• 한국임상수의학회지
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• 제34권5호
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• pp.359-365
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• 2017

Two spaniel dogs were presented with a history of lethargy, weakness, refractory hypoglycemia, and episodic seizure. A pancreatic mass on the distal end of the left limb was identified through screening tests including dualphase CT angiography in each patient. Canine insulinoma was suspected with low blood glucose, low fructosamine, and normal to high serum insulin levels. Exploratory laparotomies were performed, and partial pancreatectomy using an ultrasonic-activated scalpel was achieved without enzyme leakage or fistula formation after surgery. The lesions were definitively diagnosed as insulinoma via histopathologic examination. One dog has been doing well until POD 870 with medication; in the other dog, diffuse hepatic nodules noted during surgery were confirmed as a liver metastasis. This dog died at POD 45. This case report addresses the utility of the ultrasonic scalpel in partial pancreatectomy for the treatment of canine insulinoma and differences in prognosis according to disease stage.

• Journal of Yeungnam Medical Science
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• 제5권1호
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• pp.181-189
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• 1988

저자들은 경련성 발작후 의식소실이 자주 발생하였으며 그로 인해 항경련제를 장기간 투여하였고 저혈당으로 인한 의시소실의 상태로 내원한 비만한 여자 성인 환자에서 Insulinoma를 경험하였기에 문헌 고찰과 함께 보고하고자 한다.

• Journal of Yeungnam Medical Science
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• 제5권2호
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• pp.205-211
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• 1988

본 저자들은 44세의 여자환자로 3년전부터 발생한 경련성 발작후 의식소실로 간질로 진단 받은 후 항경련제를 투여받았으나 효과가 없었던, 금식검사에서 혈청 insulin, C-peptide, glucose, 24시간 뇨 c-peptide 및 선택적 췌장동맥 촬영술로 인술린종을 진단, 수술로 종물을 적출후 경련성 발작이 사라진 인술린종 1례를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

• 대한수의학회지
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• 제52권3호
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• pp.205-208
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• 2012

Endocrine test data from a 13-year old intact female Maltese was indicative of the presence of an insulinoma, however ultrasonography identified a pancreatic mass only after 10 months after the first admission. Following identification of both pancreatic tumor and hepatic metastasis on computed tomography (CT), surgical excision of the mass was attempted. However, total excision failed because of tumor adhesion to adjacent large vessels. The pancreatic mass was monitored over the next 25 months via ultrasonography, CT, and positron emission tomography-computed tomography (PET-CT). Histopathological and immunohistochemical data confirmed the diagnosis of insulinoma with hepatic metastasis.

• Clinical and Experimental Pediatrics
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• 제58권2호
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• pp.69-72
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• 2015

Insulinoma, which arises from insulin-producing pancreatic beta cells, is a rare tumor in children. Only 5%-10% of insulinomas are malignant and undergo metastasis. We report a case of an 11-year-old girl who experienced hypoglycemia-related seizures induced by an insulinoma; after resection of the primary tumor, she developed hepatic focal nodular hyperplasia (FNH). Laboratory test results indicated marked hypoglycemia with hyperinsulinemia. Abdominal ultrasonography (US) and computed tomography results were normal; however, magnetic resonance imaging (MRI) showed a solid mass in the pancreatic tail. Therefore, laparoscopic distal pancreatectomy was performed. Two months after the surgery, an abdominal MRI revealed multiple nodular lesions in the liver. An US-guided liver biopsy was then performed, and histological examination revealed FNH without necrosis or mitotic activity. The patient has been free of hypoglycemia for 2 years, and recent MRI studies showed a decrease in the size of FNH lesions, without any evidence of metastasis. Even though no metastatic lesions are noted on imaging, close observation and follow-up imaging studies are required in a child with insulinoma that has malignant potential on histopathologic findings.

• 한국임상수의학회지
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• 제35권5호
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• pp.211-214
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• 2018

A 14-year-old intact female Yorkshire terrier was presented with a 2-month history of shivering, intermittent pelvic limb weakness and collapse. Biochemical abnormalities revealed inappropriately increased serum insulin concentration with persistent hypoglycemia. Abdominal ultrasound revealed multiple various sized nodules in liver and fine-needle aspirates of the nodule showed typical neuroendocrine cells with high cellularity. Computed tomography (CT) revealed well-defined hyperattenuating mass in the right pancreatic lobe with homogenous enhancement. CT findings were consistent with a pancreatic tumor with malignant metastasis. Treatment was initiated with low-dose prednisolone and toceranib phosphate. The dog was maintained stable with no more progression of clinical signs and it is worth to try toceranib phosphate in a dog with metastatic insulinoma for improving the quality of life.

• 한국임상수의학회지
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• 제22권3호
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• pp.275-277
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• 2005

A six year old female Shih Tzu was euthanized after having about 2 months history of weakness and convulsion with hypoglycemia. On ultrasonography, several masses in variable sizes were noted in the liver and fine needle aspiration cytology revealed probable neoplasm of pancreatic origin. On necropsy, numerous round firm tan nodules with central depression were noted in the liver and heart. Mesenteric lymph node was enlarged and fused with presumable pancreatic tissue. Based on the histopathology and immunohistochemistry, the tumor was confirmed as malignant metastatic insulinoma.

• Journal of Veterinary Science
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• 제24권3호
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• pp.39.1-39.6
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• 2023

A 7-year-old spayed female Shih Tzu dog was presented for evaluation of recurrent hypoglycemia. Serum insulin levels during hypoglycemia were 35.3 µIU/mL. Ultrasonography and computed tomography showed a mesenteric nodule between the kidney and the portal vein, but no pancreatic mass was observed. During surgery, the nodule had neither anatomical adhesions nor vascular connections to the pancreas. Pancreatic inspection and palpation revealed no abnormalities. Hypoglycemia improved after resection of the nodule. Histopathological examination confirmed the nodule to be an islet cell carcinoma. Although extremely rare, ectopic insulinoma should be considered as a possible cause of insulininduced hypoglycemia in dogs.

• 한국임상수의학회지
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• 제30권5호
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• pp.363-365
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• 2013

15살, 중성화 암컷 2.80 kg의 말티즈 개가 불명의 경련 및 허탈로 내원하였다. 내원시, 혈청화학적검사에서 심한 저혈당이 나타났으나 전해질검사, 전혈구검사, 뇨분석 및 방사선과 복부초음파에서는 특이적인 소견이 관찰되지 않았다. 인슐린 수치는 정상이었으며, 프락토스아민은 정상범위보다 약간 낮았다. 저혈당의 교정을 위해 프레드니솔론이 처방되었고, 임상증상은 개선되었다. 처음 내원한지 45주 후에, 저혈당성 경련의 재발로 다시 내원하였고, 이때 낮은 혈당치와 매우 높은 인슐린농도가 측정되었다. 복부 초음파 상에서, 췌장은 실질이 전반적으로 증가된 균질하지 않은 에코를 보였으며, 실질 내에 저에코성의 병변이 관찰되었다. 이러한 소견을 근거로, 이 개는 인슐린종으로 임상적 진단되었다. 더 높은 용량의 프레드니솔론을 하루에 2회씩 투여하였고, 경련 등의 임상증상은 개선되었다. 처음 내원한지 688일 후, 환자는 인슐린종으로 인한 저혈당성 경련의 재발 없이 아직 생존해있다. 이 사례는 말티즈 개에서 인슐린종의 진단과 프레드니솔론 단독으로 인슐린종의 장기간 관리에 대한 좋은 예를 보여준다.

• 대한수의학회지
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• 제39권4호
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• pp.698-701
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• 1999