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Ectopic insulinoma: a systematic review

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Abstract

Knowledge of ectopic insulinomas comes from single cases. We performed a systematic review through PubMed, Web of Science, Embase, eLibrary and ScienceDirect of all cases reported in the last four decades. We also describe one unreported patient. From 28 patients with ectopic insulinoma, 78.6% were female and mean age was 55.7 ± 19.2 years. Hypoglycaemia was the first symptom in 85.7% while 14.3% complained of abdominal pain or genital symptoms. Median tumour diameter was 27.5 [15-52.5] mm and it was localised by CT (73.1%), MRI (88.9%), [68Ga]Ga-DOTA-exedin-4 PET/CT (100%), 68Ga-labelled-DOTA-conjugated somatostatin analogue PET/TC (100%), somatostatin receptor scintigraphy (40%) and endoscopic ultrasound (50%). Ectopic insulinomas were located at duodenum (n = 3), jejunum (n = 2), and one respectively at stomach, liver, appendix, rectum, mesentery, ligament of Treitz, gastrosplenic ligament, hepatoduodenal ligament and splenic hilum. Seven insulinomas were affecting the female reproductive organs: ovary (n = 5), cervix (n = 2) and remaining tumours were at retroperitoneum (n = 3), kidney (n = 2), spleen (n = 1) and pelvis (n = 1). 89.3% underwent surgery (66.7% surgery vs. 33.3% laparoscopy) and 16% underwent an ineffective pancreatectomy. 85.7% had localized disease at diagnosis and 14.3% developed distant metastasis. Median follow-up time was 14.5 [4.5–35.5] months and mortality was reported in 28.6% with median time until death of 60 [5-144] months. In conclusion, ectopic insulinomas are presented as hypoglycaemia with female preponderance. Functional imaging [68Ga]Ga-DOTA-exedin-4 PET/CT and 68Ga-labelled-DOTA-conjugated somatostatin analogue PET/TC have very high sensitivity. Clinicians should be alert to the possibility of extra-pancreatic insulinomas when classic diagnostic tests and intraoperative pancreas exploration failed to locate the tumour.

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Data Availability

The data generated and analyzed during the current study are available from the corresponding author on reasonable request.

Abbreviations

CT:

Computed tomography

EUS:

Endoscopic ultrasound

GLP-1:

Glucagon-like peptide 1

IGF-2:

Insulin-like growth factor 2

MEN-1:

Multiples endocrine neoplasia type 1

MRI:

Magnetic resonance imaging

NETs:

Neuroendocrine tumours

PET:

Positron emission tomography

SRS:

Somatostatin receptor scintigraphy

US:

Ultrasonography

WHO:

World Health Organization

References

  1. Shah P, Rahman SA, Demirbilek H, Güemes M, Hussain K. Hyperinsulinaemic hypoglycaemia in children and adults. Lancet Diabetes Endocrinol. 2017;5:729–42. https://doi.org/10.1016/S2213-8587(16)30323-0.

    Article  CAS  PubMed  Google Scholar 

  2. Douillard C, Jannin A, Vantyghem MC. Rare causes of hypoglycemia in adults. Ann Endocrinol (Paris). 2020;81:110–7. https://doi.org/10.1016/j.ando.2020.04.003.

    Article  PubMed  Google Scholar 

  3. Iglesias P, Díez JJ. Management of endocrine disease: a clinical update on tumor-induced hypoglycemia. Eur J Endocrinol. 2014;170:R147–57. https://doi.org/10.1530/EJE-13-1012.

    Article  CAS  PubMed  Google Scholar 

  4. de Groot JW, Rikhof B, van Doorn J, Bilo HJ, Alleman MA, Honkoop AH, et al. Non-islet cell tumour-induced hypoglycaemia: a review of the literature including two new cases. Endocr Relat Cancer. 2007;14:979–93. https://doi.org/10.1677/ERC-07-0161.

    Article  CAS  PubMed  Google Scholar 

  5. Maggio I, Mollica V, Brighi N, Lamberti G, Manuzzi L, Ricci AD, et al. The functioning side of the pancreas: a review on insulinomas. J Endocrinol Invest. 2020;43:139–48. https://doi.org/10.1007/s40618-019-01091-w.

    Article  CAS  PubMed  Google Scholar 

  6. Kim DU, Lubner MG, Mellnick VM, Joshi G, Pickhardt PJ. Heterotopic pancreatic rests: imaging features, complications, and unifying concepts. Abdom Radiol (NY). 2017;42:216–25. https://doi.org/10.1007/s00261-016-0874-9.

