Iriarte-Durán Maria, Teleche-Loaiza Jose, Rosero-Guerrero Alberto, Folleco-Pazmiño Edgar, García-Trujillo Andrés, Guzmán-Gómez Guillermo
Endocrinology Service, Hospital Universitario Fundación Valle del Lili, Cali, Colombia.
Radiology and Diagnostic Imaging Service, Hospital Universitario Fundación Valle del Lili, Cali, Colombia.
AACE Clin Case Rep. 2024 Nov 8;11(1):62-65. doi: 10.1016/j.aace.2024.10.007. eCollection 2025 Jan-Feb.
BACKGROUND/OBJECTIVE: Evidence on the efficacy and safety of minimally invasive treatment for insulinoma has increased over the past decade to the point of becoming a recommendation in clinical practice guidelines for the management of this type of neuroendocrine tumor.
We describe the case of an elderly male patient with multiple comorbidities and recurrent isolated insulinoma of 3.7 × 3.5 cm involving the uncinate process of the pancreas and contacting the splenomesenteric confluent many years after first resection, in whom, after refusing surgical management, was performed as successful arterial embolization of the pancreatic tumor.
When addressing this pathology, it is common to encounter patients who are not candidates for surgical management, either due to the presence of comorbidities, the location of the tumor in relation to vascular structures, or refusal of the intervention. Therefore, it is important to be aware of the different therapeutic options in localized and metastatic disease.
Minimally invasive procedures are positioned as an effective alternative for the treatment of the hormonal overproduction in patients with insulinoma.
背景/目的:在过去十年中,关于胰岛素瘤微创治疗的疗效和安全性的证据不断增加,已达到成为这类神经内分泌肿瘤临床实践管理指南中的一项推荐的程度。
我们描述了一名老年男性患者的病例,该患者有多种合并症,首次切除多年后出现复发的孤立性胰岛素瘤,大小为3.7×3.5厘米,累及胰腺钩突并与脾肠系膜汇合处相邻。在拒绝手术治疗后,该患者成功接受了胰腺肿瘤的动脉栓塞术。
在处理这种疾病时,经常会遇到因合并症、肿瘤相对于血管结构的位置或拒绝干预而不适合手术治疗的患者。因此,了解局限性和转移性疾病的不同治疗选择很重要。
微创手术是治疗胰岛素瘤患者激素分泌过多的有效替代方法。