Case history of belated diagnosis of insulinoma

A clinical case of an atypical course of neuroendocrine tumor (NET, insulinoma) of the tail of the pancreas is described. The histologic classification of WHO (2010) according to TNM and ENETS and AJCC is recognized worldwide. Of all pancreatic NET, insulinoma accounts for the highest number of case...

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Autores principales:	N. I. Bogomolov, P. P. Pakholchyuk, V. Y. Solovyov, N. N. Tomskikh, A. G. Goncharov, M. A. Goncharova, Y. Y. Lenskaya, A. S. Golyakova
Formato:	article
Lenguaje:	RU
Publicado:	Scientific Сentre for Family Health and Human Reproduction Problems 2018
Materias:	neuroendocrine tumor diagnosis surgical treatment Science Q
Acceso en línea:	https://doaj.org/article/56cd33debfce4d42ab1e020800414bbd
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spelling	oai:doaj.org-article:56cd33debfce4d42ab1e020800414bbd2021-11-23T06:14:40ZCase history of belated diagnosis of insulinoma2541-94202587-959610.29413/ABS.2018-3.2.21https://doaj.org/article/56cd33debfce4d42ab1e020800414bbd2018-04-01T00:00:00Zhttps://www.actabiomedica.ru/jour/article/view/571https://doaj.org/toc/2541-9420https://doaj.org/toc/2587-9596A clinical case of an atypical course of neuroendocrine tumor (NET, insulinoma) of the tail of the pancreas is described. The histologic classification of WHO (2010) according to TNM and ENETS and AJCC is recognized worldwide. Of all pancreatic NET, insulinoma accounts for the highest number of cases, 1-2 people per million population per year. In the treatment of NET surgical methods dominate. We present the clinical observation of a 63-year-old patient with atypical clinic who was repeatedly examined in the city hospitals. At the final stage, in the Chita State Medical Academy of Chita, the tumor of the pancreatic tail (insulinoma?) was diagnosed. The patient was operated. The tumor conglomerate including pancreatic tail, spleen and fragment of the left dome of the diaphragm with regional lymph nodes and fiber was intraoperatively detected and removed. The revision operation did not reveal any distant metastases. The macro preparation was a dense tumor of gray-white color, emanating from the tail of the pancreas with sprouting into the spleen and the left dome of the diaphragm. The postoperative period was severe, it was difficult to adjust carbohydrate metabolism. Histological conclusion: the tumor consists of adenoid-like trabecular, lobular, solid structures from relatively monomorphic mean sized cells with rounded nuclei and well expressed eosinophilic cytoplasm. Disseminated vascular invasion was noted. A belated diagnosis caused by an atypical variant of NET led to the involvement of the spleen and the left dome of the diaphragm, accompanied by metastases to the regional lymph nodes. Timely diagnosis of NET and subsequent treatment remains a difficult and complex task; it is necessary to consolidate the efforts of endocrinologists, oncologists, surgeons, radiologists and pathomorphologists.N. I. BogomolovP. P. PakholchyukV. Y. SolovyovN. N. TomskikhA. G. GoncharovM. A. GoncharovaY. Y. LenskayaA. S. GolyakovaScientific Сentre for Family Health and Human Reproduction Problemsarticleneuroendocrine tumordiagnosissurgical treatmentScienceQRUActa Biomedica Scientifica, Vol 3, Iss 2, Pp 116-120 (2018)
institution	DOAJ
collection	DOAJ
language	RU
topic	neuroendocrine tumor diagnosis surgical treatment Science Q
spellingShingle	neuroendocrine tumor diagnosis surgical treatment Science Q N. I. Bogomolov P. P. Pakholchyuk V. Y. Solovyov N. N. Tomskikh A. G. Goncharov M. A. Goncharova Y. Y. Lenskaya A. S. Golyakova Case history of belated diagnosis of insulinoma
description	A clinical case of an atypical course of neuroendocrine tumor (NET, insulinoma) of the tail of the pancreas is described. The histologic classification of WHO (2010) according to TNM and ENETS and AJCC is recognized worldwide. Of all pancreatic NET, insulinoma accounts for the highest number of cases, 1-2 people per million population per year. In the treatment of NET surgical methods dominate. We present the clinical observation of a 63-year-old patient with atypical clinic who was repeatedly examined in the city hospitals. At the final stage, in the Chita State Medical Academy of Chita, the tumor of the pancreatic tail (insulinoma?) was diagnosed. The patient was operated. The tumor conglomerate including pancreatic tail, spleen and fragment of the left dome of the diaphragm with regional lymph nodes and fiber was intraoperatively detected and removed. The revision operation did not reveal any distant metastases. The macro preparation was a dense tumor of gray-white color, emanating from the tail of the pancreas with sprouting into the spleen and the left dome of the diaphragm. The postoperative period was severe, it was difficult to adjust carbohydrate metabolism. Histological conclusion: the tumor consists of adenoid-like trabecular, lobular, solid structures from relatively monomorphic mean sized cells with rounded nuclei and well expressed eosinophilic cytoplasm. Disseminated vascular invasion was noted. A belated diagnosis caused by an atypical variant of NET led to the involvement of the spleen and the left dome of the diaphragm, accompanied by metastases to the regional lymph nodes. Timely diagnosis of NET and subsequent treatment remains a difficult and complex task; it is necessary to consolidate the efforts of endocrinologists, oncologists, surgeons, radiologists and pathomorphologists.
format	article
author	N. I. Bogomolov P. P. Pakholchyuk V. Y. Solovyov N. N. Tomskikh A. G. Goncharov M. A. Goncharova Y. Y. Lenskaya A. S. Golyakova
author_facet	N. I. Bogomolov P. P. Pakholchyuk V. Y. Solovyov N. N. Tomskikh A. G. Goncharov M. A. Goncharova Y. Y. Lenskaya A. S. Golyakova
author_sort	N. I. Bogomolov
title	Case history of belated diagnosis of insulinoma
title_short	Case history of belated diagnosis of insulinoma
title_full	Case history of belated diagnosis of insulinoma
title_fullStr	Case history of belated diagnosis of insulinoma
title_full_unstemmed	Case history of belated diagnosis of insulinoma
title_sort	case history of belated diagnosis of insulinoma
publisher	Scientific Сentre for Family Health and Human Reproduction Problems
publishDate	2018
url	https://doaj.org/article/56cd33debfce4d42ab1e020800414bbd
work_keys_str_mv	AT nibogomolov casehistoryofbelateddiagnosisofinsulinoma AT pppakholchyuk casehistoryofbelateddiagnosisofinsulinoma AT vysolovyov casehistoryofbelateddiagnosisofinsulinoma AT nntomskikh casehistoryofbelateddiagnosisofinsulinoma AT aggoncharov casehistoryofbelateddiagnosisofinsulinoma AT magoncharova casehistoryofbelateddiagnosisofinsulinoma AT yylenskaya casehistoryofbelateddiagnosisofinsulinoma AT asgolyakova casehistoryofbelateddiagnosisofinsulinoma
_version_	1718416944716054528

Case history of belated diagnosis of insulinoma

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