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05:42
Robotic Enucleation of an Intra-Pancreatic Insulinoma in the Pancreatic Head
Published on: January 3, 2020
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Multidisciplinary management of refractory insulinomas.
Emily Brown1, Daniel Watkin1, Jonathan Evans2
1Obesity and Endocrinology Research Group, University Hospital Aintree, University of Liverpool, Liverpool, UK.
Clinical Endocrinology
|December 6, 2017
Summary
This review explores advanced treatments for insulinomas, focusing on managing hyperinsulinaemic hypoglycaemia when standard therapies fail. It highlights emerging medical, surgical, and interventional options for these pancreatic neuroendocrine tumors.
Area of Science:
- Endocrinology
- Oncology
- Gastroenterology
Background:
- Insulinomas are pancreatic neuroendocrine tumors causing hyperinsulinaemic hypoglycaemia.
- While often benign and surgically resectable, management challenges arise in non-surgical candidates or metastatic cases.
Purpose of the Study:
- To review current and emerging nonsurgical management strategies for insulinomas.
- To discuss options for cases refractory to standard medical treatment.
Main Methods:
- Review of medical literature on insulinoma treatment.
- Discussion of pharmacological therapies, including somatostatin analogues, everolimus, sunitinib, and pasireotide.
- Exploration of minimally invasive procedures like ethanol ablation and peptide receptor radionuclide therapy (PRRT).
Main Results:
- Diazoxide and somatostatin analogues are common first-line medical therapies with variable efficacy.
- Novel targeted therapies like everolimus and sunitinib offer new avenues.
- Minimally invasive and radionuclide therapies provide alternatives for specific patient groups.
Conclusions:
- Management of refractory insulinomas requires a multidisciplinary approach.
- An evolving armamentarium of medical and interventional options exists for challenging cases.
- Early referral to specialized neuroendocrine tumor teams is crucial for optimal outcomes.
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