Role of EUS in the preoperative localization of insulinomas compared with spiral CT

Role of EUS in the preoperative localization of insulinomas compared with spiral CT

Author Ardengh, J. C. Google Scholar
Rosenbaum, P. Google Scholar
Ganc, A. J. Google Scholar
Goldenberg, A. Google Scholar
Lobo, E. J. Google Scholar
Malheiros, C. A. Google Scholar
Rahal, F. Google Scholar
Ferrari, A. P. Google Scholar
Institution Hosp Albert Einstein
Universidade Federal de São Paulo (UNIFESP)
Santa Casa de São Paulo
Abstract Background: Preoperative radiologic localization of insulinomas often fails because of the small size of these tumors. Endoscopic ultrasound (EUS) can localize insulinomas in up to 80% of the cases. the aim of this study was to compare EUS and computed tomography (CT) diagnostic accuracy for insulinomas,Methods: We reviewed medical records from 12 patients (10 women) with a biochemical diagnosis of hypoglycemia and hyperinsulinism from 1 university hospital and 1 community hospital. A diagnosis of insulinoma was ultimately made in all cases and before surgery the patients underwent abdominal US, spiral CT and EUS in an attempt to precisely localize the tumor. Surgery was considered the standard for tumor localization.Results: Ten tumors were benign (83.3%) and 2 were malignant (16.7%). the overall sensitivity of EUS in identifying insulinomas was 83.3% compared with 16.7% for CT. Tumors not detected by EUS had a mean size of 0.75 cm, EUS-guided fine-needle aspiration was possible in only 3 patients, with a positive cytologic diagnosis in 2 (66.6%). Tumors located in the head end body of the pancreas were identified by EUS in all patients, but those located in the tail were diagnosed in only 50% of the cases.Conclusions: EUS is superior to spiral CT and should replace it for the detection of pancreatic insulinomas, EUS identification depends on the site and size of the tumor.
Language English
Date 2000-05-01
Published in Gastrointestinal Endoscopy. St Louis: Mosby, Inc, v. 51, n. 5, p. 552-555, 2000.
ISSN 0016-5107 (Sherpa/Romeo, impact factor)
Publisher Mosby, Inc
Extent 552-555
Access rights Closed access
Type Article
Web of Science ID WOS:000087112000009

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