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Increased Calcium Ion Levels Following Systemic Circulation After the Selective Arterial Calcium Injection Test.

FIGURE 1. A, Celiac arteriography. B, Superior mesenteric arteriography. A tumor stain was found in the lesion of the inferior pancreaticoduodenal artery. The right hepatic artery was found to originate from the superiormesenteric artery. The arrowhead represents the position where calcium gluconate was administered in the right hepatic artery in the SACI test. C, The results of the first SACI test (0.025 mEq/kg). D, The results of the second SACI test (0.0045 mEq/kg). Serum insulin levels are expressed as μU/mL. RHA, right hepatic artery; SA, splenic artery; DPA, dorsal pancreatic artery; GDA, gastroduodenal artery; SMA, superior mesenteric artery; IPA, inferior pancreaticoduodenal artery. S elective arterial calcium injection (SACI) test is performed for the insulinoma localization to provide further localization data before surgery. Here, we present a case that showed a false-positive result in the SACI test to localize an insulinoma. We detected the increased calcium ion concentration after systemic circulation after calcium gluconate injection, and the circulating calcium may have stimulated insulin secretion from the insulinoma. A 67-year-old man was admitted for evaluation after loss of consciousness. On physical examination, he was 167 cm tall and weighed 71.1 kg, with a body weight gain of 10 kg over 10 years. His fasting blood glucose levels were 25 to 75 mg/dL during his hospitalization. Fasting serum insulin and C-peptide levels were 6.1 to 8.0 μU/mL and 1.7 to 2.3 ng/mL, respectively. On the basis of the endocrinological