Transportal blood sampling for preoperative localization of insulinomas

E. J. Rayfield, I. J. Goldberg, E. W. Giegerich, H. A. Mitty, A. Aufses

Research output: Contribution to journalArticlepeer-review

4 Scopus citations

Abstract

After diagnosis of an insulinoma, preoperative localization of the tumor is of great help to the surgeon. Angiography, the most widely used method, has been successful in 40% to 88% of cases. More recently, tumors have been localized by demonstration of a step-up of insulin levels in blood obtained by transportal sampling of the portal and pancreatic veins. Five cases with documented insulinomas and negative angiography and a sixth case with a positive angiogram are described. The tumor was successfully localized by transportal sampling in all six cases. A seventh case is reported in which positive angiographic and CT scan localization was questioned preoperatively because transportal venous sampling did not reveal insulin step-up in the presumed site of the tumor; incomplete portal-vein sampling did not include the area draining the tumor discovered during surgery. The need for subselective pancreatic vein sampling was evident in at least two cases. Transportal blood sampling is a reliable technique which can be used for the localization of all hormone-secreting tumors of the pancreas, including gastrinomas, glucagonomas. and tumors secreting vasoactive intestinal polypeptide.

Original languageEnglish
Pages (from-to)258-262
Number of pages5
JournalMount Sinai Journal of Medicine
Volume50
Issue number3
StatePublished - 1983

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