Test de estimulación intraarterial selectiva con calcio en el diagnóstico de localización de insulinomas: Casos clínicos

• Darío Martínez O ^[3] ; Guillermo Silva Q ^[4] ; Iván Solís O ^[4] ; Jorge Toloza H ^[4] ; Carlos Benavides C ^[5] ; James Hamilton S ^[1] ; Fernando Osorio G ^[1] ; Germán Iñiguez V ^[2] ; Néstor Soto I ^[4]
  1. [1] Hospital Padre Hurtado

     Hospital Padre Hurtado

     Santiago, Chile

     
  2. [2] Universidad de Chile

     Universidad de Chile

     Santiago, Chile

     
  3. [3] Hospital San Borja-Arriarán Unidad de Hemodinamia
  4. [4] Hospital San Borja-Arriarán Servicio de Medicina Interna
  5. [5] Hospital San Borja-Arriarán Servicio de Cirugía

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• Localización: Revista Médica de Chile, ISSN-e 0034-9887, Vol. 132, Nº. 1, 2004, págs. 71-74
• Idioma: español
• Títulos paralelos:
  • Selective intra arterial calcium stimulation for the localization of insulinomas: Report of two cases
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• Resumen

  • Insulinoma is the most common neuroendocrine tumor. Its clinical manifestations are frequently confounded with neuropsychiatric symptoms, and definitive diagnosis can be delayed for a long time. These tumors are usually small, of less than 2 cm. Thus, their preoperative localization is difficult. We report two patients with a clinical diagnosis of insulinoma, in whom the preoperative imaging study was negative. Both fulfilled diagnostic criteria, with high serum insulin levels in the presence of a blood glucose of less than 45 mg/dl. The imaging study, including abdominal computed tomography and pancreatic endoscopic ultrasonography did not disclose the location of the tumor. A pancreatic angiography with selective stimulation with intra arterial calcium and venous sampling for insulin measurements, was performed in both patients. This test allowed the exact localization of the tumors and their successful excision. A review of other localization diagnostic tests is done (Rev Méd Chile 2004; 132: 71-5).