Laparoscope resection of retroperitoneal ectopic insulinoma: A rare case

Figure 1 Radiologic findings. A: Plain scanning-phase computed tomography (CT); B: Arterial enhancement-phase CT; C: Equilibrium-phase CT showing the tumor (black arrow) in the retroperitoneum; D: Positron emission tomography showing the tumor in the retroperitoneum with no ¹⁸fluorodeoxyglucose activity.

Figure 2 Tumor imaging during surgery. A: An isolated, pink, slightly hard tumor was clearly identified under and left of the hepatoduodenal ligament (black arrow); B: Resection of the tumor was successfully performed using a harmonic scalpel with a laparoscopic approach (black arrow); C: Tumor specimen.

Figure 3 Pathologic results. Hematoxylin and eosin staining showing the tumor capsule and submucosal infiltration (A: Magnification × 40; B: Magnification × 100).

Figure 4 Immunohistochemical findings. Tumor cells were immunoreactive for Ki67 (A), Insulin (B), CD56 (C), Chromogranin A (D), Synaptophysin (E), but negative for Serotonin (F).