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__NOTOC__
{{Insulinoma}}
'''For patient information click [[{{PAGENAME}} (patient information)|here]]'''
'''For patient information click [[{{PAGENAME}} (patient information)|here]]'''


{{Infobox_Disease |
{{CMG}}; {{AE}}{{ADS}}  
  Name          = {{PAGENAME}} |
  Image          = Pancreatic insulinoma (2).jpg |
  Caption        = Histopathology of pancreatic endocrine tumor (insulinoma). |
  DiseasesDB    = 6830 |
  ICD10          = {{ICD10|C|25|4|c|15}}, {{ICD10|D|13|7|d|10}} |
  ICD9          = {{ICD9|157.4}}, {{ICD9|211.7}} |
  ICDO          = 8151 |
  OMIM          = |
  MedlinePlus    = |
  MeshID        = D007340 |
}}
{{Insulinoma}}
{{CMG}}
__NOTOC__
{{Editor Help}}


{{SK}} Pancreatic beta cell tumor; tumor of beta cells; beta cell tumor; cancer of beta cells
==[[Insulinoma overview|Overview]]==
==[[Insulinoma overview|Overview]]==


==[[Insulinoma historical perspective|Historical Perspective]]==
==[[Insulinoma historical perspective|Historical Perspective]]==
==[[Insulinoma classification|Classification]]==


==[[Insulinoma pathophysiology|Pathophysiology]]==
==[[Insulinoma pathophysiology|Pathophysiology]]==


==[[Insulinoma epidemiology and demographics|Epidemiology & Demographics]]==
==[[Insulinoma causes|Causes]]==
 
==[[Insulinoma differential diagnosis|Differentiating Insulinoma from other Diseases]]==
 
==[[Insulinoma epidemiology and demographics|Epidemiology and Demographics]]==


==[[Insulinoma risk factors|Risk Factors]]==
==[[Insulinoma risk factors|Risk Factors]]==
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==[[Insulinoma screening|Screening]]==
==[[Insulinoma screening|Screening]]==


==[[Insulinoma causes|Causes]]==
==[[Insulinoma natural history, complications and prognosis|Natural History, Complications and Prognosis]]==
 
==[[Insulinoma differential diagnosis|Differentiating Insulinoma]]==
 
==[[Insulinoma natural history|Complications & Prognosis]]==


==Diagnosis==
==Diagnosis==
[[Insulinoma history and symptoms|History and Symptoms]] | [[Insulinoma physical examination|Physical Examination]] | [[Insulinoma staging|Staging]] | [[Insulinoma laboratory tests|Laboratory tests]] | [[Insulinoma electrocardiogram|Electrocardiogram]]  | [[Insulinoma x ray|X Rays]] | [[Insulinoma CT|CT]] | [[Insulinoma MRI|MRI]] [[Insulinoma echocardiography or ultrasound|Echocardiography or Ultrasound]] | [[Insulinoma other imaging findings|Other images]] | [[Insulinoma other diagnostic studies|Alternative diagnostics]]
[[Insulinoma staging|Staging]] | [[Insulinoma history and symptoms|History and Symptoms]] | [[Insulinoma physical examination|Physical Examination]] | [[Insulinoma laboratory tests|Laboratory Findings]] | [[Insulinoma CT|CT]] | [[Insulinoma MRI|MRI]] | [[Insulinoma ultrasound|Ultrasound]] | [[Insulinoma other imaging findings|Other Imaging Findings]] | [[Insulinoma other diagnostic studies|Other Diagnostic Studies]]


==Treatment==
==Treatment==
[[Insulinoma medical therapy|Medical therapy]] | [[Insulinoma surgery|Surgical options]] | [[Insulinoma primary prevention|Primary prevention]]  | [[Insulinoma secondary prevention|Secondary prevention]] | [[Insulinoma cost-effectiveness of therapy|Financial costs]] | [[Insulinoma future or investigational therapies|Future therapies]]
[[Insulinoma medical therapy|Medical Therapy]] | [[Insulinoma surgery|Surgery]] | [[Insulinoma primary prevention|Primary Prevention]]  | [[Insulinoma secondary prevention|Secondary Prevention]] | [[Insulinoma cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Insulinoma future or investigational therapies|Future or Investigational Therapies]]


