PMID: 9430026Jan 16, 1998Paper

Acinar-islet cell carcinoma presenting as insulinoma

Journal of Gastroenterology
T ShimoikeH Nawata

Abstract

A case of acinar-islet cell carcinoma presenting as insulinoma is reported. The patient was a 28-year-old man who presented with two convulsive episodes. Fajans' index [immunoreactive insulin (IRI; microU/ml/ glucose mg/dl)] and Turner's [IRI (microU/ml) x 100/glucose (mg/dl) - 30] index were high (2.8 and 308, respectively), as were serum proinsulin levels (550 pg/ml). Abdominal computed tomography and angiography revealed a highly vascular tumor in the pancreatic tail and several similar tumors in the liver. Histologic features of a biopsy specimen from a hepatic tumor were those of a malignant pancreatic endocrine tumor. Insulin secretion by the liver metastases was confirmed by venous sampling after arterial stimulation with calcium. These findings led us to diagnose malignant insulinoma with liver metastases. Serum levels of alpha-fetoprotein and trypsin were markedly elevated, to 2234 ng/ml (normal < 10) and 22,000 ng/ml (normal < 460) respectively, and these levels continued to rise with further growth of the liver metastases. Immunohistochemically, the metastatic liver tumor specimen was positive for alpha-fetoprotein, alpha 1-antichymotrypsin, chromogranin A, and neuron-specific enolase. These findings of amphicrine fe...Continue Reading

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Citations

Sep 1, 2005·Veterinary and Comparative Oncology·Z BelshawR Reuter
May 10, 2001·Advances in Anatomic Pathology·N G Ordóñez
Sep 29, 2006·APMIS : Acta Pathologica, Microbiologica, Et Immunologica Scandinavica·Kyoko MinakawaAkio Yanagisawa
May 9, 2007·Modern Pathology : an Official Journal of the United States and Canadian Academy of Pathology, Inc·David S Klimstra
Jun 7, 2005·Cancer·Boaz HirshbergPhillip Gorden
May 15, 2013·Korean Journal of Pathology·Adam D TollSyed Z Ali
Jul 20, 2002·The American Journal of Surgical Pathology·Rhonda K YantissRobert D Odze

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