innesulinomas

Inselnulinomas are rare neuroendocrine tumors originating from the insulin-producing beta cells within the pancreatic islets of Langerhans. These tumors are classified as functioning neuroendocrine tumors because they secrete excess insulin, leading to episodes of hypoglycemia. Typically, insulenomas are benign, although malignant forms have been documented.

The primary clinical presentation of insulenomas involves symptoms related to hypoglycemia, such as sweating, confusion, weakness, palpitations, tremors, and in severe cases, loss of consciousness or seizures. These symptoms are often episodic and may be precipitated by fasting or physical activity. Diagnosis generally involves laboratory tests showing inappropriately high insulin levels during episodes of hypoglycemia, along with imaging studies like endoscopic ultrasound, CT, or MRI to localize the tumor.

The origin of insulenomas from pancreatic beta cells influences their behavior and treatment options. Surgical resection remains the mainstay of therapy and can often lead to a cure or significant symptom relief in benign cases. In cases where surgery is not feasible or the tumor is malignant, medical management may include medications such as diazoxide, which suppresses insulin secretion, or targeted therapies like somatostatin analogs.

Histologically, insulenomas are characterized by nests or cords of uniform cells with neuroendocrine features. Although most insulenomas are benign, the malignant form can metastasize, primarily to the liver and regional lymph nodes.

Early diagnosis and treatment are crucial to preventing severe hypoglycemic events. Continued research aims to improve understanding of the tumor’s biology and develop targeted therapies for malignant or inoperable cases.