A Case of Insulinoma Performed Selective Arterial Calcium Injection

Insulinomas are comparatively rare. We successfully operated on a cases of insulinoma of which localization was revealed by preoperative as well as intraoperative examinations. A 20-year-old man was admitted because of an unconsciousness attack. By magnetic resonance imaging and ultrasonography, a tumor with the size of 2cm in diameter was found in the tail of the pancreas. We performed percutaneous transhepatic portal catheterization (PTPC) and selective arterial calcium injection (SACI), in which the localization of the tumor was diagnosed by observing the marked increase in the insulin concentration of the portal venous blood sampled near the tumor site. Partial resection of the tail of the pancreas without splenectomy was performed. In our case, hypoglycemic attacks did not occur any more after the operation. Because the surgical resection is the primary choice for the treatment of insulinoma it is necessary to diagnose the localization of the tumor preoperatively and intraoperatively for a successful resection. It is though that PTPC and SACI were useful examinations for insulinoma.