EUS-guided alcohol ablation of an insulinoma

Gastrointest Endosc. 2006 Jun;63(7):1059-62. doi: 10.1016/j.gie.2005.10.034.


Background: Surgical resection is currently considered to be the criterion standard for treatment of insulinomas. Alternative treatments, despite medication with diazoxide, are lacking. EUS-guided ethanol ablation of endocrine tumors has not been reported before.

Intervention: A 78-year-old woman was referred with typical symptoms of an insulinoma. Diagnosis was confirmed by laboratory findings, EUS, and EUS-guided FNA. Because of severe complications during several hypoglycemic episodes, a poor general condition, and strict refusal of surgical resection, the decision was made to ablate the insulinoma by EUS-guided alcohol injection. A total of 8 mL 95% ethanol was injected into the tumor.

Results: The patient was discharged and exhibited no further hypoglycemic episodes, and her general condition improved rapidly. Based on clinical, morphologic, and biochemical criteria, we achieved a durable complete remission of the tumor.

Conclusions: EUS-guided ablation may become a minimally invasive alternative for patients with insulinomas in whom surgery is not feasible.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Blood Glucose / analysis
  • Endosonography*
  • Ethanol / administration & dosage*
  • Female
  • Humans
  • Hyperinsulinism / etiology
  • Insulinoma / complications
  • Insulinoma / diagnostic imaging
  • Insulinoma / drug therapy*
  • Pancreatic Neoplasms / complications
  • Pancreatic Neoplasms / diagnostic imaging
  • Pancreatic Neoplasms / drug therapy*


  • Blood Glucose
  • Ethanol