Insulinoma

Jeffrey A. Norton, Eric Whitman

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Patients with insulinoma usually present with significant neuroglycopenic symptoms. The preferred diagnostic test is a controlled and monitored fast, measuring blood levels of glucose, insulin, C-peptide, and proinsulin. Surreptitious hypoglycemia should be considered and ruled out. Screening for the presence of multiple endocrine neoplasia type 1 (MEN-1) by family history, as well as for other associated endocrine abnormalities, is an essential part of the evaluation. In patients with sporadic insulinoma, the tumor is generally singular, small, benign, and can appear anywhere within the pancreas. Radiographic localization studies are indicated to identify the tumor or to identify the region (head, body, or tail) of the pancreas that contains the tumor. Medical therapy can control some of the symptoms but, ultimately, surgical intervention is necessary. The goal of surgery for insulinoma is precise removal of tumor without sacrificing normal tissue. Intraoperative ultrasound can identify some occult tumors, reducing the need for extensive pancreatic resection. Surgical results are excellent for patients with sporadic disease: greater than 90% are cured. Patients with MEN-1 have multiple islet cell tumors, and surgical results are less satisfactory. Most patients, however, will have improvement of hypoglycemia following surgery.

Original languageEnglish (US)
Pages (from-to)258-267
Number of pages10
JournalEndocrinologist
Volume3
Issue number4
DOIs
StatePublished - Jan 1 1993
Externally publishedYes

Fingerprint

Insulinoma
Multiple Endocrine Neoplasia Type 1
Neoplasms
Hypoglycemia
Pancreas
Islet Cell Adenoma
Body Regions
C-Peptide
Routine Diagnostic Tests
Blood Glucose
Head
Insulin

All Science Journal Classification (ASJC) codes

  • Endocrinology, Diabetes and Metabolism

Cite this

Norton, Jeffrey A. ; Whitman, Eric. / Insulinoma. In: Endocrinologist. 1993 ; Vol. 3, No. 4. pp. 258-267.
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Insulinoma. / Norton, Jeffrey A.; Whitman, Eric.

In: Endocrinologist, Vol. 3, No. 4, 01.01.1993, p. 258-267.

Research output: Contribution to journalArticle

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AB - Patients with insulinoma usually present with significant neuroglycopenic symptoms. The preferred diagnostic test is a controlled and monitored fast, measuring blood levels of glucose, insulin, C-peptide, and proinsulin. Surreptitious hypoglycemia should be considered and ruled out. Screening for the presence of multiple endocrine neoplasia type 1 (MEN-1) by family history, as well as for other associated endocrine abnormalities, is an essential part of the evaluation. In patients with sporadic insulinoma, the tumor is generally singular, small, benign, and can appear anywhere within the pancreas. Radiographic localization studies are indicated to identify the tumor or to identify the region (head, body, or tail) of the pancreas that contains the tumor. Medical therapy can control some of the symptoms but, ultimately, surgical intervention is necessary. The goal of surgery for insulinoma is precise removal of tumor without sacrificing normal tissue. Intraoperative ultrasound can identify some occult tumors, reducing the need for extensive pancreatic resection. Surgical results are excellent for patients with sporadic disease: greater than 90% are cured. Patients with MEN-1 have multiple islet cell tumors, and surgical results are less satisfactory. Most patients, however, will have improvement of hypoglycemia following surgery.

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