===Diagnostic imaging===
==Case Studies==
The insulinoma might be localized by non-invasive means, using [[ultrasound]], [[CT scan]], or by [[MRI]] techniques.<br/>
[[Case study one|Case #1]]
Sometimes, [[angiography]] with percutaneous transhepatic [[pancreatic vein]] [[catheterization]] to sample the blood for insulin levels is required. [[Calcium]] can be injected into selected arteries to stimulate insulin release from various parts of the pancreas, which can be measured by sampling blood from their respective veins.  The use of calcium stimulation improves the specificity of this test.<br/>
During surgery to remove an insulinoma, an intra-operative ultrasound can sometimes localize the tumour, which helps guide the surgeon in the operation.
 
==Treatment==
The definitive management is surgical removal of the insulinoma.  This may involve removing part of the pancreas as well ([[Whipple procedure]] and distal [[pancreatectomy]]).<br>
Medications such as [[diazoxide]] and [[somatostatin]] can be used to block the release of insulin for patients who are not surgical candidates or who otherwise have inoperable tumours.<br/>
[[Streptozotocin]] is used in [[islet cell carcinoma]]s which produce excessive insulin.  Combination [[chemotherapy]] is used: either [[doxorubicin]] + streptozotocin, or [[fluorouracil]] + streptotozocin in patients where doxorubicin is contraindicated.[http://www.cancer.gov/cancertopics/pdq/treatment/isletcell/HealthProfessional/page6] <br>
In metastasizing tumours with intrahepatic growth, [[hepatic artery|hepatic arterial]] occlusion or [[embolization]] can be used. [http://www.nci.nih.gov/cancertopics/pdq/treatment/isletcell/Patient/page5]
 
==Prognosis==
Most patients with benign insulinomas can be cured with surgery.  Persistent or recurrent hypoglycemia after surgery tends to occur in patients with multiple tumours.  About two percent of patients develop [[diabetes mellitus]] after their surgery.
 
==History==
Hypoglycemia was first recognized in the 19th century.  In the 1920’s, after the discovery of insulin and its use in the treatment of diabetics, hyperinsulinism was suspected to be a cause of hypoglycemia in non-diabetics. The first report of a surgical cure of hypoglycemia by removing an islet cell tumour was in 1929.
 
==See also==
*[[hypoglycemia]]
*[[causes of hypoglycemia]]
*[[pancreas]]</br>
 
==External links==
*[http://www.endotext.org/guthormones/guthormone4/guthormoneframe4.htm www.endotext.org article]


==Related Chapters==
*[[Hypoglycemia]]
*[[Causes of hypoglycemia]]
*[[Pancreas]]
{{Tumor morphology}}
{{Tumor morphology}}
[[de:Insulinom]]
[[de:Insulinom]]
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[[Category:Disease]]
[[Category:Disease]]
[[Category:Medicine]]
[[Category:Endocrinology]]
[[Category:Endocrinology]]
[[Category:Oncology]]
[[Category:Oncology]]
[[Category:Mature chapter]]
[[Category:Mature chapter]]
[[Category:Up-To-Date]]
[[Category:Oncology]]
[[Category:Medicine]]
[[Category:Gastroenterology]]
[[Category:Surgery]]

Latest revision as of 22:38, 30 May 2019

Insulinoma Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Insulinoma from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Staging

Diagnostic Criteria

History and Symptoms

Physical Examination

Laboratory Findings

X-ray

Ultrasound

CT

MRI

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Insulinoma On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Insulinoma

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Insulinoma

CDC on Insulinoma

Insulinoma in the news

Blogs on Insulinoma

Directions to Hospitals Treating Insulinoma

Risk calculators and risk factors for Insulinoma

For patient information click here

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Amandeep Singh M.D.[2]

Synonyms and keywords: Pancreatic beta cell tumor; tumor of beta cells; beta cell tumor; cancer of beta cells

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Insulinoma from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Staging | History and Symptoms | Physical Examination | Laboratory Findings | CT | MRI | Ultrasound | Other Imaging Findings | Other Diagnostic Studies

Treatment

Medical Therapy | Surgery | Primary Prevention | Secondary Prevention | Cost-Effectiveness of Therapy | Future or Investigational Therapies

Case Studies

Case #1

Related Chapters

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