Arterial calcium-stimulated venous sampling to reveal insulinoma in case of pancreatic multiple neuroendocrine neoplasms

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Introduction: Insulinoma is a functioning pancreatic neuroendocrine tumor (pNET) that produces insulin and causes clinical symptoms of severe hypoglycemia. The arterial calcium stimulation with hepatic venous sampling (ASVS) can localize the insulin-producing tumor and help to avoid the excessive volume of surgery in case of multiple pancreatic neuroendocrine tumors.

Aim(s): To show the benefits of ASVS in case of multiple pNETs.

Materials and methods: Patient, 60-years-old female complained of episodes of weakness, anxiety, sweating, dizziness due to severe hypoglycemia. The first episode of hypoglycemia occurred 18 months before. The hypoglycemia 1.1 mmol/L was detected. Contrast-enhanced computed tomography (CT) and magnetic resonance imaging (MRI) revealed multiple neuroendocrine tumors of the pancreas: in the head (8 mm), uncinate process (9 mm), body (15 mm), tail (17 mm).

Conference: 18th Annual ENETS Concerence (2021)

Presenting Author: Kaldarov A

Authors: Kaldarov A, Panteleev V, Varava A, Raevskaya M, Davidenko P,

Keywords: insulinoma, neuroendocrine tumor, neuroendocrine neoplasm, pancreas, arterial calcium stimulation with hepatic venous sampling, ASVS, parenchyma-sparing surgery,