    Article  PubMed  Google Scholar 

  7. Rezvani M, Menias C, Sandrasegaran K, Olpin JD, Elsayes KM, Shaaban AM. Heterotopic pancreas: histopathologic features, imaging findings, and complications. Radiographics. 2017;37:484–99. https://doi.org/10.1148/rg.2017160091.

    Article  PubMed  Google Scholar 

  8. Yan ML, Wang YD, Tian YF, Lin Y. Adenocarcinoma arising from intrahepatic heterotopic pancreas: a case report and literature review. World J Gastroenterol. 2012;18:2881–4. https://doi.org/10.3748/wjg.v18.i22.2881.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021;372:n71. https://doi.org/10.1136/bmj.n71.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Lloyd RV, Osamura RY, Kloppel G, Rosai J. WHO classification of Tumours of Endocrine Organs. 4th ed. Lyon: IARC Press; 2018.

    Google Scholar 

  11. Walker MP, Shenoy V, Metz DC, Stanley CA, Fraker D, Chandrasekhara V, et al. Case presentation of 8-year follow up of recurrent malignant duodenal insulinoma and lymph node metastases and literature review of malignant Insulinoma management. BMC Endocr Disord. 2022;22:310. https://doi.org/10.1186/s12902-022-01219-9.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Zhang X, Jia H, Li F, Fang C, Zhen J, He Q, et al. Ectopic insulinoma diagnosed by 68Ga-Exendin-4 PET/CT: a case report and review of literature. Med (Baltim). 2021;100:e25076. https://doi.org/10.1097/MD.0000000000025076.

    Article  Google Scholar 

  13. Wang M, Vasey Q, Varikatt W, Mclean M. Ectopic insulin secretion by a large-cell neuroendocrine carcinoma of the cervix. Clin Case Rep. 2020;9:482–6. https://doi.org/10.1002/ccr3.3562.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Kriger A, Berelavichus S, Gorin D, Galkin G, Yukina M, Ilovayskaya I, et al. Successful surgical treatment of a patient with primary insulinoma of the liver. J Surg Case Rep. 2020;2020:rjaa519. https://doi.org/10.1093/jscr/rjaa519.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  15. Garg R, Memon S, Patil V, Bandgar T. Extrapancreatic insulinoma. World J Nucl Med. 2020;19:162–4. https://doi.org/10.4103/wjnm.WJNM_41_19.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Sun M, Luo Y, You Y, Han X, Zhao Y, Han X, et al. Ectopic insulinoma: case report. BMC Surg. 2019;19:197. https://doi.org/10.1186/s12893-019-0661-y.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. Liu Q, Duan J, Zheng Y, Luo J, Cai X, Tan H. Rare malignant insulinoma with multiple liver metastases derived from ectopic pancreas: 3-year follow-up and literature review. Onco Targets Ther. 2018;11:1813–9. https://doi.org/10.2147/OTT.S154991.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Li TN, Liu Z, Zhang Y, Wang F. Ectopic insulinomas in the pelvis secondary to rectum neuroendocrine tumour. BMJ Case Rep. 2018;2018:bcr2018224281. https://doi.org/10.1136/bcr-2018-224281.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Mossman AK, Pattison DA, Hicks RJ, Hamblin PS, Yates CJ. Localisation of occult extra-pancreatic insulinoma using glucagon-like peptide-1 receptor molecular imaging. Intern Med J. 2018;48:97–8.

    Article  PubMed  Google Scholar 

  20. Lombardi M, Battezzati MA, Grosso F, Muni A, Volante M, Ansaldi E. Appendix insulin secreting neuroendocrine tumor in a diabetic patient: a challenging diagnosis. J Syst Integr Neurosci. 2015. https://doi.org/10.15761/JSIN.1000128.

    Article  Google Scholar 

  21. Battocchio M, Zatelli MC, Chiarelli S, Trento M, Ambrosio MR, Pasquali C, et al. Ovarian tumors secreting insulin. Endocrine. 2015;49:611–9. https://doi.org/10.1007/s12020-015-0605-y.

