INSULINOMAKatie Chambers, Sharon Kurval, Marcos Reis

INSULINOMA

Insulinomas are the most common tumors arising from the pancreatic islets of Langerhans

Although most insulinomas are in the pancreas, distinguishing the location of the tumors is difficult at diagnosis

The highest incidence is in people between 40 and 60 years of age, and women are affected slightly more often than men.

SYMPTOMS

Anxiety Weight Gain (patient can become

excessively obese) Behavior Changes Clouded Vision Confusion Convulsions Dizziness Headache Hunger Loss of Consciousness Rapid Heart Rate Sweating Tremor

CAUSES

Insulinoma is a tumor found in the pancreas that continues to produce insulin even when your blood sugar drops too low

High blood insulin levels cause low blood sugar levels called Hypoglycemia

Hypogycemia may be mild, leading to symptoms such as anxiety and hunger or it can be severe, leading to seizures, coma and even death

THE PANCREAS

The pancreas is an organ in the abdomen that makes several enzymes and hormones, including insulin.

Insulin reduces the level of sugar(glucose) in the blood by helping it move into cells

When your blood sugar level drops too low, the pancreas stops making insulin until your blood sugar returns to normal

Insulinomas are rare and usually occur in single, small tumors in adults

EXAMS AND TESTS

Fasting Test: every fasting test is started in the morning by means of an oral administration of 100 g of glucose

Consists of an onset of blood sampling as late as after a 48h-fasting period

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EXAMS AND TESTS

After fasting, your blood may be tested for: Blood C-peptide level Blood glucose level Blood insulin level Drugs that cause the pancreas to release insulin

CT or MRI scan of the abdomen may be done to look for a tumor in the pancreas. If the test is negative, one of the following tests may be performed: Endoscopic ultrasound Octreotide Scan Pancreatic Arteriography Pancreatic venous sampling for insulin

SCANS

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TREATMENTS

Surgery is the recommended treatment for insulinoma. The tumor is first found by tests or surgery.

If there is a single tumor it will be removed. If there are many tumors, part of the pancreas

will need to be removed (partial pancreatectomy).

At least 15% of the pancreas must be left to produce its enzymes.

This may prevent the surgeon from removing the whole insulinoma tumor.

TREATMENTS

If no tumor is found during surgery, you may get the drug diazoxide to lower insulin production and avoid hypoglycemia. A diuretic is given to

prevent the body from retaining fluid.

Octreotide is used to reduce insulin release in some patients

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HISTORY

Historically, the three components of insulinoma 1) symptoms of hypoglycemia 2) documented plasma glucose of less

than 50 mg/dL at the time of hypoglycemic symptoms

3) relief of these symptoms with administration of glucose has been referred to as Whipple's triad.

WORKS CITED

The New York Times. (2010). Insulinoma. Retrieved February 21, 2012, from http://health.nytimes.com/health/guides/disease/insulinoma/overview.html

Medline Plus. (2012). Insulinoma. Retrieved February 21, 2012, from http://www.nlm.nih.gov/medlineplus/ency/article/000387.htm

Center for Pancreatic and Bilary Disorders. (2002). Insulinoma. Retrieved February 21, 2012, from http://www.surgery.usc.edu/divisions/tumor/pancreasdiseases/web%20pages/Endocrine%20tumors/pancreatic%20tumors/insulinoma.html

UpToDate. (2012). Insulinoma. Retrieved February 21, 2012, from http://www.uptodate.com/contents/insulinoma

Insulinoma UK. (2011). What is an insulinoma?. Retrieved February 21, 2012, from http://www.insulinoma.co.uk/page_1218566549343.html

eHow. (2011). How to Diagnose Insulinoma. Retrieved February 22, 2012, from http://www.ehow.com/how_2086786_diagnose-insulinoma.html

Medscape Reference. (2012). Insulinoma Treatment & Management. Retrieved February 22, 2012, from http://emedicine.medscape.com/article/283039-overview

University of Maryland Medical Center. (2010). Insulinoma – Treatment. Retrieved February 22, 2012, from http://www.umm.edu/ency/article/000387trt.htm