insuliinoma

Insulinoma is a rare, typically benign tumor that develops in the pancreas, specifically in the beta cells of the islets of Langerhans. These cells are responsible for producing insulin, a hormone essential for regulating blood glucose levels by facilitating the uptake of glucose into cells. Insulinomas are most commonly solitary, though they can occasionally occur as part of a genetic syndrome, such as multiple endocrine neoplasia type 1 (MEN1).

The primary symptom of insulinoma is hypoglycemia, or abnormally low blood sugar, which can lead to symptoms such as confusion, dizziness, sweating, tremors, weakness, seizures, or loss of consciousness. These episodes often occur unpredictably and may be mistaken for other conditions, such as epilepsy or psychiatric disorders. The condition is more common in middle-aged adults, with a slight predilection for women, though it can affect individuals of any age.

Diagnosis typically involves confirming recurrent hypoglycemia through blood tests, including measurements of glucose, insulin, proinsulin, and sometimes C-peptide levels. Imaging studies, such as computed tomography (CT) or magnetic resonance imaging (MRI), may be used to locate the tumor within the pancreas. In some cases, endoscopic ultrasound (EUS) or selective arterial calcium stimulation tests are employed for precise localization.

Treatment primarily involves surgical removal of the tumor, often through minimally invasive techniques. In cases where surgery is not feasible or the tumor is malignant, medical management with diazoxide or other medications may be used to control hypoglycemia. For patients with MEN1-related insulinomas, lifelong monitoring and potential surgical intervention may be necessary due to the risk of recurrence.

Prognosis for insulinoma is generally excellent, with most patients achieving long-term remission after tumor removal. However, recurrence or persistence of symptoms may occur, particularly in malignant or multifocal cases. Early diagnosis and intervention are key to managing symptoms and improving quality of life.