    Article  CAS  PubMed  Google Scholar 

  22. Liu J, Zhang CW, Hong DF, Wu J, Yang HG, Chen Y, et al. Laparoscope resection of retroperitoneal ectopic insulinoma: a rare case. World J Gastroenterol. 2015;21:4413–8. https://doi.org/10.3748/wjg.v21.i14.4413.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Ramkumar S, Dhingra A, Jyotsna V, Ganie MA, Das CJ, Seth A, et al. Ectopic insulin secreting neuroendocrine tumor of kidney with recurrent hypoglycemia: a diagnostic dilemma. BMC Endocr Disord. 2014;14:36. https://doi.org/10.1186/1472-6823-14-36.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  24. La Rosa S, Pariani D, Calandra C, Marando A, Sessa F, Cortese F, et al. Ectopic duodenal insulinoma: a very rare and challenging tumor type. Description of a case and review of the literature. Endocr Pathol. 2013;24:213–9. https://doi.org/10.1007/s12022-013-9262-y.

    Article  PubMed  Google Scholar 

  25. Xian-Ling W, Yi-Ming M, Jing-Tao D, Wen-Wen Z, Zhao-Hui L, Rong L, et al. Successful laparoscope resection of ectopic insulinoma in duodenohepatic ligament. Am J Med Sci. 2011;341:420–2. https://doi.org/10.1097/MAJ.0b013e31820b8a67.

    Article  PubMed  Google Scholar 

  26. Christ E, Wild D, Forrer F, Brändle M, Sahli R, Clerici T, et al. Glucagon-like peptide-1 receptor imaging for localization of insulinomas. J Clin Endocrinol Metab. 2009;94:4398–405. https://doi.org/10.1210/jc.2009-1082.

    Article  CAS  PubMed  Google Scholar 

  27. Cárdenas CM, Domínguez I, Campuzano M, Bezaury P, Iñiguez-Rodríguez M, Gamboa-Domínguez A, et al. Malignant insulinoma arising from intrasplenic heterotopic pancreas. JOP. 2009;10:321–3.

    PubMed  Google Scholar 

  28. Morken NH, Majak B, Kahn JA. Insulin producing primary ovarian carcinoid tumor. Acta Obstet Gynecol Scand. 2007;86:500–1. https://doi.org/10.1080/00016340600613477.

    Article  PubMed  Google Scholar 

  29. Hennings J, Garske U, Botling J, Hellman P. Malignant insulinoma in ectopic pancreatic tissue. Dig Surg. 2005;22:377–9. https://doi.org/10.1159/000090998.

    Article  PubMed  Google Scholar 

  30. Seckl MJ, Mulholland PJ, Bishop AE, Teale JD, Hales CN, Glaser M, et al. Hypoglycemia due to an insulin-secreting small-cell carcinoma of the cervix. N Engl J Med. 1999;341:733–6. https://doi.org/10.1056/NEJM199909023411004.

    Article  CAS  PubMed  Google Scholar 

  31. Ashton MA. Strumal carcinoid of the ovary associated with hyperinsulinaemic hypoglycaemia and cutaneous melanosis. Histopathology. 1995;27:463–7. https://doi.org/10.1111/j.1365-2559.1995.tb00311.x.

    Article  CAS  PubMed  Google Scholar 

  32. Leach SD, LaMorte AI, True LD, Flynn SD, Schwartz PE, Cahow CE, et al. Aberrant hormone production from ovarian neoplasms: strategies for diagnosis and therapy. World J Surg. 1990;14. https://doi.org/10.1007/BF01658520. 335 – 40; discussion 340-1.

  33. Gray HW, Smith ML, Chung FF, Yogorajah S, Beastall GH. Hyperinsulinism associated with primary renal cell carcinoma. Urology. 1989;33:238–40. https://doi.org/10.1016/0090-4295(89)90401-9.

    Article  CAS  PubMed  Google Scholar 

  34. Morgello S, Schwartz E, Horwith M, King ME, Gorden P, Alonso DR. Ectopic insulin production by a primary ovarian carcinoid. Cancer. 1988;61:800–5. https://doi.org/10.1002/1097-0142(19880215)61:4<800::aid-cncr2820610426>3.0.co;2-3.

    Article  CAS  PubMed  Google Scholar 

  35. Miyazaki K, Funakoshi A, Nishihara S, Wasada T, Koga A, Ibayashi H. Aberrant insulinoma in the duodenum. Gastroenterology. 1986;90:1280–5. https://doi.org/10.1016/0016-5085(86)90397-5.

