Diagnostics and treatment of insulinoma

Insulinomas are the most common functioning pancreatic neuroendocrine neoplasms (pNENs), developed mainly from pancreatic islet cells. More than 90% of insulinomas are sporadic, benign and small sized. Autonomous production of insulin results in neuroglycopenic and adrenergic symptomatology with potential lethality. Surgery remains the only curative treatment with a high success rate. Preoperative tumor localization is challenging, but important for appropriate surgical approach. Metastatic forms represent a challenge, mainly on the field of therapy, with the need of tumor burden reduction and glycemia stabilization. The rarity of malignant forms limits reports on therapeutic strategies and outcome. Authors present in this article a summarized overview of epidemiology, clinic, diagnostics and treatment of benign and malign forms of insulinomas.