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. 2019:64:35-40.
doi: 10.1016/j.ijscr.2019.09.024. Epub 2019 Sep 24.

Near infrared light examination as part of the management of sporadic pancreatic head insulinoma: Case report

Dan Petru Constantinescu  1 , Mihaela Ioana Constantinescu  2 , Razvan Alexandru Ciocan  2 , Stefan Chiorescu  2 , Miana Gabriela Pop  2 , Daniela Simona Pintea  2 , Valentin Muntean  2
Affiliations

Near infrared light examination as part of the management of sporadic pancreatic head insulinoma: Case report

Dan Petru Constantinescu et al. Int J Surg Case Rep. 2019.

Abstract

Introduction: We report the case of a 77-year-old female patient with the diagnosis of pancreatic head insulinoma, in whom we used near infrared light (NIR) to detect synchronous pancreatic tumors and potential secondary lymph node or liver involvement. The patient presented with hypoglycemia manifesting by lipothymia. With the diagnosis of secretory neuroendocrine tumor (insulinoma) of the pancreatic head, cephalic pancreatoduodenectomy with the preservation of the pylorus was performed after NIR visualization of the pancreatic tumor mass. At 6, 12, 18 months postoperatively, the patient no longer had hypoglycemia and her general state was good.

Conclusion: NIR with indocyanine green (ICG) evidences pancreatic neuroendocrine tumors, as well as possible synchronous tumors and secondary lymph node or liver involvement.

Keywords: Case report; Indocyanine green; Insulinoma; Near infrared light; Pancreatic neuroendocrine tumors.

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Conflict of interest statement

None of the authors have any conflict of interest.

Figures

Fig. 1
Fig. 1
Arterial phase abdominal CT – tumor mass in the pancreatic uncinate process with inner calcification of 3.4/2 cm.
Fig. 2
Fig. 2
Abdominal CT, sagittal section: tumor mass of the pancreatic uncinate process.
Fig. 3
Fig. 3
Tumor mass taking up ICG, situated in the pancreatic head.
Fig. 4
Fig. 4
Exploration of the left pancreas with ICG and NIR.
Fig. 5
Fig. 5
HE staining with Ki67 IHC.
See this image and copyright information in PMC

References

    1. Deguelte S., Mestier L., Hentic O., Cros J., Lebtahi R., Hammel P., Kianmanesh R. Preoperativ imaging and pathologic classifiaction for pancreatic neuroendocrine tumors. J. Visc. Surg. 2018;155:117–125. - PubMed
    1. Agha R.A., Borrelli M.R., Farwana R., Koshy K., Fowler A., Orgill D.P., For the SCARE Group The SCARE 2018 statement: updating consensus Surgical CAse REport (SCARE) guidelines. Int. J. Surg. 2018;60:132–136. - PubMed
    1. Shirata C., Kawaguchi Y., Kobayashi K. Usefulness of indocyanine green-fluorescence imaging for real-time visualization of pancreas neuroendocrine tumor and cystic neoplasm. J. Surg. Oncol. 2018;118:1012–1020. - PubMed
    1. TNCD: The Version Finale 2016. http://snfge.org/sites/default/files/SNFGE/TNCD/tncdtnefinale10-3-16.pdf.
    1. Jensen R.T., Cadiot G., Brandi M.L. ENSTS consensu guidelines for the management of patients with digestive neuroendocrine neoplasm: functional pancreatic endocrine tumor syndromes. Neuroendocrinology. 2012;95:98–119. - PMC - PubMed