    Article  CAS  PubMed  Google Scholar 

  36. Shetty MR, Boghossian HM, Duffell D, Freel R, Gonzales JC. Tumor-induced hypoglycemia: a result of ectopic insulin production. Cancer. 1982;49:1920–3. https://doi.org/10.1002/1097-0142(19820501)49:9<1920::aidcncr2820490927>3.0.co;2-m.

    Article  CAS  PubMed  Google Scholar 

  37. Yoshikawa K, Wakasa H. Hypoglycemia associated with aberrant insulinoma: a case report of 16 years follow-up. Tohoku J Exp Med. 1980;132:17–29. https://doi.org/10.1620/tjem.132.17.

    Article  CAS  PubMed  Google Scholar 

  38. Ghali F, Hyams ES. Heterotopic pancreatic tail appearing as adrenal mass in a patient with left pelvic kidney. Urology. 2015;85:e37–8. https://doi.org/10.1016/j.urology.2015.01.037.

    Article  PubMed  Google Scholar 

  39. Koh HM, Chang JW, Jeong SY, Hyun CL, Kim YS, Jang BG, et al. Ectopic pancreas presenting as a solid Mediastinal Mass. Int J Surg Pathol. 2015;23:585–8. https://doi.org/10.1177/1066896915596810.

    Article  CAS  PubMed  Google Scholar 

  40. Goodarzi M, Rashid A, Maru D. Invasive ductal adenocarcinoma arising from pancreatic heterotopia in rectum: case report and review of literature. Hum Pathol. 2010;41:1809–13. https://doi.org/10.1016/j.humpath.2010.06.005.

    Article  PubMed  Google Scholar 

  41. Makhlouf HR, Almeida JL, Sobin LH. Carcinoma in jejunal pancreatic heterotopia. Arch Pathol Lab Med. 1999;123:707–11. https://doi.org/10.5858/1999-123-0707-CIJPH.

    Article  CAS  PubMed  Google Scholar 

  42. Service FJ, McMahon MM, O’Brien PC, Ballard DJ. Functioning insulinoma–incidence, recurrence, and long-term survival of patients: a 60-year study. Mayo Clin Proc. 1991;66:711–9. https://doi.org/10.1016/s0025-6196(12)62083-7.

    Article  CAS  PubMed  Google Scholar 

  43. Okabayashi T, Shima Y, Sumiyoshi T, Kozuki A, Ito S, Ogawa Y, et al. Diagnosis and management of insulinoma. World J Gastroenterol. 2013;19:829–37. https://doi.org/10.3748/wjg.v19.i6.829.

    Article  PubMed  PubMed Central  Google Scholar 

  44. Giannis D, Moris D, Karachaliou GS, Tsilimigras DI, Karaolanis G, Papalampros A, et al. Insulinomas: from diagnosis to treatment. A review of the literature. J BUON. 2020;25:1302–14.

    PubMed  Google Scholar 

  45. Placzkowski KA, Vella A, Thompson GB, Grant CS, Reading CC, Charboneau JW, et al. Secular trends in the presentation and management of functioning insulinoma at the Mayo Clinic, 1987–2007. J Clin Endocrinol Metab. 2009;94:1069–73. https://doi.org/10.1210/jc.2008-2031.

    Article  CAS  PubMed  Google Scholar 

  46. Borson-Chazot F, Cardot-Bauters C, Mirallie É, Pattou F. French endocrine society. Insulinoma of genetic aetiology. Ann Endocrinol (Paris). 2013;74:200–2. https://doi.org/10.1016/j.ando.2013.05.006.

    Article  PubMed  Google Scholar 

  47. Soga J. Statistical evaluation of 2001 carcinoid cases with metastases, collected from literature: a comparative study between ordinary carcinoids and atypical varieties. J Exp Clin Cancer Res. 1998;17:3–12.

    CAS  PubMed  Google Scholar 

  48. Low SK, Giannis D, Bahaie NS, Trong BLH, Moris D, Huy NT. Competing mortality in patients with neuroendocrine tumors. Am J Clin Oncol. 2019;42:668–74. https://doi.org/10.1097/COC.0000000000000575.

    Article  PubMed  Google Scholar 

  49. Ma H, Zhang XP, Zhang Y, Lu HD, Wang JT, Zhang Y, et al. Pancreatic insulinoma misdiagnosed as Epilepsy for eight years: a Case Report and Literature Review. Intern Med. 2015;54:1519–22. https://doi.org/10.2169/internalmedicine.54.3708.

