Abstract
Insulinoma remains a very rare tumor, and the first challenge to making the diagnosis is to consider it. Although these tumors are typically benign, they can cause severe and often bizarre symptoms. The diagnosis is established with biochemical confirmation of hypoglycemia and endogenous hyperinsulinemia after fasting, and is distinguished from the postprandial hyperinsulinemic hypoglycemia of Noninsulinoma Pancreatogenous Hyperinsulinemia Syndrome (NIPHS). Operative removal of the tumor is the mainstay of treatment, but is predicated on precise preoperative localization. Multiple imaging options are available, including: transabdominal ultrasound, computed tomography, endoscopic ultrasound (EUS), angiography with intraarterial calcium stimulation testing, and intraoperative ultrasound (IOUS). Patients with MEN-1 syndrome virtually always have multiple pancreatic neuroendocrine tumors, and evaluation and treatment of these patients is different than for sporadic disease. Surgical excision of the disease is the only cure; in the rare case of malignant disease, an aggressive surgical and multimodal approach is recommended, even for palliation of hypoglycemia.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 235-252 |
| Number of pages | 18 |
| Journal | Cancer Treatment and Research |
| Volume | 153 |
| DOIs | |
| State | Published - 2010 |
| Externally published | Yes |
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ASJC Scopus subject areas
- Oncology
- Cancer Research
Cite this
Insulinoma. / Grant, Clive; Vanderveen, Kimberly.
In: Cancer Treatment and Research, Vol. 153, 2010, p. 235-252.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Insulinoma
AU - Grant, Clive
AU - Vanderveen, Kimberly
PY - 2010
Y1 - 2010
N2 - Insulinoma remains a very rare tumor, and the first challenge to making the diagnosis is to consider it. Although these tumors are typically benign, they can cause severe and often bizarre symptoms. The diagnosis is established with biochemical confirmation of hypoglycemia and endogenous hyperinsulinemia after fasting, and is distinguished from the postprandial hyperinsulinemic hypoglycemia of Noninsulinoma Pancreatogenous Hyperinsulinemia Syndrome (NIPHS). Operative removal of the tumor is the mainstay of treatment, but is predicated on precise preoperative localization. Multiple imaging options are available, including: transabdominal ultrasound, computed tomography, endoscopic ultrasound (EUS), angiography with intraarterial calcium stimulation testing, and intraoperative ultrasound (IOUS). Patients with MEN-1 syndrome virtually always have multiple pancreatic neuroendocrine tumors, and evaluation and treatment of these patients is different than for sporadic disease. Surgical excision of the disease is the only cure; in the rare case of malignant disease, an aggressive surgical and multimodal approach is recommended, even for palliation of hypoglycemia.
AB - Insulinoma remains a very rare tumor, and the first challenge to making the diagnosis is to consider it. Although these tumors are typically benign, they can cause severe and often bizarre symptoms. The diagnosis is established with biochemical confirmation of hypoglycemia and endogenous hyperinsulinemia after fasting, and is distinguished from the postprandial hyperinsulinemic hypoglycemia of Noninsulinoma Pancreatogenous Hyperinsulinemia Syndrome (NIPHS). Operative removal of the tumor is the mainstay of treatment, but is predicated on precise preoperative localization. Multiple imaging options are available, including: transabdominal ultrasound, computed tomography, endoscopic ultrasound (EUS), angiography with intraarterial calcium stimulation testing, and intraoperative ultrasound (IOUS). Patients with MEN-1 syndrome virtually always have multiple pancreatic neuroendocrine tumors, and evaluation and treatment of these patients is different than for sporadic disease. Surgical excision of the disease is the only cure; in the rare case of malignant disease, an aggressive surgical and multimodal approach is recommended, even for palliation of hypoglycemia.
UR - http://www.scopus.com/inward/record.url?scp=77953674758&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=77953674758&partnerID=8YFLogxK
U2 - 10.1007/978-1-4419-0857-5_13
DO - 10.1007/978-1-4419-0857-5_13
M3 - Article
C2 - 19957228
AN - SCOPUS:77953674758
VL - 153
SP - 235
EP - 252
JO - Cancer Treatment and Research
JF - Cancer Treatment and Research
SN - 0927-3042
ER -