花田 稔¹, 小泉 勝¹, 小針 瑞男¹, 小野寺 博義¹, 後藤 由夫¹, 今村 幹雄²

Minoru HANADA¹, Masaru KOIZUMI¹, Mizuo KOBARI¹, Hiroyoshi ONODERA¹, Yoshio GOTO¹, Mikio IMAMURA²

¹東北大学医学部第三内科, ²東北大学医学部第一外科

¹The Third Department of Internal Medicine, Tohoku University School of Medicine, ²The First Department of Surgery, Tohoku University School of Medicine

キーワード : Insulinoma, Polypoid lesion of the gallbladder, Metastatic tumor

We described a case of metastatic insulinoma of the gallbladder presenting polypoid lesion by ultrasonogram, which to our knowledge has not been reported.
A 53-year-old female was admitted to our hospital to check up a polypoid lesion of the gallbladder. She had been operated on caudal panceatectomy on the diagnosis of the insulinoma twelve years ago, and irradiated to the lumber metastatic tumor of unknown origin two years ago. She had taken no episode of typical hypoglycemic attack after the operation. Laboratory findings on admission revealed anemia and liver dysfunction. Ultrasonogram demonstrated a smooth-surface polypoid lesion, 13 mm in diameter, in the neck of the gallbladder with small stones. DIC findings disclosed defect of shadow at the same location. Celiac angiography revealed hypervascularity and tumor stain supplied by cystic artery. Cholecystectomy was performed. The resected tumor was proved malignant insulinoma by histopathological and immunohistological findings.