    Article  PubMed  Google Scholar 

  50. Vella A. Insulinoma. UpToDate. 2023. http://www.uptodate.com. Accessed April, 2023.

  51. Burghardt L, Meier JJ, Uhl W, Kahle-Stefan M, Schmidt WE, Nauck MA. Importance of localization of insulinomas: a systematic analysis. J Hepatobiliary Pancreat Sci. 2019;26:383–92. https://doi.org/10.1002/jhbp.642.

    Article  PubMed  Google Scholar 

  52. Rayamajhi SJ, Lee J, Mittal BR, Jessop AC, Chasen B, Bhosale P. Cross sectional and nuclear medicine imaging of pancreatic insulinomas. Abdom Radiol (NY). 2017;42:531–43. https://doi.org/10.1007/s00261-016-0904-7.

    Article  PubMed  Google Scholar 

  53. Antwi K, Fani M, Nicolas G, Rottenburger C, Heye T, Reubi JC, et al. Localization of Hidden Insulinomas with 68Ga-DOTA-Exendin-4 PET/CT: a pilot study. J Nucl Med. 2015;56:1075–8. https://doi.org/10.2967/jnumed.115.157768.

    Article  CAS  PubMed  Google Scholar 

  54. Luo Y, Yu M, Pan Q, Wu W, Zhang T, Kiesewetter DO, et al. 68Ga-NOTA-exendin-4 PET/CT in detection of occult insulinoma and evaluation of physiological uptake. Eur J Nucl Med Mol Imaging. 2015;42:531–2. https://doi.org/10.1007/s00259-014-2946-9.

    Article  PubMed  Google Scholar 

  55. Luo Y, Li N, Kiesewetter DO, Chen X, Li F. 68Ga-NOTA-Exendin-4 PET/CT in localization of an Occult Insulinoma and Appearance of coexisting esophageal carcinoma. Clin Nucl Med. 2016;41:341–3. https://doi.org/10.1097/RLU.0000000000001087.

    Article  PubMed  PubMed Central  Google Scholar 

  56. Prasad V, Sainz-Esteban A, Arsenic R, Plöckinger U, Denecke T, Pape UF, et al. Role of (68)Ga somatostatin receptor PET/CT in the detection of endogenous hyperinsulinaemic focus: an explorative study. Eur J Nucl Med Mol Imaging. 2016;43:1593–600. https://doi.org/10.1007/s00259-016-3331-7.

    Article  CAS  PubMed  Google Scholar 

  57. Shah R, Garg R, Majmundar M, Purandare N, Malhotra G, Patil V, et al. Exendin-4-based imaging in insulinoma localization: systematic review and meta-analysis. Clin Endocrinol (Oxf). 2021;95:354–64. https://doi.org/10.1111/cen.14406.

    Article  CAS  PubMed  Google Scholar 

  58. Kann PH, Moll R, Bartsch D, Pfützner A, Forst T, Tamagno G, et al. Endoscopic ultrasound-guided fine-needle aspiration biopsy (EUS-FNA) in insulinomas: indications and clinical relevance in a single investigator cohort of 47 patients. Endocrine. 2017;56:158–63. https://doi.org/10.1007/s12020-016-1179-z.

    Article  CAS  PubMed  Google Scholar 

  59. Wang H, Ba Y, Xing Q, Cai RC. Diagnostic value of ASVS for insulinoma localization: a systematic review and meta-analysis. PLoS ONE. 2019;14:e0224928. https://doi.org/10.1371/journal.pone.0224928.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  60. Mehrabi A, Fischer L, Hafezi M, Dirlewanger A, Grenacher L, Diener MK, et al. A systematic review of localization, surgical treatment options, and outcome of insulinoma. Pancreas. 2014;43:675–86. https://doi.org/10.1097/MPA.0000000000000110.

    Article  PubMed  Google Scholar 

  61. Aggeli C, Nixon AM, Karoumpalis I, Kaltsas G, Zografos GN. Laparoscopic surgery for pancreatic insulinomas: an update. Horm (Athens). 2016;15:157–69. https://doi.org/10.14310/horm.2002.1670.

    Article  Google Scholar 

  62. Qin S, Liu Y, Ning H, Tao L, Luo W, Lu D, et al. EUS-guided lauromacrogol ablation of insulinomas: a novel treatment. Scand J Gastroenterol. 2018;53:616–20. https://doi.org/10.1080/00365521.2017.1402206.

