Related articles: Insulinoma
Definition
Insulinoma is an endocrine tumor of the pancreas that affects beta cells, located in the islands of Langerhans.
The main feature of this neoplasm is fasting hypoglycemia, which appears due to the excessive and inappropriate production of insulin compared to blood glucose levels.
Insulinomas are generally single and benign neoplasms; only 5-10% of cases are malignant. Multiple forms are found above all in patients with type 1 multiendocrine neoplasms (MEN 1).
The peak incidence is found in adult subjects with a median age of 50 years.
Most common symptoms and signs *
- Asthenia
- Ataxia
- Weight gain
- palpitations
- Coma
- Convulsions
- Hunger
- Hypoglycemia
- Lethargy
- Headache
- Nausea
- Nervousness
- Drowsiness
- Confusional state
- Sweating
- Fainting
- Tremors
- Dizziness
- Double vision
Further indications
The main symptom of insulinoma is a sensitive lowering of blood glucose away from meals, which quickly and completely regresses with carbohydrate ingestion or parenteral glucose administration.
Other typical manifestations of insulinoma are related to hypoglycemia and to the suffering of the central nervous system. Therefore, there may be headaches, nervousness, mental confusion, drowsiness, diplopia, weakness and paresis.
When hypoglycemic crises are severe and prolonged, these symptoms can progress to unconsciousness and coma. Nausea, tremor, palpitations, profuse sweating, excessive hunger and weight gain may also appear.
The diagnosis of insulinoma requires hospitalization for the determination of blood glucose and insulin levels in the blood by fasting tests of 48-72 hours, followed by an endoscopic ultrasound to localize the tumor mass.
Treatment, when possible, is surgical and involves the removal of insulinoma, trying to save the greatest amount of healthy pancreatic tissue. If hypoglycaemia persists, drugs that block insulin secretion, such as diazoxide and octreotide, can be used.
