Table 2 Summary of Extrapancreatic Insulinomas in the Literature
Year | Author(s) | Age (y)/ Sex | Symptoms and Duration | Location | Metastases | Localization Technique | Treatment | Follow up |
|---|---|---|---|---|---|---|---|---|
2021 | Zhang et al. [13] | 23/male | 1 year of recurrent hypoglycemia | Gastric antrum | Negative | • Pancreatic volume perfusion CT: positive • MRI abdomen: positive • Ga68-DOTATATE PET/CT: positive • 68 GA-Exendin-4PET/CT: positive • 18F-FDG PET/CT: positive • Endoscopic ultrasound: positive | Laparoscopic wedge resection of gastric antrum | N/A |
2021 | Wang et al. [14] | 62/female | Postcoital bleeding initially; symptomatic hypoglycemia after 1 year | Cervical lip | Lungs and liver | • 18 FDG-PET: positive • Ultrasound: positive • CT: positive | Initially chemotherapy; palliative care with metastases | Patient died |
2020 | Garg et al. [15] | 38/male | Recurrent hypoglycemia for 5 years, improved with food intake | Proximal jejunum | Negative | • Contrast-enhanced CT: positive • 68Ga-DOTATATE PET/CT: positive 68Ga-Exendin-4 PET/CT: positive | Excision | N/A |
2016 | Lombardi et al. [5] | 79/male | Persistent hypoglycemia despite insulin cessation after 30 years with insulin-treated type 2 diabetes | Microscopically infiltrated appendix wall to sub serosa with lymphatic and vascular invasion | Lymphatic and vascular invasion; one lymph node | • Contrast-enhanced CT: negative • EUS: negative • 68Gallium DOTANOC: positive | Laparoscopic resection | 2 months |
2014 | Ramkumar et al. [4] | 44/female | Persistent hypoglycemia, diaphoresis, and palpitations, and seizures for 3 years, usually in the morning | Right kidney | Negative | • Abdominal CT: positive • MRI abdomen: positive • EUS: negative pancreatic lesion • 68Gallium DOTANOC: positive • 99mTc-HYNICTOC: positive | Abdominal exploration and right nephrectomy | 3 months |
2013 | La Rosa et al. [2] | 75/female | Vertigo, weakness, fainting, and loss of consciousness, improved with sugar intake | 2nd portion of the duodenum | Negative | • Abdominal CT: positive • EGD: positive • EUS: positive | Surgically enucleated | 32 months |
2011 | Xian-Ling et al. [3] | 21/male | Persistent dizziness, sweating, and loss of consciousness for 3 years that resolved with glucose intake | Duodenohepatic ligament | Negative | • Transabdominal ultrasound: negative • Abdominal CT: positive • Digital subtraction angiography: positive | Laparoscopic resection | N/A |
2009 | Cárdenas et al. [6] | 46/male | 3 episodes of dizziness, blurred vision, headache, and confusion, improved sugar intake | Inferior splenic pole and hilum with perineural and vascular invasion | Three lymph nodes | • CT Scan: negative • EUS: negative • 185 MBq SC-99 m-Tc scintigraphy: negative • MRI abdomen: positive | Splenectomy | 1 year |
2005 | Hennings et al. [8] | 74/female | Intermittent dizziness for 1 year | Adjacent to ligament of Treitz | Negative | • MRI: negative • CT: negative • 111In-DTPA-octreotide: positive • EUS: positive • Transabdominal ultrasound: positive | Resection | 4 months |
1980 | Yoshikawa and Wakasa [7] | 76/female | 16 years of upper abdominal pain, intense hunger, and loss of consciousness | Retroperitoneal adipose tissue | Negative | • Autopsy | Autopsy | Patient died |