The risks of failure of conventional treatment of insulinomas should be reduced, it seems, when the surgical operation is carried out using an artificial pancreas. The Biostator, used with feed back controlled glucose infusion in 32 cases of which two personal effectively allows one firstly to operate in complete security since it is programmed to maintain a pre-determined glycaemia during the various stages of the operation; it also allows one to put into evidence an occult tumour in a segment rendered suspect due to the sudden hypoglycaemia observed during its mobilisation; it finally allows one by the appearance of a post-excision hyperglycaemia peak to find out whether the procedure has been complete.
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Arq Bras Cir Dig
January 2025
Universidade de São Paulo, Faculty of Medicine - São Paulo (SP), Brazil.
Background: Pancreatic neuroendocrine tumors (PNETs) are uncommon and heterogeneous neoplasms, often exhibiting indolent biological behavior. Their incidence is rising, largely due to the widespread use of high-resolution imaging techniques, particularly influencing the diagnosis of sporadic non-functioning tumors, which account for up to 80% of cases. While surgical resection remains the only curative option, the impact of factors such as tumor grade, size, and type on prognosis and recurrence is still unclear.
View Article and Find Full Text PDFJ Pak Med Assoc
January 2025
Department of Endocrinology, Shaukat Khanum Cancer Memorial Hospital and Research Centre, Lahore, Pakistan.
Insulinoma is a pancreatic neuroendocrine tumour that primarily leads to episodes of hypoglycaemia due to inappropriate and excessive secretion of insulin. It classically presents with neuroglycopenic and autonomic sympathetic symptoms, which resolve promptly with glucose administration. Elevated level of insulin and Cpeptide in the presence of low plasma glucose level and absence of plasma sulfonylurea are diagnostic features.
View Article and Find Full Text PDFRare Tumors
January 2025
Digestive Surgical Department C, Ibn Sina University Hospital, Rabat, Morocco.
Even though insulinoma is the most frequent neuroendocrine tumor, it represents only 2% of pancreatic 2% of all pancreatic neoplasms. Diagnosis is relatively simple, and surgery after accurate determination of the tumors location within the pancreas is the cornerstone of its treatment. We herein report 4 patients undergoing various surgeries for benign secreting insulinomas, after extensive radiological and endoscopic exploration.
View Article and Find Full Text PDFRev Med Chil
June 2024
Departamento de endocrinología, Hospital Clínico San Borja Arriarán, Santiago, Chile.
Multiple endocrine neoplasia type 1 (MEN1) is a rare autosomal dominant disease with an estimated prevalence of 2 per 100,000. This disease is caused by a mutation in the tumor suppressor gene MEN1, which is located on chromosome 11 and codifies the menin protein. It is characterized by a predisposition of parathyroids, enteropancreatic, and anterior pituitary tumors, affecting the quality of life and lifespan of those who have the disease.
View Article and Find Full Text PDFInt J Surg Case Rep
January 2025
Department of Gastrointestinal and General Surgery, Kathmandu Medical College and Teaching Hospital, Kathmandu, Nepal.
Introduction And Importance: Insulinomas are rare pancreatic neuroendocrine neoplasms with an incidence of one to four cases per million annually and a 5 % to 10 % association with hereditary multiple endocrine neoplasia type-1. While most insulinomas are benign and well-encapsulated, approximately 6 % may have malignant potential. Intraoperative localization remains a vital component of treatment, often facilitated by modern imaging techniques like intraoperative ultrasound and fluorescence modalities.
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