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Orv Hetil. 2014 Oct 12;155(41):1647-51. doi: 10.1556/OH.2014.30012.

[Endoscopic ultrasound-guided ethanol ablation: an alternative option for the treatment of pancreatic insulinoma].

[Article in Hungarian; Abstract available in Hungarian from the publisher]

Author information

1
Szegedi Tudományegyetem, Általános Orvostudományi Kar I. Belgyógyászati Klinika Szeged Korányi fasor 8-10. 6720.
2
Szegedi Tudományegyetem, Általános Orvostudományi Kar Patológiai Intézet Szeged.

Abstract

in English, Hungarian

Endoscopic ultrasound is the most accurate imaging modality for the diagnosis of pancreatic cancer, and endoscopic ultrasound-guided fine needle injection has already been used for palliative interventions. Surgical resection is currently the standard treatment for pancreatic insulinoma. Medical treatment may be necessary for symptomatic patients with unresectable disease. Case reports have been published about the success of endoscopic ultrasound-guided alcoholic ablation, but it has not been reported previously in Hungarian literature. The authors present the history of an 83-year-old woman who was evaluated because of repeated hypoglycemic coma occurring during the night. Endosonographic image and laboratory findings (elevated serum insulin and chromogranin A) revealed pancreatic insulinoma. Because of severe comorbidities and high risk of surgical resection, the decision was made to ablate the insulinoma by endoscopic ultrasound-guided alcohol injection. A total of 3 mL 95% ethanol was injected into the tumor. Despite the discontinuation of the diazoxide therapy the hypoglycemic episodes disappeared. This case history confirms that endoscopic ultrasound-guided alcoholic ablation is a novel, minimal invasive alternative treatment for patients with pancreatic neuroendocrine tumors in whom surgery is not feasible.

KEYWORDS:

EUS; EUS-FNI; alcoholic ablation; alkoholos ablatio; endoscopic ultrasound; endoszkópos ultrahang; insulinoma; neuroendocrine tumor; neuroendokrin tumor; pancreas cancer; pancreastumor

PMID:
25282110
DOI:
10.1556/OH.2014.30012
[Indexed for MEDLINE]

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