Updates in Management of Insulinoma

Abstract

Background: Among pancreatic endocrine tumors, insulinoma is the most common type. This tumor was reported in 1–4 people per one million person years. It can be seen at any age and occurs slightly more frequently in female than male . Usually insulinoma clinical presentation is benign, with a solitary and small size (<2 cm in diameter). Most are sporadic, however, 10 % of insulinomas are multiple and occur as part of multiple endocrine neoplasia syndrome type I (MEN–I). Because of nonspecific symptoms, insulinoma may be misdiagnosed with other disorders. Patients often present with hypoglycemia signs resulting from inappropriate insulin secretion. After biochemical confirmation of hyperinsulinism, preoperative localization of the tumor in the pancreas may be difficult. Surgical removal, often curative, continues to be the treatment of choice. Aim of the Work: The aim of this work is to give an updated and detailed view of the management of patients with insulinoma. Conclusion: Benign insulinomas are cured by surgical removal and its recurrency is extremely rare. Recurrence is a frequent finding and therefore reoperation for metastatic disease is frequently needed and can result in excellent long term survival of up to 70% after 10 years. The median overall survival (OS) of patients with Stages I, II, III and IV was 112, 63, 36 and 14 months, respectively . Keywords: Insulinoma, Pancreas, Diagnosis, Management, Surgery