A rare pancreatic neuroendocrine tumor with proinsulin-secreting activity
Anna R. Volkova,
Svetlana V. Dora,
Elena N. Ostrouchova,
Anna V. Lisker,
Galina V. Semikova,
Ekateryna U. Demydenko https://doi.org/10.14341/serg12342
Abstract
This paper presents a clinical case describing hypoglycemic condition with atypical symptoms in a young patient in the early postpartum period. Abdominal ultrasound revealed a large formation in the hook region of the pancreas, which was subsequently confirmed according to endoscopic ultrasound, CT and MRI. The idea of insulinoma was formed according to the presence of pancreatic formation, documented Whipple’s triad, and data on hyperinsulinism at the outpatient stage. However, the 72-hour fasting test showed no significant increase in insulin and C-peptide levels. After excluding other causes of hypoglycemia, the patient was suspected of having proinsulinoma, which was confirmed by increased blood proinsulin level. Gastropancreatoduodenal resection was performed. We detected a highly differentiated neuroendocrine pancreatic tumor with the expression of CD56, NSE, synaptophysin and chromogranin A, with a Ki-67 index of about 1%. After surgical treatment, hypoglycemic conditions were not observed.
About the Authors
Anna R. Volkova
First Pavlov State Medical University of Saint Petersburg
Russian Federation
Russian Federation
MD, PhD, Professor
Svetlana V. Dora
First Pavlov State Medical University of Saint Petersburg
Russian Federation
Russian Federation
MD, PhD
Elena N. Ostrouchova
First Pavlov State Medical University of Saint Petersburg
Russian Federation
Russian Federation
MD, PhD
Anna V. Lisker
First Pavlov State Medical University of Saint Petersburg
Russian Federation
Russian Federation
MD
Galina V. Semikova
First Pavlov State Medical University of Saint Petersburg
Russian Federation
Russian Federation
MD
Ekateryna U. Demydenko
First Pavlov State Medical University of Saint Petersburg
Russian Federation
Russian Federation
medical resident
References
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Supplementary files
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1. Figure 1. Ultrasound examination of the abdominal organs with formation in the pancreas. | |
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2. Figure 2. MRI of the abdominal organs with contrast enhancement. Arrows show the formation in the pancreas. | |
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| Type | Исследовательские инструменты | |
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For citations:
Volkova A.R., Dora S.V., Ostrouchova E.N., Lisker A.V., Semikova G.V., Demydenko E.U. A rare pancreatic neuroendocrine tumor with proinsulin-secreting activity. Endocrine Surgery. 2020;14(2):16-20. (In Russ.) https://doi.org/10.14341/serg12342
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