Elastographic localization of insulinoma

#3324

Introduction: A 15-year-old healthy female, initially admitted with less serious signs of hypoglycemia. Laboratory studies showed a glucose concentration of 1.2 mmol/l and insulin 9.6 μU/ml. Complete blood count, basal metabolic profile, activity of C - reactive protein and urine drug screen, were unremarkable. Fasting test confirmed biochemical signs of insulinoma.

Aim(s): In June 2016, the first CT and EUS were performed with negative or less convincing results. The diagnostics was extended by PET CT and MRI using fluorodopa and 68Ga-DOTATOC. Only atypical changes of the pancreatic head were recorded.

Materials and methods: In March 2017, we implemented an extended EUS. Strain EG EUS picture showed consistent lowering in elasticity in particular region in the pancreatic head, strain ratio (SR) index 10,38 was calculated. After administration of contrast agent (sulphur hexafluoride), we observed hypoenhancement of the lesion in CE EUS and hypervascularization in conventional Doppler mode EUS.

Conference: 18th Annual ENETS Concerence (2021)

Presenting Author: Uhrík P

Authors: Uhrík P, Nosakova L, Pindura M, Bánovčin P, Hyrdel R,

Keywords: insulinoma, endosonography, elastography,