    Article  PubMed  Google Scholar 

  63. Qin SY, Lu XP, Jiang HX. EUS-guided ethanol ablation of insulinomas: case series and literature review. Med (Baltim). 2014;93:e85. https://doi.org/10.1097/MD.0000000000000085.

    Article  Google Scholar 

  64. Berwaerts J, Verhelst J, Hubens H, Kunnen J, Schrijvers D, Joosens E, et al. Role of hepatic arterial embolisation in the treatment for metastatic insulinoma. Report of two cases and review of the literature. Acta Clin Belg. 1997;52:263–74. https://doi.org/10.1080/17843286.1997.11718588.

    Article  CAS  PubMed  Google Scholar 

  65. Cigrovski Berkovic M, Ulamec M, Marinovic S, Balen I, Mrzljak A. Malignant insulinoma: can we predict the long-term outcomes? World J Clin Cases. 2022;10:5124–32. https://doi.org/10.12998/wjcc.v10.i16.5124.

    Article  PubMed  PubMed Central  Google Scholar 

  66. Magalhães D, Sampaio IL, Ferreira G, Bogalho P, Martins-Branco D, Santos R, et al. Peptide receptor radionuclide therapy with 177Lu-DOTA-TATE as a promising treatment of malignant insulinoma: a series of case reports and literature review. J Endocrinol Invest. 2019;42:249–60. https://doi.org/10.1007/s40618-018-0911-3.

    Article  CAS  PubMed  Google Scholar 

  67. Nikfarjam M, Warshaw AL, Axelrod L, Deshpande V, Thayer SP, Ferrone CR, et al. Improved contemporary surgical management of insulinomas: a 25-year experience at the Massachusetts General Hospital. Ann Surg. 2008;247:165–72. https://doi.org/10.1097/SLA.0b013e31815792ed.

    Article  PubMed  Google Scholar 

  68. Crippa S, Zerbi A, Boninsegna L, Capitanio V, Partelli S, Balzano G, et al. Surgical management of insulinomas: short- and long-term outcomes after enucleations and pancreatic resections. Arch Surg. 2012;147:261–6. https://doi.org/10.1001/archsurg.2011.1843.

    Article  PubMed  Google Scholar 

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Acknowledgements

Georgina F. Caulfield for the language review of the paper.

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Author notes

  1. Fernando Guerrero-Pérez and Nuria Vilarrasa contributed equally.

Authors and Affiliations

  1. Department of Endocrinology, Bellvitge University Hospital, Barcelona, Spain

    Fernando Guerrero-Pérez, Nuria Vilarrasa, Lidia V. Huánuco & Carles Villabona

  2. Biomedical Research Institute of Bellvitge (IDIBELL), L’Hospitalet de Llobregat, Barcelona, Spain

    Fernando Guerrero-Pérez, Nuria Vilarrasa, Lidia V. Huánuco, Juli Busquets, Lluis Secanella, José L. Vercher-Conejero, Noemi Vidal & Carles Villabona

  3. CIBER de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain

    Fernando Guerrero-Pérez & Nuria Vilarrasa

  4. Department of Hepatobiliary and Pancreatic Surgery, Hospital Universitari de Bellvitge, L’Hospitalet de Llobregat, Barcelona, Spain

    Juli Busquets & Lluis Secanella

  5. Department of Nuclear Medicine-PET Unit, University Hospital Bellvitge, L’Hospitalet de Llobregat, Barcelona, Spain

    José L. Vercher-Conejero

  6. Department of Pathology, Bellvitge University Hospital, L’Hospitalet de Llobregat, Barcelona, Spain

    Noemi Vidal

  7. Department of Endocrinology, Joan XXIII University Hospital, Tarragona, Spain

    Silvia Näf Cortés

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Contributions

FG-P, NV, CV (conceived the study and wrote original draft); FG-P, LH, SNC, NV (acquisition and curation data); FG-P, NV, JLV-C (analysis and interpretation data); JB, LS, JLC-C, NV (critical revision of the manuscript). All authors have read and agreed to publish the final version of the manuscript.

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Correspondence to Fernando Guerrero-Pérez.

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Guerrero-Pérez, F., Vilarrasa, N., Huánuco, L.V. et al. Ectopic insulinoma: a systematic review. Rev Endocr Metab Disord 24, 1135–1146 (2023). https://doi.org/10.1007/s11154-023-09824-2

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  • DOI: https://doi.org/10.1007/s11154-023-09824-2

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