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CC BY-NC-ND 4.0 · World J Nucl Med 2020; 19(02): 162-164
DOI: 10.4103/wjnm.WJNM_41_19
Case Report

Extrapancreatic insulinoma

Robin Garg
Department of Endocrinology, Seth GS Medical College, Mumbai, Maharashtra, India
,
Saba Memon
Department of Endocrinology, Seth GS Medical College, Mumbai, Maharashtra, India
,
Virendra Patil
Department of Endocrinology, Seth GS Medical College, Mumbai, Maharashtra, India
,
Tushar Bandgar
Department of Endocrinology, Seth GS Medical College, Mumbai, Maharashtra, India
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Abstract

A 38-year-old female presented with recurrent episodes of hypoglycemia for 5 years. On 72-h fast test, critical sample biochemistry was suggestive of endogenous hyperinsulinemic hypoglycemia. Both constrast-enhanced computed tomography and 68Ga-DOTATATE positron emission tomography/computerized tomography (PET/CT) revealed no pancreatic lesion but showed a jejunal lesion suggestive of neuroendocrine tumor (NET) but not confirmatory of insulinoma. 68Ga-Exendin-4 PET/CT showed intense uptake in the proximal jejunum, and this being a specific scan for insulinoma, confirmed it as an ectopic insulinoma. The patient attained normoglycemia after excision of this NET confirming it to be a case of ectopic insulinoma located in the jejunum. Although most insulinomas are located in the pancreas, rarely ectopic cases have been described in the spleen, perisplenic tissue, duodenohepatic ligament, adjacent to the ligament of Treitz, duodenum, and the jejunum. Functional scanning with 68Ga-Exendin-4 PET/CT scan aids the localization of ectopic insulinoma.

Keywords

68Ga-Exendin-4 positron emission tomography/computerized tomography - 68Ga-DOTATATE positron emission tomography/computerized tomography - ectopic jejunal insulinoma

Financial support and sponsorship

Nil.




Publication History

Received: 26 March 2019

Accepted: 14 July 2019

Article published online:
19 April 2022

© 2020. Sociedade Brasileira de Neurocirurgia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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