Diagnosis and Treatment of Insulinoma: an up-to-date Overview

Year 2017, , 32 - 37, 01.01.2017

Esra Ademoğlu Zehra Candan Hikmet Tekçe

https://doi.org/10.5505/abantmedj.2017.24892

Abstract

Insulinoma is a rare endocrine tumor derived from pancreatic β–cells and the most common cause of organic hyperinsulinemic hypoglycemia. It is usually a small, solitary, intrapancreatic, and benign tumor. It is generally seen as sporadic cases, but it can also be associated with multiple endocrine neoplasia type 1 syndrome MEN-1 . Distinction between malignant and benign tumor can only made by the presence of metastasis as there are no specific morphologic, biochemical or genetic features distinguishing them. Several invasive and non-invazive procedures are present for localization of tumor. Once the localization of tumor is determined, excision can be curative as more than 90% of insulinomas are benign lesions and enucleation is generally sufficient. The treatment includes systemic chemotherapy, chemoembolization, cryotherapy and peptide radionuclide treatment in cases which cannot be operated.

Keywords

Insulin, C peptide, Hypoglycemia

İnsülinoma Tanı ve Tedavisi: Güncel Bakış

Abstract

İnsülinoma, pankreas beta hücrelerinden köken alan nadir görülen bir endokrin tümördür ve organik hiperinsülinemik hipogliseminin en sık nedenidir. Çoğunlukla küçük, soliter, intrapankreatik ve benign bir tümördür. Genellikle sporodik olarak görülür ancak multıpl endokrin neoplazi sendromu MEN-1 ile de birliktelik gösterebilir. Malign ve benign tümör ayrımını sağlayan spesifik morfolojik, biyokimyasal veya genetik özellikler olmadığı için malignite tanısı lokal ve uzak metastaz varlığı ile konur. Lokalizasyonda girişimsel ve girişimsel olmayan birçok yöntem mevcuttur. Tümör lokalize edildikten sonra cerrahi tedavi ile tümörün çıkarılması olguların %90’ından fazlası benign olduğu için küratiftir ve genelde enükleasyon yeterli olmaktadır. Opere edilemeyen malign insülinomalarda tedavi sistemik kemoterapi, kemoembolizasyon, kriyoterapi ve peptid radyonüklid tedaviyi içerir.

Keywords

İnsülin, C peptid, Hipoglisemi

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