Surgical strategy for insulinomas in multiple endocrine neoplasia type I

被引:23
作者
Lo, CY
Lam, KY
Fan, ST
机构
[1] Univ Hong Kong, Queen Mary Hosp, Dept Surg, Hong Kong, Peoples R China
[2] Univ Hong Kong, Queen Mary Hosp, Dept Pathol, Hong Kong, Peoples R China
关键词
D O I
10.1016/S0002-9610(98)00012-9
中图分类号
R61 [外科手术学];
学科分类号
摘要
BACKGROUND: Hyperinsulinemia in multiple endocrine neoplasia type I (MEN-I) is a rare but potentially curable condition that presents difficulties not encountered in sporadic cases. METHODS: The present report documents our surgical approach to 3 MEN-I patients with hyperinsulinemia. RESULTS: Primary hyperparathyroidism was manifested in all 3 patients at the time of presentation. Distal subtotal pancreatectomy with enucleation of tumor at the head of pancreas detected intraoperatively resulted in immediate cure of 2 patients. Persistent disease occurred in 1 patient after enucleation of tumor at the head of the pancreas guided by preoperative imaging elsewhere. The patient was subsequently cured by distal subtotal pancreatectomy. Pathology revealed multiple tumors (4 to 14) in all patients. CONCLUSIONS: A different surgical strategy with an aim of distal subtotal pancreatectomy and enucleation of any tumor identified in the head of pancreas is the treatment of choice for hyperinsulinemia in MEN-I patients. (C) 1998 by Excerpta Medica, Inc.
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收藏
页码:305 / 307
页数:3
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