• 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.

• 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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• 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.

• 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.

• 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.

• Advances in pediatric surgery
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• 제13권2호
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• pp.155-161
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• 2007

Pancreatic tumors in children are very rare but have a better prognosis compared with that in adult. Pediatric pancreatic tumors are more often benign and easier to resect. To evaluate the characteristics and prognosis, the records of 13 patients who underwent pancreatic resection, from June 1997 to May 2005, at Samsung Medical Center were reviewed. The mean follow up period was 48 months. The male to female ratio was 1: 1.6. Mean age was 10.3 years. Signs and symptoms included abdominal pain (7), abdominal palpable mass (5), jaundice (1), hypoglycemic (1), and non-specific GI symptoms (4). The commonly used diagnostic tools were CT and abdominal sonography. In addition, MRI, ERCP, EEG, and hormone test were also done when indicated. Surgical procedures included distal pancreatectomy (5), pylorus preserving pancreaticoduodenectomy (4), tumor excision (3), and subtotal pancreatectomy (1). Locations of lesions in pancreas were head (4), tail (5), and body and tail (4). Postoperative complications developed in 3 cases; postoperative ileus (1), wound problem (1), and pancreatitis (1). The pathologic diagnosis included solid-pseudopapillary tumor (6), congenital simple cyst (1), pancreatic duplication cyst (1), serous oligocystic adenoma (1), mucinous cystadenocarcinoma (1), rhabdomyosarcoma (1), insulinoma (1), and pancreatoblastoma (1). Three cases received adjuvant chemotherapy and radiotherapy. Overall survival rate was 81 %. One patient with a mucinous cystadenocarcinoma died. In this study, pancreatic tumors in children were resectable in all patients and had good survival. Surgery of pancreatic tumors should be regarded as the gold standard of treatment and a good prognosis can be anticipated in most cases of benign and malignant tumors.