Insulinomas are rare neuroendocrine tumors of the pancreas. Therapy of first choice is the surgical resection or enucleation. In cases of metastases or in patients with high surgical risk, medical therapy with diazoxide or octreotide is an alternative. In this case, we describe the successful use of computed tomography (CT)-guided radiofrequency ablation (RFA) of an insulinoma in an 80-year-old female patient. The patient suffered from episodes of severe nightly hypoglycemia with a minimal glucose concentration of 1.95 mmol/l (36 mg/dl). An insulinoma measuring 1.5 cm in diameter was localized by endoscopic ultrasound and CT scan in the tail of the pancreas. Owing to a high surgical risk caused by the patient's comorbidities and poor physical condition, the resection of the tumor was not considered. The medical treatment with diazoxide failed to control the symptoms of hypoglycemia sufficiently. Using CT-guided percutaneous RFA, the insulinoma was successfully ablated. No postinterventional complications occurred. During a 5-week follow-up, episodes of hypoglycemia were absent. A control-CT, 5 weeks after RFA, revealed no residual tumor. In conclusion, we found RFA suitable for the treatment of pancreatic insulinomas. Until more data concerning efficacy and complication rates have been collected; the procedure should be reserved for the treatment of patients who are no candidates for surgical therapy and in whom symptoms cannot be controlled by the medical therapy.
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http://dx.doi.org/10.1097/meg.0b013e328323d70e | DOI Listing |
Heart Rhythm O2
December 2024
Department of Cardiovascular Medicine, Kyorin University School of Medicine, Mitaka, Japan.
Background: Junctional rhythm (JR) frequently occurs during radiofrequency (RF) ablation procedures targeting the slow pathway (SP) for atrioventricular nodal re-entrant tachycardia (AVNRT), signaling successful ablation. Two types of JR have been noticed: typical JR as His activation preceding atrial activation, and atypical JR as atrial activation preceding the His activation. Nevertheless, the origin and characteristics of JR remain incompletely defined.
View Article and Find Full Text PDFJHEP Rep
January 2025
Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan.
Background & Aims: Radiofrequency ablation (RFA) is the standard treatment for small hepatocellular carcinoma (HCC), specifically for tumors <3 cm in size and numbering fewer than three, excluding surgical candidates. Microwave ablation (MWA) is an innovative approach believed to have theoretical benefits over RFA; however, these advantages are yet to be empirically verified. Therefore, we evaluated and compared the effectiveness of MWA and RFA in managing HCC tumors up to 4 cm in size.
View Article and Find Full Text PDFEndosc Ultrasound
September 2024
Gastroenterology & Hepatology, Advent Health at Porter Adventist Hospital, Denver, CO, USA.
Eur Heart J Case Rep
January 2025
Cardiovascular Centre, Fukuoka City Hospital, 13-1 Yoshizukahon-machi, Hakata-ku, Fukuoka 812-0046, Japan.
Background: Radiofrequency ablation (RFA) procedures including cavo-tricuspid isthmus (CTI) ablation have proven to be safe and effective therapies for the treatment of many cardiac tachyarrhythmias. The incidence of coronary arterial injury (CAI) associated with RFA including CTI ablation is estimated to occur in <0.1% of patients.
View Article and Find Full Text PDFWorld J Radiol
December 2024
Department of Radiology, Interventional Radiology, Detroit Medical Center/Wayne State University, Detroit, MI 48201, United States.
Urinary fistulae are abnormal connections between the urinary system and adjacent body parts, often resulting from factors such as infection, radiation, malignancy, protracted labor, gynecologic surgery, and gastrointestinal tract surgery. These fistulae can lead to persistent urinary incontinence, skin breakdown, social humiliation, psychosocial trauma, and severe infections. Current treatments include surgical repair, urinary diversion, and ureteral embolization, though these can have complications and are not always successful or feasible for all patients.
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