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

Détails

ID Serval
serval:BIB_D3C9A6F1C0F6
Type
Article: article d'un périodique ou d'un magazine.
Sous-type
Etude de cas (case report): rapporte une observation et la commente brièvement.
Collection
Publications
Titre
Ectopic duodenal insulinoma: a very rare and challenging tumor type. Description of a case and review of the literature.
Périodique
Endocrine Pathology
Auteur(s)
La Rosa S., Pariani D., Calandra C., Marando A., Sessa F., Cortese F., Capella C.
ISSN
1559-0097 (Electronic)
ISSN-L
1046-3976
Statut éditorial
Publié
Date de publication
2013
Peer-reviewed
Oui
Volume
24
Numéro
4
Pages
213-219
Langue
anglais
Notes
Publication types: Case Reports ; Journal Article ; ReviewPublication Status: ppublish
Résumé
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.
Mots-clé
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
Création de la notice
06/09/2016 12:57
Dernière modification de la notice
20/08/2019 15:53
Données d'usage