1.Insulinoma: nonvisualization on MR.
Seung Yon BAEK ; Moon Gyu LEE ; Kyu Bo SUNG ; Kyoung Sik CHO ; Yong Ho AUH
Journal of the Korean Radiological Society 1991;27(6):817-820
No abstract available.
Insulinoma*
2.Localization of insulinomas.
Journal of Korean Society of Endocrinology 1993;8(2):125-126
No abstract available.
Insulinoma*
3.Insulinoma of the Pancreas.
Young Kyung YOO ; Il Young PARK ; Hyung Min CHIN ; Kee Whan KIM ; Keun Ho LEE ; Seong LEE ; Jun Gi KIM ; Dong Goo KIM ; Eung Kook KIM ; Chung Soo CHUN
Journal of the Korean Surgical Society 2003;64(6):498-504
PURPOSE: Insulinomas are a rare disease, which can be cured by surgical management if diagnosed early. However, diagnosis and localization are difficult, due to their small size and varied clinical manifestations. We analyzed the clinicopathological features, diagnosis and surgical management of insulinomas. METHODS: We retrospectively analyzed 12 insulinoma patients who had undergone pancreatic surgery, between 1988 and 2001, at the Department of Surgery, College of Medicine, The Catholic University of Korea. RESULTS: The male to female ratio of the insulinoma patients was 1: 1 with a mean age of 37.9 years, ranging from 20 to 65. The clinical manifestations were loss of consciousness, weakness, confusion and dizziness, and all the patients had findings compatible with Whipple's triad. The median duration of symptoms before surgery was 16.8 months, ranging from 1 to 48 months. Hyperinsulinemic hypoglycemia was confirmed, during prolonged fasting, when the concomitant fasting blood sugar level was 42.4mg/dl and insulin level was 25.2 microU/ml (8.1~61.8 microU/ml). The insulinoma can be localized in 11 patients (91.7%) preoperatively. For the preoperative localization, a transhepatic portal vein sample (THPVS), selective angiography and a CT scan were good diagnostic methods. Intraoperative ultrasonography was the most useful localization tool during the operation. For treating the insulinoma, an enucleation, a distal pancreatectomy, and a pylorus preserving pancreaticoduodenectomy were performed in 5, 6 and 1 patients, respectively. An enucleation case was diagnosed as nesidioblastosis after surgery, thus needing a near total pancreatectomy. One patient with a multiple endocrine neoplasia (MEN), subtype I, needed a thyroidectomy and an adrenalectomy. All cases were single, benign tumors within the pancreas. The symptoms of hypoglycemia and the laboratory values were normal in all patients after surgery. CONCLUSION: We experienced 12 insulinoma patients, where preoperative suspicions, proper utilization of diagnostic tools, and prudent intraoperative diagnostic procedures enhanced the diagnostic accuracy of the insulinoma, and led to better treatment strategies.
Insulinoma*
;
Pancreas*
4.A case of insulinoma localized by endoscopic ultrasonography.
Jae Yong CHIN ; Cheal Whan LEE ; Jae Young KANG ; Hye Ryeon KIM ; Kee Up LEE ; Gi Soo KIM ; Deok Jong HAN ; In Cheol LEE ; S W PARK
Journal of Korean Society of Endocrinology 1993;8(2):197-202
No abstract available.
Endosonography*
;
Insulinoma*
5.Metastatic Insulinoma Presenting as a Liver Cyst
Hua LI ; Tony El JABBOUR ; Ankesh NIGAM ; Hwajeong LEE
Journal of Pathology and Translational Medicine 2019;53(2):148-151
No abstract available.
Insulinoma
;
Liver
6.A Case of Insulinoma with Hypoglycemic Encephalopathy.
Kyung Hoon KIM ; Eun Sook KIM ; Chan Sung PARK ; Myung Kwan KO ; Sung Su BYUN ; Jung Min HONG ; Mu Yeol LEE ; Il Sung NAM-GOONG ; Young Il KIM ; Yang Won NA ; Hye Jung CHOI ; Ji Hyun KWON
Journal of Korean Diabetes 2013;14(2):98-101
A 47-year-old male with recurrent abnormal behavior for ten years was referred to our clinic. He was diagnosed with insulinoma and cognitive dysfunction. Persistent hypoglycemia leads to a high risk of cognitive dysfunction in diabetic patients. However, cognitive dysfunction associated with insulinoma is rare. In this case study, cognitive dysfunction was confirmed by neurological testing.
