A Case of Islet Cell Tumor with Wide Invasion to the Spleen

Ryutaro Mori, Koichiro Misuta, Ryusei Matsuyama, Satoshi Hasegawa, Shiho Natori, Seiji Hasegawa, Akira Nakano, Syunsuke Kobayashi and Yoichi Iemoto*

Department of Surgery and Department of Pathology*, Fujisawa Municipal Hospital

Insulinoma was suspected in a 49-year-old woman, presenting with Whipple's triad, and she was admitted to our hospital. She was clinically, diagnosed as having insulinoma, but while there was a could be seen a giant tumor of the spleen, no tumor of the pancreas in the imaging study. With a diagnosis of insulinoma of unknown location and splenic tumor, laparotomy was performed. Intraoperative ultrasonography revealed that the tumor had spread from the pancreatic tail to the spleen, and a distal pancreatectomy and splenectomy were performed. Pathological findings revealed malignant islet cell tumor in which vascular invasion was seen. This case suggested the switch from a functioning islet cell tumor to a nonfunctioning one.

Key words
malignant insulinoma, splenic invasion, non functioning islet cell tumor

Reprint requests
Ryutaro Mori Department of Surgery, Yokohama Red Cross Hospital
2-85 Negishi-cho, Naka-ku, Yokohama, 231-0836 JAPAN

Accepted
February 25, 2004

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