma usually has a poor prognosis, as no efficient medical treatment is available. The somatostatin analogs octreotide and lanreotide have limited ability to control the hypoglycemic events. Pasireotide is a multi-receptor targeted somatostatin-analog with improved affinity for SSTR5. There is to date no reported treatment experience with this drug in such tumors …