Insulinoma: A retrospective study analyzing the differences between benign and malignant tumors

Area of Science:

• Endocrinology
• Oncology
• Surgical Pathology

Background:

• Insulinoma is a rare pancreatic tumor, usually benign but occasionally malignant and aggressive.
• Distinguishing between benign and malignant insulinomas is crucial for patient management and prognosis.

Purpose of the Study:

• To identify clinical, laboratory, and histological differences between benign and malignant insulinomas.
• To establish predictors for malignant behavior in insulinoma patients.

Main Methods:

• Retrospective analysis of 103 patients with insulinoma treated at a tertiary center.
• Evaluation of demographic, clinical, laboratory, tumor characteristics, and follow-up data.
• Histological examination to differentiate benign from malignant tumors.

Main Results:

• 87% of patients had benign insulinomas with a 100% surgical survival rate.
• Malignant insulinomas (13%) had a poor prognosis, with a 5-year survival rate of 24% and 77% related deaths.
• Predictors of malignancy included symptom duration < 24 months, hypoglycemia onset < 8 hours, insulin ≥ 28 μU/mL, C-peptide ≥ 4.0 ng/mL, and tumor size ≥ 2.5 cm.

Conclusions:

• While most insulinomas are benign and surgically curable, malignant forms present significant treatment challenges.
• Specific clinical and biochemical markers can help predict malignant potential.
• Long-term follow-up is recommended for patients diagnosed with insulinoma, especially those with risk factors for malignancy.