Humans
;
Hypoglycemia
;
Insulinoma
;
Male
7.A systematic review of the accuracy of Insulin and C-peptide secretion ratios during the oral glucose tolerance test to diagnose insulinoma
Fransiskus Mikael Chandra ; Dicky Tahapary
Journal of the ASEAN Federation of Endocrine Societies 2024;39(1):79-83
Background:
Insulinoma is one of the causes of recurrent hypoglycemia, one of the chief complaints for emergency department admission. The gold standard in diagnosing insulinoma is a 72-hour fasting test which is inconvenient and inefficient as it requires hospitalization. Research has found that measurement of insulin and C-peptide during OGTT may help diagnose insulinoma. We aimed to assess the diagnostic value of OGTT in diagnosing insulinoma.
Methodology:
The literature search was conducted on 19 August 2022 using several databases (MEDLINE, Scopus, Embase, and ScienceDirect). All studies that measured OGTT as diagnostic tools in diagnosing insulinoma and 72-hour fasting test as reference standard were included. The quality assessment of the selected studies was based on the Centre of Evidence-Based Medicine University of Oxford and the Quality Assessment of Diagnostic Accuracy-2 tool (QUADAS-2). Analysis of the included studies was performed qualitatively. This study was registered on PROSPERO (CRD42022360205).
Results:
A total of two case-control studies (106 patients) were included, which were at risk of bias and low concern of applicability. Both studies demonstrated that the combination of insulin and C-peptide levels measured during OGTT had high specificity, sensitivity, positive predictive value, and negative predictive value in diagnosing insulinoma compared to the reference standard. A logistic regression model of 8.305 – (0.441 × insulin 2-h/0-h) – (1.679 × C-peptide 1-h/0-h) > 0.351 has the highest diagnostic value in one study (AUC 0.97, Sensitivity 86.5%, Specificity 95.2%, PPV 94.1, NPV 88.9).
Conclusion
The measurement of 0-h and 2-h insulin and C-peptide levels during 2-h OGTT was found in two small case-control studies with a total of 106 patients to have good sensitivity and specificity. However, due to these limitations, future research is still needed to validate the potential use of OGTT for the diagnosis of insulinoma.
Insulinoma
;
Glucose Tolerance Test
8.Pattern of weight loss after successful enucleation of an insulin-producing pancreatic neuroendocrine tumor
Mark Anthony Santiago Sandoval ; Tom Edward Ngo Lo ; A&rsquo ; Ericson Berberabe ; Mark Anthony De Lusong ; Juan Maria Ibarra Co
Journal of the ASEAN Federation of Endocrine Societies 2015;30(2):160-163
We report the case of a patient with hypoglycemic symptoms and weight gain. Biochemical investigations revealed endogenous hyperinsulinemic hypoglycemia. A CT scan and MRI of the abdomen were initially not successful in localizing a pancreatic mass. However, an endoscopic ultrasound was able to demonstrate a pancreatic head mass. Enucleation of the mass resulted in clinical and biochemical improvement. This report also demonstrates the pattern of weight loss after surgery, showing an initial phase of gradual weight loss followed by a rapid loss of weight. This pattern of weight loss after successful removal of an insulin-producing pancreatic neuroendocrine tumor is a novel addition to the existing knowledge we have about this condition.
Hypoglycemia
;
Insulinoma
;
Weight Loss
9.Successful Endoscopic Ultrasound-Guided Alcohol Ablation of Sporadic Insulinoma Using Three-Dimensional Targeting (with Video).
Guru TRIKUDANATHAN ; Shawn J MALLERY ; Stuart K AMATEAU
Clinical Endoscopy 2016;49(4):399-401
Surgical resection is considered the standard of care in the management of symptomatic insulinoma. In this video, we describe the successful management of a symptomatic insulinoma by using linear array endoscopic ultrasound (EUS)-guided ethanol ablation in a poor surgical candidate. EUS-guided ethanol ablation of insulinoma offers a safer, effective, and less invasive alternative to surgery.
Ethanol
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Insulinoma*
;
Standard of Care
;
Ultrasonography
10.A case of autoimmune hypoglycemia during treatment with anti-tuberculosis drugs.
Dong Jin KIM ; Jae Min LEE ; Sang Ok LEE ; Nae Yu KIM ; Jung Yun LEE ; Hyun Jin KIM ; Kang Seo PARK
Korean Journal of Medicine 2008;74(5):574-577
Autoimmune hypoglycemia is characterized by insulin autoantibody, hyperinsulinemia and fasting hypoglycemia without previous insulin immunization. Negative results on the anatomic studies of the pancreas and an inability to reproduce hypoglycemia during a prolonged fast may be helpful in excluding insulinoma. Autoimmune hypoglycemia is self-limited disorder. We recently experienced a case of autoimmune hypoglycemia in a patient with insulin antibody, and the patient was without previous insulin injection therapy or any evidence of insulinoma, during treatment with anti-tuberculosis drugs. We present this case along with a review of the literature.
Humans
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Hyperinsulinism
;
Hypoglycemia
;
Immunization
;
Insulin
;
Insulinoma
;
Pancreas