Surgery Versus Snacking as Treatment of Insulinoma

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Surgery Versus Snacking as Treatment of Insulinoma Deepna D. Jaiswal, DO, Erik A. Wallace, MD Mayo Clinic Proceedings Volume 89, Issue 1, Pages e7-e8 (January 2014) DOI: 10.1016/j.mayocp.2013.05.034 Copyright © 2014 Mayo Foundation for Medical Education and Research Terms and Conditions

Figure 1 Computed tomography of abdomen depicting 1.2 x 1.5 x 1.1 cm pancreatic mass posterior to pancreaticoduodenal artery. Mayo Clinic Proceedings 2014 89, e7-e8DOI: (10.1016/j.mayocp.2013.05.034) Copyright © 2014 Mayo Foundation for Medical Education and Research Terms and Conditions

Figure 2 Metaiodobenzylguanidine scan negative for signs of metastasis. Mayo Clinic Proceedings 2014 89, e7-e8DOI: (10.1016/j.mayocp.2013.05.034) Copyright © 2014 Mayo Foundation for Medical Education and Research Terms and Conditions

Figure 3 Postsurgical resection of specimen. Pathological dissection depicting mass at superior head of pancreas (designated by pointer on upper left). Mayo Clinic Proceedings 2014 89, e7-e8DOI: (10.1016/j.mayocp.2013.05.034) Copyright © 2014 Mayo Foundation for Medical Education and Research Terms and Conditions

Figure 4 Histological specimen of insulinoma, (hematoxylin and eosin staining, x10 magnification) shown at the interface of normal tissue and tumor tissue. The cells stained positively for pan keratin, chromogranin, and synaptophysin. Mayo Clinic Proceedings 2014 89, e7-e8DOI: (10.1016/j.mayocp.2013.05.034) Copyright © 2014 Mayo Foundation for Medical Education and Research Terms and Conditions

Figure 5 Histological specimen of pancreas (x40 magnification). Immunohistochemical staining positive for pan keratin consistent with an insulinoma. Mayo Clinic Proceedings 2014 89, e7-e8DOI: (10.1016/j.mayocp.2013.05.034) Copyright © 2014 Mayo Foundation for Medical Education and Research Terms and Conditions

Figure 6 Histological specimen of pancreas (x20 magnification) staining positive for chromogranin consistent with an insulinoma. Mayo Clinic Proceedings 2014 89, e7-e8DOI: (10.1016/j.mayocp.2013.05.034) Copyright © 2014 Mayo Foundation for Medical Education and Research Terms and Conditions

Figure 7 Histological specimen of pancreas (x20 magnification) staining positive for synaptophysin consistent with an insulinoma. Mayo Clinic Proceedings 2014 89, e7-e8DOI: (10.1016/j.mayocp.2013.05.034) Copyright © 2014 Mayo Foundation for Medical Education and Research Terms and Conditions