Multimodality preoperative imaging of pancreatic insulinomas
ABSTRACT Pancreatic insulinomas are rare tumours of the islet cells of the pancreas, which account for the majority of functional neuroendocrine tumours of the pancreas. There is often a typical history of recurrent hypoglycaemic collapse and dizzy spells. Insulinomas are usually solitary, and the vast majority are intra-pancreatic in location. They are characteristically small with approximately 66% being less than 2cm at presentation. Insulinomas continue to pose a diagnostic challenge to physicians, surgeons and radiologists alike. The role of imaging is to detect and provide precise anatomical localization and staging of tumours prior to surgery. Due to their small size at clinical presentation, they are notoriously difficult to localize radiologically, and specifically designed protocols are necessary to aid detection. In this review, we describe the current "state of the art" imaging protocols that may be used in the preoperative localization of insulinomas.
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ABSTRACT: The insulinoma is a rare pancreatic endocrine tumor, the incidence being estimated at only four per one million person-years. We reported three patients seen in the National Cancer Institute with symptoms, biochemical proof of endogenous hyperinsulinemic hypoglycemia and images compatible whit insulinoma, they were undergoing to surgical treatment with completed resolution of her symptoms. This paper discusses the clinical presentation and diagnosis of insulinoma with particular emphasis on localization techniques and the treatment. Early recognition and appropriate diagnostic of this uncommonly pancreatic tumor it is important because it is potentially curative with surgical treatment.Revista Colombiana de Gastroenterologia 09/2008; 23(3):280-288.
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ABSTRACT: Among the various diagnostic criteria for insulinoma, the ratio criteria have been controversial. However, the amended insulin-glucose ratio exhibited excellent diagnostic performance in a recent retrospective cohort study, although it has not yet been validated in other patient cohorts. We examined the diagnostic performance of the current criteria of the Endocrine Society, insulin-glucose ratio, C-peptide-glucose ratio, and amended ratios in terms of differentiating insulinomas.07/2014; 29(4). DOI:10.3803/EnM.2014.29.4.498
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ABSTRACT: Objective: Fasting hypoglycemia may occur in subjects with systemic lupus erythematosus (SLE) when accompanied with insulin-binding antibodies or insulin receptor antibodies. However, insulinoma has not been reported in SLE subjects with hypoglycemia.Methods: We present a case report and review the relevant literature.Results: A 26-year-old female with underlying SLE experienced several episodes of neuropsychiatric symptoms in a fasting state. The steroid dosage was titrated up, but in vain. Timely imaging studies showed a pancreatic tumor, and insulinoma was proven by pathology. Hypoglycemia did not recur after surgery.Conclusion: Physicians should distinguish insulinoma from autoimmunity-mediated hypoglycemia in SLE patients with fasting hypoglycemia.Endocrine Practice 08/2014; 1(-1):1-15. DOI:10.4158/EP14181.CR · 2.59 Impact Factor