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[Insulinoma: diagnostic elements. 13 cases].

J Hazard, D Simon, L Perlemuter

    Presse Medicale (Paris, France : 1983)
    |October 12, 1985
    PubMed
    Summary
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    This study on 13 patients found that insulinomas, tumors causing inappropriate insulin secretion, often present with neurological and behavioral symptoms. Diagnosis can be delayed, but imaging techniques like phlebography aid in locating these tumors before surgery.

    Area of Science:

    • Endocrinology
    • Oncology
    • Neurosurgery

    Background:

    • Insulinomas are rare pancreatic neuroendocrine tumors responsible for endogenous hyperinsulinism.
    • Diagnosis can be challenging due to nonspecific symptoms and delayed presentation.

    Observation:

    • The study analyzed 13 patients (mean age 50.5 years) presenting with diverse symptoms including malaise, behavioral changes, coma, syncope, and hemiparesis.
    • Symptoms often occurred in the morning or between meals, indicative of hypoglycemia.
    • Diagnostic delay averaged 20.3 months, with confirmed hypoglycemia in 11/13 patients.

    Findings:

    • Inappropriate insulin secretion was confirmed through fasting tests and insulin/glucose ratio calculations.
    • Preoperative localization of insulinomas utilized various imaging modalities, with phlebography and catheterization proving most effective (8/9 cases).

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  • Histological examination confirmed adenoma in 12 cases, with no evidence of malignancy.
  • Implications:

    • Early recognition of characteristic hypoglycemic symptoms is crucial for timely insulinoma diagnosis.
    • Advanced imaging and biochemical tests are vital for accurate preoperative localization and surgical planning.
    • Surgical resection is the primary treatment for benign insulinomas, leading to favorable outcomes.