Ectopic duodenal insulinoma: a very rare and challenging tumor type. Description of a case and review of the literature.

Details

Serval ID
serval:BIB_D3C9A6F1C0F6
Type
Article: article from journal or magazin.
Publication sub-type
Case report (case report): feedback on an observation with a short commentary.
Collection
Publications
Title
Ectopic duodenal insulinoma: a very rare and challenging tumor type. Description of a case and review of the literature.
Journal
Endocrine Pathology
Author(s)
La Rosa S., Pariani D., Calandra C., Marando A., Sessa F., Cortese F., Capella C.
ISSN
1559-0097 (Electronic)
ISSN-L
1046-3976
Publication state
Published
Issued date
2013
Peer-reviewed
Oui
Volume
24
Number
4
Pages
213-219
Language
english
Notes
Publication types: Case Reports ; Journal Article ; ReviewPublication Status: ppublish
Abstract
Although most insulinomas are located in the pancreas, very rare ectopic cases have been described in the spleen, perisplenic tissue, duodenohepatic ligament, and adjacent to the ligament of Treitz. Moreover, three cases located in the duodenum have also been reported in the English literature. Ectopic insulinomas represent challenging neoplasms with clinical implications mainly due to the difficulties in their pre-operatory diagnosis and localization. In the present paper, we describe the fourth ectopic duodenal insulinoma so far reported. A 75-year-old woman presented at clinical observation due to neuroglycopenic symptoms that disappeared after glucose intake. Tumor was localized in the second portion of the duodenum in front of the papilla of Vater and was surgically enucleated. Microscopically, it was composed of monomorphic cells with eosinophilic cytoplasm arranged in trabecular and lobular patterns and diffusely positive for insulin, proinsulin, amylin, and PDX1. About 30 % of tumor cells also showed immunoreactivity for somatostatin, while no positivity for glucagon, pancreatic polypeptide, gastrin, serotonin, and somatostatin receptor subtype 2A was found. The Ki67 proliferative index was 1 %. We have also reviewed the literature on this topic to give the reader a comprehensive overview of this very rare tumor type.
Keywords
Aged, Duodenal Neoplasms/metabolism, Duodenal Neoplasms/pathology, Female, Homeodomain Proteins/metabolism, Humans, Insulin/metabolism, Insulinoma/metabolism, Insulinoma/pathology, Somatostatin/metabolism, Trans-Activators/metabolism
Pubmed
Web of science
Create date
06/09/2016 12:57
Last modification date
20/08/2019 15:53
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